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109 ch. 48

Breast Disorders

what are 5 stages of breat dev 1.prepubertal breast 2.breast budding, 1st dign of puberty 3.enlargment and areola 4.nipple/areola form 2nd mound on br tissue 5.more enlargement
where is breast found bn 2nd and 6th ribs over pectoralis muscle. Tail of Spence goes into axilla(more cancer) Cooper's ligaments support on chest wall Inframmatory fold - crease at bottom, fat
Each breast contains how many lobes 12-20 cone shaped, made up of lobules/ducts where milk is produced
how often should have breast exam at risk should have q3yrs til 40, then q yr.
what are breast quadrants upper inner/outer; lower inner/outer; Tail of Spence UOQ and Tail of Spence - more cancer
what is gynecomastia enlargement of glandular tissue beneath and surrounding areola of male
when is BSE(breast self exam) performed best 5-7 days after menses
what are abnormal signs in BSE dimpling/retraction/incr venous prominence/nipple inversion/peau d'Orange(edema), mastitis/ Paget's disease (erythema of nipple/areola/thickening/scaling
what are three patterns for BSE circular, clockwise/wedge/vertical strip
what are risk factors for breast cancer fam hx(1st line hx mother), age(60-65), hormones, obesity, high fat diet
what are two genetic mutations and factors for these BRCA1 & BRCA2 (blood test) 1st degree relative wtih early onset, breast/ovarian Ca, male
what are diagnostic testings for Breast disorders MRI, Biopsies: percutaneous: FNA-fine needle aspiration(draw cells), core, surgical: stereotactic/ultrasound biopsy, mammography, galactography
what is only sure way to know if it's cancer biopsy
what do benign fibrocystic cycts feel like palpable, moveable, round
what is good diet for fibro cysts low Na, caffeine, chocolate Need vit E, Danocrine, diuretics, antiestrogen Rx
what could nipple discharge mean intraductal papilloma: 40-60age, wart-like, bloody discharge Ductal ectasia: peri/post men., multi-colored discharge, burning, itching, retracting nipple, abscess
What kind of breast infection is mastitis inflam or infection of brest tissue, mostly in breastfeeding, red, fever Tx: antibiotics, cold compresses
what is usually cause of mastitis S. aureus
what is mastalgia breast pain, cyclic, noncyclic
what are cysts in breasts fluid filled sacs dev as breast ducts dilate, estrogen factor, not increase risk of breast cancer
what is fibroadenoma movable, painless lump, (hard masses not good), Af. Am 15-25 age
what are two common diagnoses of benign proliferative breast disease atypical hyperplasia: abnormal incr in ductal/lobular cells in breast. Incr risk of br. Ca 4-5x Lobular Carcinoma in Situ: cells in lobules, marker for incr risk
what are three types of radiation for breast Ca primary radiation: shrink tumor to surgically take out brachytherapy: internal palliative therapy: decr tumor sites, s/s
what is most effective therapy against breast Ca chemotherapy other therapies: hormonal, biologic and targeted
Breast cancer lesions are more like nontender, fixed not mobile, hard wtih irregular borders
what is cryoablation cold gas injected to freeze tumor
what are surgical mgmt for breast Ca conservation tx, total mastectomy: not anymore, modified radical Goal: gain local control of disease mast, sentinel node biopsy, axillary lymph node dissection, reconstruction
what is SLNB, sentinel node biopsy and ALND axillary lymph node dissection take first node that receives drainage from tumor, test for cancer. If find cancer(positive), take more nodes...means past Stage 1
what is potential complication after ALND lymphedema of arm: fluid build up, pain, heavy, impair motor fx, numbness, can be chronic hematoma/seroma: fluid collection infection
what are precautions for mastectomy pts no BP, injections, blood drawn, excercises 3x/day
what are two more important factors for breast Ca prognosis tumor size and if spread to lymph nodes under arm
what is modified radial mastectomy remove entire breast tissue, nipple/areola, portion of axillary lymph nodes(ALND)
what is radical mastectomy remove muscles as well
what is total mastectomy remove breast/nipple/areola, NOT ALND
what is mammoplasty breast augmentation: silicone envelopes breast reduction(mammoplasty) breast lift(matopexy)
Nonsurgical Tx for breast Ca radiation therapy, chemotherapy, hormonal therapy
what are absolute contradicitons to tx 1st/2nd trimester of preg multicentric disease in breast prior radiation to breast
What is most common radiation tx external beam begins 6 wks after surgery
what is brachytherapy partial breast radiation of lumpectomy site
what is adjuvant chemotherapy chemo along with other tx
what is mainstay tx for hormonal agents SERM for premenopausal
what are aromatase inhibitors block estrogen for hormone therapy
what is new standard therapy for breast Ca target therapy, target HER2/neu protein. For pt with tumor >1cm in size
what is a tissue xfer procedure after breast Ca surgery transverse rectus abdominis myocutaneous(TRAM) flap
Created by: palmerag