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Surgery.(General 2).Breast > 7. Fibrocystic disease of the breast > Flashcards

7. Fibrocystic disease of the breast Flashcards

1
Q

Fibrocystic disease of the breast

A
  • Alternative names
  • Incidence
  • Etiology
  • Pathology
  • Clinical Picture
  • Investigations
  • Treatment
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2
Q

Alternative names for Fibrocystic disease of the breast

A
  • Mammary dysplasia
  • Fibroadenosis
  • chronic interstitial mastitis.
  • ANDI (aberration of normal development and involuion)
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3
Q

Incidence of Fibrocystic disease of the breast

A

The most frequent disorder of the breast.

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4
Q

Etiology ofFibrocystic disease of the breast

A
  • The exact cause is unknown
  • ANDI stands for aberration of normal development and involuion due to abnormal response to estrogen with each menstrual cycle
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5
Q

Pathology ofFibrocystic disease of the breast

A

The changes which take place include a mixture of the following with a variable proportion :

  • Adenosis
  • Epitheliosis
  • Fibrosis
  • Cyst formation
  • Note concerning papilloma and fibroadenoma
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6
Q

Adenosis in thePathology of Fibrocystic disease of the breast

A
  • non-neoplastic glandular hyperplasia

* causing multiplication of acini.

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7
Q

Epitheliosis in thePathology of Fibrocystic disease of the breast

A
  • Definition
  • Papillomatosis
  • atypical Epithelial hyperplasia
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8
Q

Definition of Epitheliosis in thePathology of Fibrocystic disease of the breast

A

Epithelial hyperplasia within the small ducts.

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9
Q

Papillomatosis in Epitheliosis in thePathology of Fibrocystic disease of the breast

A

Extensive Epithelial hyperplasia within the small ducts forming intraductal papillary growths

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10
Q

atypical Epithelial hyperplasia in epitheliosis in thePathology of Fibrocystic disease of the breast

A
  • in rare cases

* accompanied by a higher possibility of developing breast cancer

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11
Q

Fibrosis in thePathology of Fibrocystic disease of the breast

A

Fibrous tissue replaces the fat and elastic tissue

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12
Q

Cyst formation in thePathology of Fibrocystic disease of the breast

A

a. Microcyst (commonest )

b. Macrocyst

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13
Q

Microcyst in Cyst formation in thePathology of Fibrocystic disease of the breast

A
  • Incidence

* Pathogenesis

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14
Q

Incidence of Microcyst in Cyst formation in thePathology of Fibrocystic disease of the breast

A

commonest cyst formation in the Pathology of Fibrocystic disease of the breast

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15
Q

Pathogenesis of Microcyst in cyst formation in thePathology of Fibrocystic disease of the breast

A

Degeneration cysts of the acini.

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16
Q

Macrocyst in cyst formation in thePathology of Fibrocystic disease of the breast

A
  • Alternative name

* Pathogenesis

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17
Q

Alternative name for Macrocyst in cyst formation in thePathology of Fibrocystic disease of the breast

A

Blue-domed cyst of Bloodgood

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18
Q

Pathogenesis of Macrocyst in cyst formation in thePathology of Fibrocystic disease of the breast

A
  • Retention cyst

* due to obstruction of ducts by fibrosis or epitheliosis

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19
Q

Note concerning papilloma and fibroadenoma in thePathology of Fibrocystic disease of the breast

A

It’s probable that:

  • Duct papilloma is a localized form of epitheliosis
  • Fibroadenoma is a localized form of adenosis and fibrosis
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20
Q

Clinical Picture of Fibrocystic disease of the breast

A
  • Symptoms

* Examination

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21
Q

Symptoms in Clinical Picture of Fibrocystic disease of the breast

A
  1. Completely asymptomatic
  2. Mastalgia : Commonest presentation
  3. Nipple discharge
  4. Painful nodularity
  5. Breast lump
22
Q

Mastalgia in Symptoms in Clinical Picture of Fibrocystic disease of the breast

A
  • Incidence
  • Character
  • Meaning of Mastodynia
23
Q

Incidence of Mastalgia in Symptoms in Clinical Picture of Fibrocystic disease of the breast

A

The commonest presentation ofFibrocystic disease of the breast

24
Q

Character of Mastalgia in Symptoms in Clinical Picture of Fibrocystic disease of the breast

A

Usually a cyclical mastalgia

25
Q

Meaning of Mastodynia in Mastalgia in Symptoms in Clinical Picture of Fibrocystic disease of the breast

A

marked mastalgia

26
Q

Nipple discharge in Symptoms in Clinical Picture of Fibrocystic disease of the breast

A
  • Usually clear or yellow
  • brown or green
  • bloody
27
Q

Pathogenesis of bloody Nipple discharge in Symptoms in Clinical Picture of Fibrocystic disease of the breast

A

Epithelial ulceration

28
Q

Painful nodularity in Symptoms in Clinical Picture of Fibrocystic disease of the breast

A
  • Definition

* Time

29
Q

Definition of Painful nodularity in Symptoms in Clinical Picture of Fibrocystic disease of the breast

A
  • Multiple small painful lumps

* that may be unilateral or bilateral.

