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31 Cards in this Set
- Front
- Back
Axillary Tail of Spence
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extension of breast tissue into axilla
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Breast is made of
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Glandular Tissue, Fibrous Tissue, and Adipose tissue
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Glandular Tissue
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15-20 lobes that radiate from nipple made of lobules that are made of clusters of alveoli that produce milk
Lobes empty into lactiferous duct Lactiferous duct forms collecting system that converge towards nipple where they form ampullae which are reservoirs for storing milk |
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Suspensory ligaments or Cooper's ligaments
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fibrous bands extending from surface to attach on chest well muscles. Support breast tissue. BEcomes contracted during breast cancer producing pits/dimples
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Four Quadrants
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Upper Outer, Upper Inner, Lower Outer, Lower Inner, AND TAIL OF SPENCE
Site of most breast tumors: Upper Outer |
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Lymphatics: Central Axillary Nodes
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High up in middle of axilla over ribs and serratus anterior muscle. Receive lymph from other 3 groups of nodes
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Lymphatics: Pectoral (anterior)
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Along lateral edge of pectoralis major muscle, inside anterior axillary fold, drains towards central axillary node
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Lymphatics: Subscapular (posterior)
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Along lateral edge of scapula, deep in posterior axillary fold
Drains towards Central Axillary Node |
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Lymphatics: Lateral
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Along humerus, inside upper arm. Flows up to infraclavicular and supraclavicular nodes.
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Cross Cultural: Breast Cancer
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Lower in AA women but mortality is higher
Lower in countries where diet is low in fat |
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Lymphatics: Central Axillary Nodes
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High up in middle of axilla over ribs and serratus anterior muscle. Receive lymph from other 3 groups of nodes
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Lymphatics: Pectoral (anterior)
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Along lateral edge of pectoralis major muscle, inside anterior axillary fold, drains towards central axillary node
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Lymphatics: Subscapular (posterior)
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Along lateral edge of scapula, deep in posterior axillary fold
Drains towards Central Axillary Node |
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Lymphatics: Lateral
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Along humerus, inside upper arm. Flows up to infraclavicular and supraclavicular nodes.
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Cross Cultural: Breast Cancer
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Lower in AA women but mortality is higher
Lower in countries where diet is low in fat |
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If lump or mass is present, note
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Location (clock and cm), size (cm), shape, consistency, mobility, distinctness (solitary or multiple), nipple (displaced or retracted), overlying skin, tenderness, lymphadenopathy, temperature and color
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When to do BSE
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4th to 7th day of menses
Start in shower and next do while supine |
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Dimpling
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Skin retraction due to fibrosis which contracts suspensory ligaments -> sign of cancer
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Fixation
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asymmetry, distortion, or decreased mobility with elevated arm maneuver
fibrosis fixes breast to underlying pectoral muscles sign of cancer |
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Edema (peau d'orange)
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Orange peel appearance of breast due to edema produced by lymphatic obstruction. Thickens skin and exaggerates hair follicles. This suggests cancer. Edema usually begins in skin around and beneath areola.
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Deviation in Nipple Pointing
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Cancer causes fibrosis in mammary ducts which pull nipple angle toward it.
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Nipple Retraction
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Retracted nipple is flatter broader, like underlying crater. May suggest cancer which cause fibrosis of duct system and pull in nipple. Can also be benign lesions such as ectasia of the ducts.
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Benign breast disease
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Multiple tender masses, bilateral nodularity, regular firm nodules that are mobile, demarcated, rubbery, small like water balloons. Dull pain, heavy, cyclic, or just before menses.Cysts are discrete, fluid-filled.
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Cancer
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solitary unilateral nontender mass. Single focus in ONE area, solid, hard, dense, fixed, irregular borders and poorly delineated. Grows constantly, painless often, UOQ, 30-80 y/o, esp 40 to 44 and >50.
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Fibroadenoma
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Solitary nontender mass. Benign breast disease. Solid, firm, rubbery, elastic, round, oval, or lobulated (1-5cm), freely movable, slippery, most common 15-30 y/o, grows quickly and constantly
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Paget's Disease
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Early lesion has unilateral, clear, yellow d/c and dry, scaling crusts, friable at nipple apex. Spreads outward to areola with erythematous halo on areola and crusted, eczema-tous, retracted nipple. Later lesions shows nipple reddened, excoriated, ulcerated, bloody d/c, erythematous plaque surrounding nipple.
Tingling, burning, itching |
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Plugged Duct
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common, not serious; one milk duct clogged, one section of breast is tender, may be reddened, no infection. Usually resolves <1 day
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Breast Abscess
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Rare complication of generalized infection if untreated. Pocket of pus accumulates in one local area. Extensive nipple edema and abscess is pointing.
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Mastitis
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Inflammation of breast; inflammatory mass before abscess formation, occurs in single quadrant; area is red, swollen, tender, hot, and hard. May have headache, malaise, fever, chills, sweating, increased pulse, and flulike symptoms. First few months of lactation and may turn into abscess if untreated
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Gynecomastia
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Noninflammatory enlargment of male breast tissue. Physiologic at puberty, unilateral, mild, and transient. Common amongst aging males.
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Carcinoma in men
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Hard, ireggular, nontender mass, most often directly under areola, fixed to area, and may have nipple retraction. Mass is noticeable early because of minimal breast tissue.
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