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A patient reports spontaneous discharge from her left nipple. How
would you determine if the discharge was from one or multiple ducts?
Order an ultrasound.
,Order a mammogram.
Compress the nipple and examine with a magnifying glass.
Depress the nipple into the well behind the areola and observe
discharge. - Answer: Compress the nipple and examine with a
magnifying glass.
Mrs. Harris presents to your office with a complaint of a red rash on her
breast suggestive of either Paget disease or eczema. Which is a
distinguishing factor between these two problems?
The location of the lesion on the nipple.
The presence or absence of crust.
The response to cortisone
The pattern of fever - Answer: The response to cortisone
Mrs. Ulman is a 56-year-old patient who presents to your office for her
routine follow-up after having a mastectomy of the right breast 2 years
ago. Which statement applies to your examination of this patient?
Swelling, thickening, and small lumps at the mastectomy site are
expected.
The mastectomy site is inspected but not palpated because of pain.
If malignancy recurs, it may be at the scar site.
,There is no need to examine the mastectomy site. - Answer: If
malignancy recurs, it may be at the scar site.
Mrs. Yates is a 58-year-old patient who presents to your office for her
yearly physical examination. She asks you how often a mammogram is
recommended. The best response by the examiner is:
"every year."
"every 3 years."
"every 5 years."
"every year if you have a family history of cancer." - Answer: "every
year."
Mrs. Venin brings her 18-year-old son in for a follow-up examination.
You have examined him before due to his enlarged breast tissue, which
has not resolved spontaneously. Which action is most appropriate?
Refer him to a surgeon for removal.
Explain that it may still resolve spontaneously.
Ask about history of sexual activity.
Ask about illicit or prescription drug use. - Answer: Ask about illicit or
prescription drug use.
, Mrs. Harold is a 37-year-old patient who presents for her yearly
physical examination. Which statement made by Mrs. Harold would
make the examiner suspect fibrocystic changes?
"I have a lump in my breast that is not tender."
"My right breast is larger than the left breast."
"My nipples are darker than before my baby was born."
"I feel lumps before my period." - Answer: "I feel lumps before my
period."
Mrs. Black brings her 12-year-old daughter in with a complaint of a
breast mass. On examination, you note unilateral breast enlargement
with associated tenderness but no mass. Which action do you take?
Refer for mammogram.
Refer for biopsy.
Ask the mother about her own breast development.
Explain that this is an expected finding. - Answer: Explain that this is an
expected finding.
Mrs. Newer brings her young child in for a yearly physical examination.
On examination, you note a supernumerary nipple. For which other
finding do you need to be alert?
Papillomatosis