NM701 EXAM 4 QUESTIONS AND VERIFIED CORRECT
ANSWERS LATEST UPDATE
Components of breast tissue
-nipple and areola
-lobes of glandular tissue
-ducts
-fibrous tissue
-fatty tissue (amount determines size)
Describe glandular lobes of the breast
-12 to 20 lobes per breast
-10 to 100 lobules per lobe
-lobules are subdivided into secretory alveoli
---produce milk during lactation
each lobe empties into a single lactiferous duct that travels out through the nipple
How to evaluate mastalgia
-cyclic vs non-cyclic (prospective diary may help)
-diffuse vs focal
-non-breast pain (chest wall pain)
-thorough OLDCARTS
-other symptoms like discharge or mass
,-h/o breast disease or surgery
-hx including menstruation, pregnancy, lactation, medications
-complete breast exam
Dx testing for mastalgia
Imaging if mass or other abnormality
-mammo
-u/s
-MRI
-tomosynthesis
Likely causes of mastalgia
cyclic: common in luteal phase, ages 30-50
non-cyclic: pregnancy, mastitis, cysts, abscesses, cancer (rare, more of concern if
postmenopausal)
chest wall: costochondritis, Tietze syndrome
other: medications, arthritis, pleuritis, cervical spondylitis, herpes zoster, cholecystitis,
MI
What is 1st line treatment for mastalgia
reassurance is effective for 85% of women
-adjust hormones for postmenopausal
, -change type of hormonal contraceptive
-various medications
Mammary duct ectasia: define and clinical presentation
Ducts dilate/expand and become inflamed
ectasia = expansion = icktasia
-bilateral, multiductal, sticky, green, brown, or black discharge
-those >50 yrs; inflammation and fibrosis around ducts
-may have palpable mass
Management of mammary duct ectasia
expectant r/t usually benign
surgical removal of subareolar ducts if focal thickening of duct wall or severe symptoms
Intraductal papilloma: define and clinical presentation
Benign lesion in ducts that may or may not be palpable
-spontaneous bloody, unilateral, uniductal discharge
-age 40 to 50
-small benign growth in duct
-may have palpable mass
Intraductal papilloma management
duct excision if multiple OR single and >1 cm
no treatment if single and <1 cm
ANSWERS LATEST UPDATE
Components of breast tissue
-nipple and areola
-lobes of glandular tissue
-ducts
-fibrous tissue
-fatty tissue (amount determines size)
Describe glandular lobes of the breast
-12 to 20 lobes per breast
-10 to 100 lobules per lobe
-lobules are subdivided into secretory alveoli
---produce milk during lactation
each lobe empties into a single lactiferous duct that travels out through the nipple
How to evaluate mastalgia
-cyclic vs non-cyclic (prospective diary may help)
-diffuse vs focal
-non-breast pain (chest wall pain)
-thorough OLDCARTS
-other symptoms like discharge or mass
,-h/o breast disease or surgery
-hx including menstruation, pregnancy, lactation, medications
-complete breast exam
Dx testing for mastalgia
Imaging if mass or other abnormality
-mammo
-u/s
-MRI
-tomosynthesis
Likely causes of mastalgia
cyclic: common in luteal phase, ages 30-50
non-cyclic: pregnancy, mastitis, cysts, abscesses, cancer (rare, more of concern if
postmenopausal)
chest wall: costochondritis, Tietze syndrome
other: medications, arthritis, pleuritis, cervical spondylitis, herpes zoster, cholecystitis,
MI
What is 1st line treatment for mastalgia
reassurance is effective for 85% of women
-adjust hormones for postmenopausal
, -change type of hormonal contraceptive
-various medications
Mammary duct ectasia: define and clinical presentation
Ducts dilate/expand and become inflamed
ectasia = expansion = icktasia
-bilateral, multiductal, sticky, green, brown, or black discharge
-those >50 yrs; inflammation and fibrosis around ducts
-may have palpable mass
Management of mammary duct ectasia
expectant r/t usually benign
surgical removal of subareolar ducts if focal thickening of duct wall or severe symptoms
Intraductal papilloma: define and clinical presentation
Benign lesion in ducts that may or may not be palpable
-spontaneous bloody, unilateral, uniductal discharge
-age 40 to 50
-small benign growth in duct
-may have palpable mass
Intraductal papilloma management
duct excision if multiple OR single and >1 cm
no treatment if single and <1 cm
