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    Breast Masses

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    Rima Hajjar
    1) Mammography is most beneficial for women ages 60-69, reducing mortality by 33%. 2) For women presenting with a palpable breast mass, fine needle aspiration is preferred over ultrasound for masses that are solid or complex, as it can determine if a mass is completely cystic or solid. 3) Treatment options for breast cancer include aromatase inhibitors or tamoxifen, with aromatase inhibitors having fewer side effects and increased disease-free survival for postmenopausal women.

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    Breast Masses

    Uploaded by

    Rima Hajjar
    25 views25 pages
    1) Mammography is most beneficial for women ages 60-69, reducing mortality by 33%. 2) For women presenting with a palpable breast mass, fine needle aspiration is preferred over ultrasound for masses that are solid or complex, as it can determine if a mass is completely cystic or solid. 3) Treatment options for breast cancer include aromatase inhibitors or tamoxifen, with aromatase inhibitors having fewer side effects and increased disease-free survival for postmenopausal women.

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    1) Mammography is most beneficial for women ages 60-69, reducing mortality by 33%. 2) For women presenting with a palpable breast mass, fine needle aspiration is preferred over ultrasound for masses that are solid or complex, as it can determine if a mass is completely cystic or solid. 3) Treatment options for breast cancer include aromatase inhibitors or tamoxifen, with aromatase inhibitors having fewer side effects and increased disease-free survival for postmenopausal women.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    25 views25 pages

    Breast Masses

    Uploaded by

    Rima Hajjar
    1) Mammography is most beneficial for women ages 60-69, reducing mortality by 33%. 2) For women presenting with a palpable breast mass, fine needle aspiration is preferred over ultrasound for masses that are solid or complex, as it can determine if a mass is completely cystic or solid. 3) Treatment options for breast cancer include aromatase inhibitors or tamoxifen, with aromatase inhibitors having fewer side effects and increased disease-free survival for postmenopausal women.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 25

    BREAST MASSES

    The greatest benefit of


    mammography was a 33%
    reduction in mortality in the age
    group of 60–69 years
    Key Points
    • Risk of malignancy in a woman with breast lump depends on age :
    1- 1% in women 40 years and younger
    2- 10% in women 41-55%
    3- 37% in women 55 and older
    • There is a difference between screening mammography and diagnostic mammography
    • Screening mammography involves taking two views of the breast (Craniocaudal,
    mediolateral oblique)
    • Diagnostic involves multiple views , including magnified shots of the area of concern
    • 15% of women with a palpable breast cancer can have a normal mammography  Do
    further testing cannot reassure.
    Cnt’
    • For palpable masses FNA is preferred because it can determine whether a cyst is
    completely cystic or solid and send the specimen for pathology
    • 80% of palpable breast masses will be solid and will require pathological
    evaluation this is why FNA is preferred to ultrasound
    • The procedure can sometimes be bother diagnostic and therapeutic
    • After FNA you need to re-evaluate the patient in 6 months
    • Blood from aspirate should be sent for cytology as this can often be due to
    malignancy
    • If no fluid or tissue is obtained, if fluid is obtained and there is still residual mass, or
    if mass recurs after FNA  core needle or excisional biopsy for definitive diagnosis
    • Women in whom breast cancer is diagnosed may be offered therapy to reduce the risk of recurrence.
    • The 2 therapies : Aromatase inhibitors, tamoxifen citrate
    • There is advantage for aromatase over tamoxifen in women with breast cancer who are
    postmenopausal  Increased disease free survival
    • Tamoxifen uses :
    Tx Metastatic Breast CA

    Decrease risk of developing breast CA

    Decrease risk of recurrence in 5 years by 50%

    Side effects : fatigue, hot flushes, vaginal dryness, vaginal discharge, and mood swings, thrombosis,
    endometrial CA
    *Aromatase inhibitors do not have these side effects. The most important side effect is on BMD
    Key points
    • Due to intraductal papilloma 35-48%
    • Next most common : ductal ectasia 17-36%
    • Carcinoma : 5-21% (Intraductal carcinoma in situ or papillary carcinoma)
    • Cytology is not enough because it might be negative
    • Ductography can miss out on 20% of the lesion, its not the first step but if
    diagnostic mammography is negative , ductography would be the next step along
    with subareolar ultrasound
    Histologic evaluation
    • FNA  small bore, cytologic specimen
    • Core Needle  large bore , histologic specimen
    • Excisional  difficult location or particular lesions assessed by core needle and
    require further excisional procedure
    A woman presents with a palpable mass
    • Women with palpable masses require imaging. The appropriate diagnostic
    imaging study is determined based on the woman’s age. For women younger
    than 30 years with a palpable mass, ultrasonography is the preferred initial
    modality 

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