benign breast disease - amazon web services：乳腺良性疾病的亚马逊网络服务

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1、BenignBreastDiseaseElizabethPeralta,M.D.BreastSurgeonSutterPacificMedicalGroupoftheRedwoodsBreastComplaintsPainMassSkinorNippleChangesNippleDischargeDiagnosisandTreatmentofBreastComplaintsMostimportantistoruleoutmalignancySignificanceofafindingisgreatestina

2、high-riskpatientBalancebetweenreassuranceandexhaustingalldiagnosticoptionsTreatmentshouldnotbeworsethanthediseaseMammaryductogramdemonstratinglobulesPre-menarchalductuleTerminalductal-lobularunitBreastDevelopmentMenarcheandReproductiveCycles:Pulsedestrogene

3、xposurecausesrapidgrowth,elongationandbranchingTermpregnancyleadstoterminaldifferentiationandstopsgrowthEndbudepithelialtissueundergoescyclicproliferationBreastfeedingisassociatedwithalowerriskofbreastcancerNormalbreastinpregnancyandafterBreastDevelopmentIn

4、volution:ChangesofinvolutionbeginaftercessationoflactationandcontinuethroughmenopauseCompetinginvolutionandproliferativeprocessesarepatchyandincreasedinperi-menopauseandwithHRTHyperplasiawithatypiaandDCISpeakinthisperiodInvolutionalandcysticchangePre-Cancer

5、ChangesIntraepithelialneoplasia(IEN):alesionwhichisnon-invasivebutcontainsgeneticabnormalities,lossofcellularcontrolfunctions,andsomemicroscopicfeaturesofcancercellsBiopsyresultswhichrepresentincreasedbreastcancerrisk:AtypicalDuctalHyperplasia(ADH)AtypicalL

6、obularHyperplasia(ALH)LobularCarcinomainSitu(LCIS)Biopsyresultswhichdonotshowbreastcancerrisk:CystsFibrosisBreastCancerRiskMajorRiskFactors(RR>4)PreviousbreastcancerFamilyhistory(bilateral,premenopausalormotherandsister)AtypicalhyperplasiaLCISorDCISLBreastI

7、magingReportingandDataSystem(BI-RADS)CategoryDefinitionActionPPVmalignancy0Incomplete,possiblefindingAdditionalimaging15%1NegativeRoutinescreening<1%2BenignfindingsRoutinescreening<1%3Probablybenignfindings6mofollow-up2%4SuspiciousabnormalityBiopsy30-45%5Hi

8、ghlysuggestiveofmalignancyBiopsy,actionasindicated93%CausesofBreastPainEndocrine:Cyclical,peri-menopausal,andwithhormonereplacementtherapyEdema/weight(caffeine,lackofsupport)Mastitis(termusuallyassocia