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2: Benign Breast Disease Flashcards

1
Q

Define mastalgia

A

Breast Pain

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2
Q

What are the two types of mastalgia

A
  1. Cyclical

2. Non-Cyclical

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3
Q

What is cyclical breast pain

A

Bilateral breast pain that occurs a few days before menstrual cycle and subsides afterwards

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4
Q

Which individuals may cyclical breast pain be seen in

A
  • Mensturating women

- Women on HRT

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5
Q

What is non-cyclical breast pain

A

Breast pain unrelated to the menstrual cycle

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6
Q

What medications can cause non-cyclical breast pain

A
  • Anti-depressants
  • Anti-psychotics
  • COCP
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7
Q

What investigation should be ordered for those with mastalgia

A 
Pregnancy test 
(Mastalgia alone does not justify imaging)
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8
Q

What is first-line management for mastalgia

A

Reassurance + advice

Analgesia

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9
Q

What is second-line management for mastalgia

A

Danazol

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10
Q

What is danazol

A

anti-gonadotropin agent

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11
Q

What is a method of classifying benign breast disease

A

ANDI

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12
Q

What does ANDI stand for

A

Abnormal Development and Breast Involution

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13
Q

What is the theory behind ANDI

A

Benign conditions of the breast are due to abnormalities in either:

  • Development
  • Hormonal changes
  • Involution
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14
Q

What is involution

A

Necrosis of mammary glands during weaning to cause remodelling to pre-pregnant state

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15
Q

According to ANDI, what common benign breast condition is due to abnormal development

A

Fibroadenoma

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16
Q

According to ANDI, what common benign breast condition is due to a cyclical change

A

Mastalgia

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17
Q

According to ANDI, what common benign breast condition is due to involution

A

Fibrocystic change

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18
Q

What is another term for fibrocystic change

A

Fibroadenosis

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19
Q

What is fibrocystic change

A

Formation of fibrous or cystic tissue within the breast

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20
Q

What is the most common benign breast disease

A

Fibrocystic change

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21
Q

What age does fibrocystic change occur in

A

30-50

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22
Q

How will fibrocystic change appear

A
  • Lumpy Bumpy breasts
  • Smooth tender/non-tender nodules
  • Pre-menstrual mastalgia
  • Clear/Milky discharge
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23
Q

What is used to investigate fibrocystic change

A

Triple assessment

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24
Q

On mammogram, what may be seen in fibrocystic change

A

Halo sign

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25
How is fibrocystic change managed
- Reassurance | - POP may be given if symptoms severe
26
What is a fibroadenoma
benign proliferation of glandular of fibrous tissue
27
What is the most common breast tumour in women under 35-years
fibroadenoma
28
What is the peak incidence of fibroadenoma
15-35
29
What is a risk factor for fibroadenomas
Oestrogen exposure
30
How will fibroadenomas present clinically
- Solitary, well-defined, non-tender, HIGHLY MOBILE, mass
31
What is used to investigate fibroadenomas
Tripple assessment
32
How may a fibroadenoma present on mammography
Popcorn calcifications
33
What is primary management of fibroadenomas
Observation
34
What is the criteria for excising fibroadenomas
>3cm or patient preference
35
What is fat necrosis
Ischaemic necrosis of fat lobules
36
What is fat necrosis usually associated with
Trauma (40%)
37
How will a lump present in fat necrosis
Irregular solid lump
38
What is the investigation of fat necrosis
Triple assessment
39
How is fat necrosis managed
- Reassurance | - Analgesia
40
What is mammary ductal ectasia
Dilation and shortening of the lactiferous ducts
41
In which age group
Peri-menopausal
42
How will mammary ductal ectasia present
- Green discharge - Palpable mass - Nipple retraction
43
What investigation is ordered for mammary ductal ectasia
Triple assessment
44
What will be seen on mammography in mammary ductal ectasia
Calcification of the ducts
45
In young patients how is mammary ductal ectasia managed
Microdochectomy
46
How is mammary ductal ectasia managed in older patients
Total ductal excision
47
What is a galactocele
Milk-retaining cyst of the mammary gland
48
In which population do galactocele's occur
Breast Feeding
49
How will galactocele's present
- Soft - Non-tender - SUB-AREOLAR MASS
50
If there is pain with a galactocele what does it indicate
superimposed infection
51
How is a galactocele diagnosed
clinical
52
What is gynaecomastia
Presence of breast tissue in males
53
What are the two broad categories of gynaecomastia
1. Physiological | 2. Pathological
54
When does physiological gynaecomastia occur and why
1. Adolescence: if there is a late surge in testosterone. This means oestrogen is high beforehand which can cause gynaecomastia appearance 2. Elderly: drop in testosterone
55
What causes pathological gynaecomastia
When there is a higher oestrogen level relative to testosterone
56
What are the four broad categories of pathological gynaecomastia
1. Idiopathic 2. Raised oestrogen 3. Low testosterone 4. Medications
57
What may increase oestrogen leading to gynaecomastia
- Leydig cell tumour - Adrenal tumour - Obesity - Hypothyroidism - Liver disease
58
What may decrease testosterone leading to gynaecomastia
- Klinefelter syndrome - Androgen insensitivity - Renal disease - Testicular atrophy
59
What medications can cause gynaecolmastia
- Marijuana - Digoxin - Metronidazole - Spirinolactone - Gosrelin
60
what should be performed in all young males with gynaecomastia and why
Testicular exam - as Leydig cell testicular tumours can cause gynaecomastia

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