Breast Anatomy, Pathology, and Screening: Comprehensive Quizlet

Where are the paired mammary glands located anatomically?

Superficial to pectoralis major and serratus anterior, spanning from the 2nd rib to the 6th rib

How many glandular lobes does each breast have, and how many lobules per lobe?

20 glandular lobes, each with 20-40 lobules

What do the lobules of the breast contain?

Milk-producing acini and lactiferous ducts that drain the lobes

What provides structural support to the fibrous tissue of the breast?

Cooper's ligaments

What is the vascular supply of the breast?

The internal mammary artery and the lateral thoracic artery

What supplies the bulk of the breast's volume?

Subcutaneous fat and retromammary fat

How many quadrants does the breast have, and what additional structure extends from it?

4 quadrants, plus the tail of Spence

Which quadrant of the breast has the greatest amount of glandular tissue?

The upper outer quadrant

What is unique about the nipple epithelium?

It contains smooth muscle fibers

What are Montgomery tubercles?

Sebaceous glands located in the areola

How do superficial and deep lymphatics of the breast differ in what they drain?

Superficial lymphatics drain the skin; deep lymphatics drain the mammary lobules

What does male breast tissue consist of at birth?

Mostly ducts, with almost no lobules

Is breast cancer the most commonly diagnosed cancer in the world?

Yes

What are major risk factors for breast cancer?

Age, family history, genetics, personal history, dense breasts, and high levels of endogenous hormones

What factors are protective against breast cancer?

Early term pregnancy, breastfeeding, late menarche, early menopause, exercise/healthy body weight, and limiting alcohol

What should be done for women with a family history of breast, ovarian, tubal, or peritoneal cancer?

Screen for BRCA testing and consider prophylactic mastectomy or SERMs

How often should mammography be performed, and for what age range?

Every 2 years, for ages 40-74

When is the best time to perform a clinical breast exam?

5-7 days after the onset of menstruation

What are the methods of palpation used in a breast exam?

Chest wall sweep, bimanual palpation, and lymph node palpation

How should a breast exam be performed when the patient is supine?

Use circular motion with finger pads (fingers 2, 3, 4), noting any mass for tenderness, consistency, and nodularity

What underlying condition should be evaluated for if nipple discharge is spontaneous, unilateral, or bloody?

Intraductal papilloma

What is a normal chest exam finding for someone assigned male at birth?

A thin layer of fatty tissue over the muscle

What is the exam finding in gynecomastia?

A firm disk of glandular tissue is felt

What are fibrocystic changes of the breast?

Benign fluid-filled cysts due to ductal enlargement, common in ages 25-50, with a nodular, rope-like texture on exam

What is a fibroadenoma?

A benign, single breast mass, most common in ages 15-25, round/disc-like or lobular, very mobile, firm, and nontender

At what age are malignant breast tumors most common, and what is their typical exam finding?

Age 50 and up; typically singular, irregular, and firm

What causes fat necrosis of the breast?

A benign lump resulting from an inflammatory response to injury

What are visible signs of breast cancer on exam?

Retraction signs, abnormal contours, dimpling, nipple deviation, edema, peau d'orange, and Paget disease

What is galactorrhea, and what is its most common cause?

Milk-containing nipple discharge unrelated to pregnancy or lactation; most commonly caused by hyperprolactinemia

What is mastitis, when does it most commonly occur, and what are its symptoms?

Inflammation associated with lactation, most commonly occurring 4-6 weeks into breastfeeding; presents with pain, swelling, redness, and possibly flu-like symptoms; may progress to abscess

What should a breast exam assess for after a mastectomy?

Scar, masses, irregularities, infection (to look for recurrence), and lymphedema

What breast characteristics are common in transgender women, and why?

Likely more dense breasts, related to hormone therapy or breast augmentation

How does breast cancer risk in transgender women compare to cisgender men and cisgender women?

Increased risk compared to cisgender men, but lower risk than cisgender women

What breast cancer screening considerations apply to transgender men?

They require proper documentation of surgeries to understand their risk, and need the same breast cancer screening as nontransgender women unless they have had a bilateral mastectomy