11. Breast Lump Flashcards
What are the 4 most common diagnoses for a breast lump?
Benign cystic change
fibroadenoma
cyst
carcinoma
what are other potential diagnoses for a breast lump?
- fat necrosis
- periductal mastitis
- abscess
- galactocele
- phyllodes tumour
- sarcoma
- duct papilloma
- non breast lump
What are the most common diagnoses for a breast lump in women under 30?
- Physiologically normal lumpy breast
- benign cystic change
- fibroadenoma
- abscess if breastfeeding
- galactocele if breast feeding
What are the most common diagnoses for a breast lump in women aged 30-45 ?
- Benign cystic change
- cyst, abscess
- carcinoma
What are the most common diagnoses for a breast lump in women aged 45-60?
- Cyst
- abscess (smokers)
- carcinoma
What are the most common diagnoses for a breast lump in women aged over 60?
Carcinoma
What diagnoses would you only encounter in breast-feeding women?
Galactoceles and mastitis
Galactoceles =
- might occur during or after cessation of lactation
- presents as a firm mass (similar to a cyst)
- caused by obstruction of the lactiferous duct
Mastitis =
lactating women are pre-disposed to causative agents eg. staph aureus or staph epidermidis
What are the main risk factors for breast cancer?
- Previous breast cancer
- Family Hx of breast cancer
3 close relatives develop breast cancer
2 relatives before age of 60
1 relative before the age of 40
- Previous bowel, ovarian and endometrial cancer
- irradiation to the chest wall
- increased exposure to oestrogens
eg.
early menarche
late menopause
nulliparity
having a first child after 30
HRT and COCP
obesity
What questions should you ask in a breast lump history?
- How long has the lump been there,
- when was it first noticed?
- Has there been any breast trauma?
- Has the lump got bigger, smaller or stayed the same size?
- Are changes related to the menses?
- Is the lump painful?
- Have you noticed any skin changes
- nipple discharge?
- is the patient otherwise fit and well
- does the patient have any other risk factors
What will you look for on inspection in a breast exam?
- Asymmetry,
- countours
- skin changes
- nipple changes/ discharge
what features of the breast lump need to be observed?
- surface
- borders
- consistency
- mobility
- fixity
- lymphadenopathy
What kind of consistency do cysts have?
Firm to lax
What kind of consistency do fibroadenomas have?
Rubbery
What kind of consistency do carcinomas have?
Hard
what are the four most common presentations of a breast lump?
