Questions and Answers
Which of the following best describes inflammatory breast cancer?
Which statement is true regarding Paget disease of the breast?
What is included in the diagnostic process for breast cancer?
In the context of breast cancer treatment, what is the primary goal of chemotherapy?
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What characterizes ductal carcinoma in situ (DCIS)?
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Which of the following is a symptom of breast cancer metastasis?
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What type of treatment is considered for hormone receptor-positive breast cancer?
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Which type of benign breast lesion has a substantial increased risk of developing into cancer?
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Which of the following medications is known to contribute to mastalgia?
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What is the primary action to take if a breast mass is found to be benign upon examination?
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When should a unilateral breast mass be referred for further evaluation?
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Which diagnostic test is recommended for patients under 30 years old presenting with a breast mass?
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Which type of breast mass is most likely to be benign and cyclical?
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What is the main characteristic of cyclic mastalgia?
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What is the common age range for peak incidence of fibroadenoma?
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Which characteristics are indicative of fibroadenoma?
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What is the recommended definitive diagnosis method for fibroadenoma?
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Which symptom is most associated with fibrocystic breasts?
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What is a common treatment approach for both fibroadenoma and fibrocystic breasts?
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Which element is NOT typically seen in fibrocystic breast changes?
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What should be considered for excision of a fibroadenoma?
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What is the primary age recommendation for starting mammograms in average-risk individuals according to the U.S. Preventative Services Task Force?
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For transgender women and transfeminine individuals on feminizing hormones, when should screening begin?
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Which imaging technique is primarily used to differentiate between cystic and solid breast masses in individuals under 30 years?
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What is the main purpose of screening mammography?
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If a transgender male has not undergone a mastectomy, what should be the breast cancer screening approach?
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How often should individuals aged 40-74 perform screening mammograms?
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What does mammography use to create images of breast tissue?
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When diagnostic mammography is performed after a screening, what does it indicate?
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What factor is primarily associated with the changing density of breast tissue as a person ages?
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Study Notes
Types of Breast Cancer
- Invasive Ductal Carcinoma: Arises from the epithelial lining of ducts.
- Invasive Lobular Carcinoma: Originates in the tissue of the lobules.
- Inflammatory Breast Cancer: Presents similarly to mastitis with erythema and heavy, nontender breast.
- Non-Invasive Ductal Carcinoma In Situ (DCIS): Confined to the duct without invasion.
Paget Disease
- Characterized by nipple ulceration.
- Areola may be affected or spared.
- Can indicate underlying ductal carcinoma.
- Patients require imaging and breast biopsy.
Breast Cancer Diagnosis
- Detection often starts with palpable lesions, abnormal symptoms, or screening mammography results.
- Comprehensive breast exams assess for skin changes, masses, and nipple discharge.
- Symptoms of metastases include bone pain, jaundice, and weight loss among others.
- Diagnostic testing includes imaging studies and tissue sampling.
- Diagnosis utilizes the TNM system based on tumor size, lymph node involvement, and metastatic spread.
Breast Cancer Treatment
- Treatment options include surgery, chemotherapy, radiation, and hormonal therapy (e.g., Tamoxifen).
- Breast-Conserving Surgery: Lumpectomy or partial mastectomy preserves most of the breast.
- Chemotherapy: Can be administered pre- or post-surgery.
- Radiation Therapy: Typically follows breast-sparing surgeries.
- Hormonal therapy for hormone receptor-positive tumors may extend for 5-10 years to prevent recurrence.
Common Breast Disorders
Mastalgia (Breast Pain)
- Commonly experienced during pregnancy and lactation, benign in over 90% of cases.
- Can be cyclic (linked to menstrual cycle) or non-cyclic; cyclic pain is mostly benign.
- Bilateral/unilateral pain can occur; upper outer quadrants typically have denser tissue.
- Contributing medications: antidepressants, hormone replacement therapy, hormonal contraceptives.
- Treatment focuses on underlying causes; reassurance and supportive measures recommended.
Breast Masses
- Most masses are benign but malignancy should be ruled out.
- Comprehensive history and physical exam necessary to assess symptoms.
- Differential diagnoses include fibrocystic changes, cysts, infections, and malignancies.
- Benign lesions classified as:
- Non-proliferative (low risk, e.g., simple cysts).
- Proliferative without atypia (small increased risk).
- Proliferative with atypia (substantial increased risk).
- Diagnostic approach: Ultrasound for those under 30; diagnostic mammogram for those over 30, plus potential additional imaging or biopsy if suspicious.
Fibroadenoma
- Represents 12% of breast lumps, peaking in individuals aged 21-25.
- Often presents as painless lumps, well-defined, rubbery texture, commonly in the upper outer quadrant.
- Diagnosis confirmed with mammogram or ultrasound, with core needle biopsy as definitive.
- Education, reassurance, and monitoring recommended; excision considered for atypical cases or significant growth.
Fibrocystic Breasts
- Characterized by hormonal fluctuations affecting normal breast tissue, typically bilateral.
- May cause tenderness but without lymphadenopathy or skin changes.
- Diagnose through ultrasound or biopsy; complex cysts require core biopsy to rule out malignancy.
- Treatments focus on education and reassurance.
Breast Cancer Screening Recommendations
- U.S. Preventive Services Task Force advises against routine breast self-exams.
- Initial mammography recommended at age 40, biennially until age 74.
- For transgender individuals on feminizing hormones, begin screening at age 50 after 5 years of hormone therapy; transmasculine individuals without mastectomy should follow cisgender guidelines.
Mammography and Ultrasound
- Mammography: X-ray procedure for breast screening, detects lesions 2 years before they become palpable.
- Ultrasound: Differentiates cystic from solid masses; recommended as primary diagnostic tool for individuals under 30.
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Description
Explore the various types of breast cancer, including invasive ductal and lobular carcinomas, as well as inflammatory breast cancer and DCIS. Additionally, learn about Paget disease and its characteristics. This quiz is designed to enhance your understanding of these critical topics in breast health.
