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Breast > 2: Benign Breast Disease > Flashcards

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
Q

How is fibrocystic change managed

A
  • Reassurance

- POP may be given if symptoms severe

26
Q

What is a fibroadenoma

A

benign proliferation of glandular of fibrous tissue

27
Q

What is the most common breast tumour in women under 35-years

A

fibroadenoma

28
Q

What is the peak incidence of fibroadenoma

A

15-35

29
Q

What is a risk factor for fibroadenomas

A

Oestrogen exposure

30
Q

How will fibroadenomas present clinically

A
  • Solitary, well-defined, non-tender, HIGHLY MOBILE, mass
31
Q

What is used to investigate fibroadenomas

A

Tripple assessment

32
Q

How may a fibroadenoma present on mammography

A

Popcorn calcifications

33
Q

What is primary management of fibroadenomas

A

Observation

34
Q

What is the criteria for excising fibroadenomas

A

> 3cm or patient preference

35
Q

What is fat necrosis

A

Ischaemic necrosis of fat lobules

36
Q

What is fat necrosis usually associated with

A

Trauma (40%)

37
Q

How will a lump present in fat necrosis

A

Irregular solid lump

38
Q

What is the investigation of fat necrosis

A

Triple assessment

39
Q

How is fat necrosis managed

A
  • Reassurance

- Analgesia

40
Q

What is mammary ductal ectasia

A

Dilation and shortening of the lactiferous ducts

41
Q

In which age group

A

Peri-menopausal

42
Q

How will mammary ductal ectasia present

A
  • Green discharge
  • Palpable mass
  • Nipple retraction
43
Q

What investigation is ordered for mammary ductal ectasia

A

Triple assessment

44
Q

What will be seen on mammography in mammary ductal ectasia

A

Calcification of the ducts

45
Q

In young patients how is mammary ductal ectasia managed

A

Microdochectomy

46
Q

How is mammary ductal ectasia managed in older patients

A

Total ductal excision

47
Q

What is a galactocele

A

Milk-retaining cyst of the mammary gland

48
Q

In which population do galactocele’s occur

A

Breast Feeding

49
Q

How will galactocele’s present

A
  • Soft
  • Non-tender
  • SUB-AREOLAR MASS
50
Q

If there is pain with a galactocele what does it indicate

A

superimposed infection

51
Q

How is a galactocele diagnosed

A

clinical

52
Q

What is gynaecomastia

A

Presence of breast tissue in males

53
Q

What are the two broad categories of gynaecomastia

A
  1. Physiological

2. Pathological

54
Q

When does physiological gynaecomastia occur and why

A
  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
Q

What causes pathological gynaecomastia

A

When there is a higher oestrogen level relative to testosterone

56
Q

What are the four broad categories of pathological gynaecomastia

A
  1. Idiopathic
  2. Raised oestrogen
  3. Low testosterone
  4. Medications
57
Q

What may increase oestrogen leading to gynaecomastia

A
  • Leydig cell tumour
  • Adrenal tumour
  • Obesity
  • Hypothyroidism
  • Liver disease
58
Q

What may decrease testosterone leading to gynaecomastia

A
  • Klinefelter syndrome
  • Androgen insensitivity
  • Renal disease
  • Testicular atrophy
59
Q

What medications can cause gynaecolmastia

A
  • Marijuana
  • Digoxin
  • Metronidazole
  • Spirinolactone
  • Gosrelin
60
Q

what should be performed in all young males with gynaecomastia and why

A

Testicular exam - as Leydig cell testicular tumours can cause gynaecomastia

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