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Surgery.(General 2).Breast > 8. Benign tumours of the female breast > Flashcards

8. Benign tumours of the female breast Flashcards

1
Q

Benign tumours of the female breast

A
  • Duct papilloma

* Fibroadenoma

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2
Q

Duct papilloma In Benign tumours of the female breast

A
  • Etiology
  • Pathology
  • Clinical Picture
  • Investigations
  • Treatment
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3
Q

Etiology of Duct papilloma In Benign tumours of the female breast

A
  1. Benign tumour arising from the columnar epithelium of the ducts
  2. Excessive localization of epitheliosis of ANDI
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4
Q

Pathology of Duct papilloma In Benign tumours of the female breast

A
  • Cell of origin
  • Composition
  • Ulceration
  • Blocking the duct
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5
Q

Cell of origin in Pathology of Duct papilloma In Benign tumours of the female breast

A

arises in one of the main ducts near the nipple in a Young woman

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6
Q

Composition in Pathology of Duct papilloma In Benign tumours of the female breast

A

composed of vascular C.T Core Covered by hyperplastic columnar epithelium

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7
Q

Ulceration in Pathology of Duct papilloma In Benign tumours of the female breast

A
  • Before it becomes big enough to form a palpable lump, it usually ulcerates
  • Causes bleeding per nipple
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8
Q

Blocking the duct in Pathology of Duct papilloma In Benign tumours of the female breast

A

causes a retention cyst.

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9
Q

Clinical Picture of Duct papilloma In Benign tumours of the female breast

A
  1. Bleeding per nipple

2. Retroareolar retention cyst may be felt

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10
Q

Pathogenesis of Retroareolar retention cyst in Clinical Picture of Duct papilloma In Benign tumours of the female breast

A

due to obstruction of the duct

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11
Q

Investigations of Duct papilloma In Benign tumours of the female breast

A
  1. Differential pressure
  2. Ductography
  3. Cytology For the discharge
  4. Mammography & complementary breast U/S :
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12
Q

Benefits of Differential pressure in Investigations of Duct papilloma In Benign tumours of the female breast

A

To localize the papilloma

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13
Q

Finding of Ductography in Investigations of Duct papilloma In Benign tumours of the female breast

A

Shows the lesion as a filling defect

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14
Q

Benefits of Mammography & complementary breast U/S in Investigations of Duct papilloma In Benign tumours of the female breast

A

to detect non palpable lump.

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15
Q

Treatment of Duct papilloma In Benign tumours of the female breast

A

Microdochectomy

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16
Q

Microdochectomy in Treatment of Duct papilloma In Benign tumours of the female breast

A
  • Excision of the affected duct in duct papilloma

* The duct is identified at operation by passing a blunt tipped needle through the discharging nipple opening

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17
Q

Fibroadenoma In Benign tumours of the female breast

A
  • Incidence
  • Etiology
  • Pathology
  • Clinical picture
  • Differential Diagnosis
  • Investigations
  • Treatment
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18
Q

Incidence of Fibroadenoma In Benign tumours of the female breast

A

The commonest benign breast mass of females

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19
Q

Etiology of Fibroadenoma In Benign tumours of the female breast

A
  1. Benign tumour arising from both fibrous & glandular elements.
  2. Excessive localization of fibrosis & adenosis of ANDI
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20
Q

Pathology of Fibroadenoma In Benign tumours of the female breast

A

There are two types:

  1. Pericanalicular fibroadenoma
  2. Intracanalicular fibroadenoma
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21
Q

Pericanalicular fibroadenoma in Pathology of Fibroadenoma In Benign tumours of the female breast

A
  • Alternative name

* Composition

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22
Q

Alternative names for Pericanalicular fibroadenoma in Pathology of Fibroadenoma In Benign tumours of the female breast

A

Hard fibroadenoma

breast mouse because it’s mobile all over

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23
Q

Composition of Pericanalicular fibroadenoma in Pathology of Fibroadenoma In Benign tumours of the female breast

A
  • These tumours are formed mainly of fibrous tissue & Iess glandular element
  • They tend to be small.
24
Q

Intracanalicular fibroadenoma in Pathology of Fibroadenoma In Benign tumours of the female breast

A
  • Alternative name

* Composition

25
Q

Alternative name for Intracanalicular fibroadenoma in Pathology of Fibroadenoma In Benign tumours of the female breast

A

Soft fibroadenoma

26
Q

Composition of Intracanalicular fibroadenoma in Pathology of Fibroadenoma In Benign tumours of the female breast

A

Contains more glandular element than fibrous tissue .

The markedly dilated acini

They are usually larger and softer than the pericanalicular type.

27
Q

The markedly dilated acini in Composition of Intracanalicular fibroadenoma in Pathology of Fibroadenoma In Benign tumours of the female breast

A

showing projections inside

The fibrous tissue is loosely arranged around them (hence the false name intracanalicular).

28
Q

Clinical Picture of Fibroadenoma In Benign tumours of the female breast

A
  • Symptoms
  • Examination
  • Other clinical variants for soft fibroadenoma
29
Q

Symptoms in Clinical Picture of Fibroadenoma In Benign tumours of the female breast

A
  • Accidentally discovered painless lump
  • Age of presentation in Hard fibroadenoma
  • Age of presentation in soft fibroadenoma
30
Q

Age of presentation in Hard fibroadenoma in Clinical Picture of Fibroadenoma In Benign tumours of the female breast

A

commonly in young women 20-30 years of age

31
Q

Age of presentation in soft fibroadenoma in Clinical Picture of Fibroadenoma In Benign tumours of the female breast

A

between the ages of 30-50 years.

32
Q

Examination in Clinical Picture of Fibroadenoma In Benign tumours of the female breast

A

a. Breast :

b. Axillary L.N.:

33
Q

Breast Examination in Clinical Picture of Fibroadenoma In Benign tumours of the female breast

A

Mass with the following criteria :

  1. Size
  2. Shape
  3. Surface
  4. Mobility
  5. Edge
  6. Consistency
34
Q

Size of the breast Mass in Breast Examination in Clinical Picture of Fibroadenoma In Benign tumours of the female breast

A
  • Small in hard fibroadenoma

* large in soft fibroadenoma.

35
Q

Shape of the breast Mass in Breast Examination in Clinical Picture of Fibroadenoma In Benign tumours of the female breast

36
Q

Surface of the breast Mass in Breast Examination in Clinical Picture of Fibroadenoma In Benign tumours of the female breast

A

Smooth in hard fibroadenoma

lobulated in soft fibroadenoma.

37
Q

Mobility of the breast Mass in Breast Examination in Clinical Picture of Fibroadenoma In Benign tumours of the female breast

A

Mobile all over ( hard fibroadenoma is called breast mouse).

38
Q

Edge of the breast Mass in Breast Examination in Clinical Picture of Fibroadenoma In Benign tumours of the female breast

A

Well circumscribed.

39
Q

Consistency of the breast Mass in Breast Examination in Clinical Picture of Fibroadenoma In Benign tumours of the female breast

A
  • Firm in pericanalicular ( hard ) fibroadenoma

* soft in intracanalicular ( soft ) fibroadenoma.

40
Q

Axillary L.N Examination in Clinical Picture of Fibroadenoma In Benign tumours of the female breast

A

Not enlarged

41
Q

Other clinical variants for soft fibroadenoma in Clinical Picture of Fibroadenoma In Benign tumours of the female breast

A
  1. