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Mammograms should be done yearly starting at age ____ for the general female population and ___ years prior to disease diagnosis age of 1st degree relative
_______ should be done yearly beginning at age 40 for general female population and 10 years prior to disease diagnosis age of 1st degree relative
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What are some issues with breast MRI? (4)
- 1) More sensitive than mammograms
- 2) Expensive!
- 3) More false positives leading to more biopsies of benign lesions
- 4) Now covered as screening for some patients
These are all issues with what breast screening procedure?
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A clinical breast exam should be done when? (2)
- 1) Every 3 years ages 20-40
- 2) Yearly for 40+
This is how often what should be done?
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Breast self exam (BSE) is option for women ____ +, and sudies have show this does not save lives
___ ___ ___ is option for women 20+, and sudies have show this does not save lives
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Name 2 definitivie diagnosis that would indicate a breast biopsy.
- 1) If suspicious mass on imaging (mammogram, MRI, breast ultrasound) OR
- 2) If palpable mass even if imaging studies are negative
Either one of these would indicate the need for what kind of study.
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Name two types of breast biopsys?
- 1) Fine needle aspiration (FNA)
- 2) Stereotactic/utrasound core biopsy
These are two types of ______ ______.
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This procedure involves the aspiration of cellular fluid by inserting a needle into the lesion in the breast.
–Quick results
Fine needle aspiration (FNA) involves what procedure?
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What is done if the fine needle aspiration (FNA) is negative.
A more difinitive biopsy is warrented if an FNA is _____.
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This type of biopsy of the breast involves a gun device that removes a core sample of the lesion with several areas sampled
a)
What are the advantage over open surgical biopsy: (5)
b)
- a) Stereotactic/utrasound core biopsy invoves what procedure?
- b) Less scarring, local anesthesia, outpatient procedure, lower cost, and it's a reliable diagnostic technique
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Name some benign breast disorders. (4)
- 1) Mastalgia (breast pain)
- 2) Fibrocystic breast changes
- 3) Fibroadenoma
- 4) Mastitis
These are types of what breast disorders?
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What differentiates Cyclic from noncyclic masalgia.
Cyclic masalgia is related to hormonal changes noncyclic is not.
NOQ
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Discribe the symptoms of cyclic mestalgia. (2)
- 1) Diffuse tenderness or heaviness in the breasts
- 2) Often decreases with menopause
These are symptoms of _____ _____.
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Discribe noncyclic mestalgia. (2)
- 1) Burning, aching, or soreness
- 2) May be due to trauma, fat necrosis, or ductal ectasia
These are symptoms of _____ _____.
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Name some managements for mastalgia. (4)
- 1) Mammogram or other imaging to rule out cancer or ID source of pain
- 2) Decrease caffeine, dietary fats
- 3) Vitamins E, A, B complex
- 4) Gamma-linoleic acid (evening primrose oil)
These are all managements for _______.
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What are some fibrocystic breast changes. (4)
- 1) Development of excess fibrous tissue
- 2) Hyperplasia of the epithelial lining of the mammary ducts
- 3) Proliferation of mammary ducts
- 4) Cyst formation
These are types of what changes?
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In fibrocystic breast changes they are usually located where?
In ______ breast changes they are usually located bilaterally most prominently in the upper , outer quadrants.
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In fibrocyctic breast changes they are often _____ and ______ to hormonal influence.
In ____ ____ ____ they are often tender and sensitive to hormonal influence
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1) Usually a small, painless, round, well delineated, firm, unilateral mass
2) Generally occurs in women ages 15-25
3) Size not affected by menstruation, but may grow during pregnancy
4) Rarely associated with cancer
These are a discription of what breast disorder.
Discribe fibroadenoma.
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Discribe mastitis.
Localized tenderness, erythema and inflammation of the breast discribes what breast disorder?
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Mastitis is most commonly seen in _____ women. It's usually cause by the introduction of _________ bacteria through a cracked or abraded nipple
______ is most commonly seen in lactating women. It's usually cause by the introduction of Staphylococci bacteria through a cracked or abraded nipple
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It is ok to nurse with mastitis unless what?
Unless prurulent drainage is noted it is ok to ____ with mastitis
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What is the treatment for mastitis.
Antibiotics are the treatment for what breast disorder?
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What can happen if insufficient antibiotic treatment is used with mastitis?
Can develop into an abcess (collection of purulent fluid) if insufficient antibiotic treatment is used with _______.
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Discribe some statistics of breast cancer. (5)
- 1) Follows skin cancer as the most common malignancy in American women
- 2) Follows lung cancer as the leading cause of death from cancer in women
- 3) White women have higher incidence of breast cancer
- 4) African American women have lower survival rates than white women even with early diagnosis
- 5) Incidence and mortality rates lower among Hispanic and Asian/Pacific Islander women even though Hispanic women have lower screening rates and tend to be diagnosed at later stages
These are statistics of what breast disorder?
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Name some risk factors for breast cancer. (9)
- 1) Female (99% of all cases)
- 2) Age 50+
- 3) Family history:
- •1st degree relative (parent or sibling)
- •BRCA-1, BRCA-2 mutations in 5-10% of cases
- 4) Personal history of breast, colon, endometrial, or ovarian cancer
- 5) Menarche <age 12, Menopause >age 55
- 6) First full-term pregnancy >30, nulliparity
- 7) Atypical epithelial hyperplasia, lobular carcinoma in situ
- 8) Weight gain and obesity after menopause
- 9) Exposure to ionizing radiation
These are all risk factors for what breast disorder?
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Hormone replacement therapy has show what when it comes to breast cancer?
_____ _____ therapy has show a slight increase is breast cancer
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What are the findings with birth control pills and breast cancer?
___ ___ pills show no increased risk for developing breast cancer.
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How does alcohol effect breast cancer.
Studies show that ______ consuption increases the risk for breast cancer.
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5-10% of all breast cancers are related to what genes.
___-___% of all breast cancers are related to the BRCA-1 and BRCA-2 genes.
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The BRCA-1 and BRCA-2 genes show a ___-___% lifetime risk for developing breast cancer and is associated with increased risk for ovarian cancer.
The _____ and _____ genes show a 40-80% lifetime risk for developing breast cancer and is associated with increased risk for ovarian cancer.
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What are the preventive options if a patient is DNA tested for the BRCA-1, and BCRA-2 genes and is positive. (2)
- 1) Prophylactic mastectomy
- 2) Oophorectomy
These are options for patients who tested positive for the ____ and ____ gene.
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What are some factors affecting the prognosis of breast cancer? (6)
- 1) Tumor size
- 2) Axillary node involvement
- 3) Tumor differentiation
- 4) Human epidermal growth factor receptor 2 (HER2) status
- •A receptor that helps regulate cell growth and is often overexpressed in patients with breast cancer
- •Historically poor prognostic indicator if present
- 5) Estrogen and progesterone receptor status
- 6) TYPE of cancer seems to have little prognostic significance once the cancer has metastasized
These are all factors affecting the prognosis of ____ _____.
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