Breast Disease

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Breast Disease

• Amy Waer, M.D.

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Risk Factors

• Family History
• Age
• Age at menarche
• Breast feeding history
• Childbirth prior age 30
• Age of menopause
• Genetic

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Xray

• Mammogram
• Breast ultrasound
• Breast MRI
• PET scan

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Mammogram

• Baseline 35 40
• Every year after 40
• Five years prior 1st degree relative

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Breast ultrasound

• Useful in younger women
• Tells if a mass is cystic (fluid filled) or solid

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Breast MRI

• Highly sensitive
• Useful in evaluating breast implants

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PET Scan

• More useful in metastatic disease
• Can be used to follow disease progress

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Biopsy options

• Fine needle aspiration
• Core biopsy
• Stereotactic biopsy
• Incisional biopsy
• Excisional biopsy
• Wire localization biopsy

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Cysts

• Simple
• Complex
• When to aspirate
• When to excise

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Pathology

• Fibrocystic changes
• Fibroadenoma
• Atypical ductal hyperplasia
• Lobular carcinoma in situ
• Ductal carcinoma in situ

• Infiltrating ductal
• Infiltrating lobular
• Inflammatory
• Pagets
• Intraductal papilloma
• Phylloides tumor

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Surgical options

• Observation
• Lumpectomy
• Mastectomy
• Sentinel node biopsy
• Axillary dissection
• Reconstruction
• Prophylactic mastectomy

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Chemotherapy

• Neoadjuvant
• Prophylactic
• Lymph node positive

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Breast radition

• Post lumpectomy
• Axillary bed
• Chest wall

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Special circumstances

• Pregnancy
• BrCa1 or 2
• Nipple discharge
• Male breast cancer

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