Term
What Family History risk is most important in breast disease? |
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Definition
1st degree affected: mother, sister, daughter |
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Term
When do you do a Screening for breast disease? |
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Definition
When patient has no problems, begins at age 40, continues until life expectancy is < 7 years. |
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Term
When do you do a Diagnostic test? |
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Definition
Pt. has problems: lumps, nipple discharge, focal pain (not generalized), follow-up from screening if problem detected, f/u prior abnl mammogram, ladies w/ previous breast cancer. |
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Term
How many categories are there in the BI-RADS Reporting System (Breast Imaging and Reporting Data System)? |
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Definition
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Term
What is the BI-RADS category when the patient needs to come in for additional imaging/information? |
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Definition
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Term
If you were a woman, which BI-RADS category would you like to hear after your breast imaging. |
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Definition
Category 1: negative- don't worry about it
Yuppie! |
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Term
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Definition
Benign findings such as a calcification; NOT cancer |
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Term
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Definition
Category 3: Probably benign, short term interval f/u; see in 6 mos
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Term
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Definition
Category 4: Suspicious abnormality, consider biopsy, pt returns for biopsy
Category 5: highly suspicious for malignancy, appropriate action should be taken
*the suspicious categories |
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Term
High frequency sounds waves
NO radiation
determine palpable lump/ if visible mass is cystic or solid
Women <30 w/ a lump
Women >30 w/ a lump following mammogram |
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Definition
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Term
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Definition
Known malignancy (after dx, before surgery) |
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Term
Does a mammogram use radiation?
In what population is mammogram no routinely used?
what are the two views? |
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Definition
-Low dose radiation
-no usually used in younger women (<30 yo)
-Medial Lat Oblique & CranioCaudal |
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Term
Does MRI use radiation?
What kind of patient you should not use MRI? |
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Definition
MRI does NOT use radiation but it does use Gadolinium so pt must have adequate Renal fxn. & cannot be pregnant. |
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Term
What characteristic of tumors allow them to be seen on MRI? |
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Definition
Tumor Angiogenesis: formation of bys (neoangiogenesis) have permeable intercellular connections which enable the passage of proteins into the EC space (they LEAK!). |
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Term
MRI screening is recommended for women with what? |
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Definition
-BRCA1 or BRCA2 gene mutations
-1st degree relative w/ BRCA1 or 2, but have not genetic testing themselves
-Lifetime risk of BC 20-25% according to risk assessment tools
-Had radiations therapy to chest btw. ages 10-30
-certain syndromes: Li-Fraumeni, Cowden's Syndrome |
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Term
What steps do you take in a pt w/ a palpable lump? |
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Definition
| Send her to diagnostic mammography or sonography, if negative then ask pt to return for clinical exam in 6-8 wks --> may get larger but if not & still concerning consult with breast surgeon. |
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Term
Nipple Discharge: what to do? |
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Definition
-assess color: serous (clear) or blood--> more concerning
-unilateral or bilateral: breast malign does not cause bilateral discharge.
-work-up: mammogram, sonogram, can refer to breast surgeon, galactogram |
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Term
Does Breast Cancer cause pain? |
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Definition
Not often, most breast pain is not associated with Cancer. |
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Term
Inflammatory Carcinoma
vs
Infection Mastitis |
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Definition
Inflammatory Carcinoma: invasive CA w/ involvement of dermal lymphatics (peau d/orange appearance of skin, red, tender)
Mastitis: infection, usually painful, give ABs, if not respond send to surgeon for incision & drainage |
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Term
It is very important to _____ even if inflammatory breast resolves with antibiotics |
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Definition
Follow up!
MRI does not distinguish btwn CA and mastitis |
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