30
Q

Time of Painful nodularity in Symptoms in Clinical Picture of Fibrocystic disease of the breast

A

The lady Usually observes this in relation to her cycles

31
Q

Pathogenesis of Breast lump in Symptoms in Clinical Picture of Fibrocystic disease of the breast

A

Caused by:

  • a macro cyst

Or

  • sclerosing adenosis
32
Q

sclerosing adenosis in Pathogenesis of Breast lump in Symptoms in Clinical Picture of Fibrocystic disease of the breast

A

when fibrosis is extensive )> lump formation )> sclerosing adenosis

33
Q

Examination in Clinical Picture of Fibrocystic disease of the breast

A

a. Breast

b. Axillary L.N

34
Q

Breast Examination in Clinical Picture of Fibrocystic disease of the breast

A
  1. Tender breast.
  2. Tender nodularity
  3. Breast lump :
35
Q

Tender nodularity Examination in Breast Examination in Clinical Picture of Fibrocystic disease of the breast

A

Better felt by the tips of the fingers.

36
Q

Breast lump Examination in Breast Examination in Clinical Picture of Fibrocystic disease of the breast

A
  • May be felt.

* The lump may disappear if the patient is re-examined 1 week after the menstrual cycle

37
Q

Axillary L.N Examination in Clinical Picture of Fibrocystic disease of the breast

A
  • Results

* Pathogenesis of the results

38
Q

Results of Axillary L.N Examination in Clinical Picture of Fibrocystic disease of the breast

A

May be enlarged, tender & firm.

39
Q

Pathogenesis of the results of Axillary L.N Examination in Clinical Picture of Fibrocystic disease of the breast

A

due to reactive hyperplasia

40
Q

Investigations of Fibrocystic disease of the breast

A

Indications

Radiological Investigations

Laboratory Investigations

41
Q

Indications of Investigations of Fibrocystic disease of the breast

A
  • Investigations are usually not required

* Done to rule out breast cancer in suspected cases.

42
Q

Radiological Investigations of Fibrocystic disease of the breast

A
  1. Mammography & complementary breast ultrasound.

2. U/S guided aspiration of a cyst

43
Q

U/S guided aspiration of a cyst in Radiological Investigations of Fibrocystic disease of the breast,considered benign if

A
  • The fluid is not blood-stained.
  • The lump disappears completely after aspiration.
  • Does not recur within two weeks.
44
Q

Laboratory Investigations of Fibrocystic disease of the breast

A
  1. Cytology of the fluid

2. Excision biopsy

45
Q

Indications of Excision biopsy in Laboratory Investigations of Fibrocystic disease of the breast

A
  • a solid mass

* a recurrent cyst.

46
Q

Treatment of Fibrocystic disease of the breast

A
  1. Reassurance and follow up.
  2. Advise the patient to get pregnant.
  3. treatment of Cyclic mastalgia
  4. Cysts are treated by aspiration
  5. A recurrent cyst is treated by excision biopsy
47
Q

Treatment ofCyclic mastalgia in Treatment of Fibrocystic disease of the breast

A

a. Supportive brassiere at day time & a soft brassiere at night.
b. Avoiding caffeine consumption may be useful.
c. Primaleve ( capsules of primrose oil ) for 3 months.
d. Treatment of intractable mastalgia

48
Q

Treatment ofintractable mastalgia in Treatment ofCyclic mastalgia in Treatment of Fibrocystic disease of the breast

A
  • Prolactin inhibitors

* Tamoxifen

49
Q

Prolactin inhibitors in Treatment ofintractable mastalgia in Treatment ofCyclic mastalgia in Treatment of Fibrocystic disease of the breast

A
  • bromocriptine

* 2.5 mg twice daily

50
Q

Tamoxifen in Treatment ofintractable mastalgia in Treatment ofCyclic mastalgia in Treatment of Fibrocystic disease of the breast

A

rarely needed to deprive the breast epithelium of estrogenic drive.

Surgery.(General 2).Breast (8 decks)

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