••• Chapter 41^ Breast Disorders^405
❍ What is the most common cause of galactorrhea?
Hyperprolactinemia.
❍ How should galactorrhea be investigated initially?
Serum prolactin levels.
❍ How can galactorrhea be treated if caused by a pituitary adenoma or persistent lactation?
Bromocriptine.
❍ Breast hypoplasia is generally associated with what conditions?
Gonadal dysgenesis and Turner syndrome.
❍ A 9-year-old patient presents with a complaint of unilateral breast lump and tenderness. What is the proper
management?
Reassurance. This mass represents the breast bud’s initial development at thelarche.
❍ What is the preferred radiographic technique to diagnose breast abscess?
Ultrasound.
❍ What is the workup of a 25-year-old patient with a palpable breast mass?
A complete history and physical examination is initially performed. The next step is an ultrasound of the lesion.
Fine needle aspiration or core needle biopsy is the final step.
❍ What are the initial imaging studies for a breast mass during pregnancy and lactation?
Ultrasound.
❍ What is the cause of axillary swelling and pain during late pregnancy?
Ectopic axillary breast tissue.
❍ How is swelling from ectopic axillary breast tissue treated?
The condition is initially treated with reassurance and observation. The swelling will usually resolve with the
cessation of nursing and lactation. When swelling is persistent and causes discomfort or cosmetic dissatisfaction,
ectopic axillary breast tissue can be removed by a subcutaneous resection.
❍ When is core needle biopsy preferred over fine-needle aspiration?
Core needle biopsy is preferred for solid lesions. Fine-needle aspiration is preferred for cyst aspirations.
❍ What is the average radiation exposure during a routine mammogram?
The FDA limits radiation dose for a mammogram to 300 mrad for an average thickness breast per exposure.
❍ Which lymph node groups are most likely to be affected by breast cancer metastases?
Axillary, supraclavicular, internal mammary, and cervical lymph nodes.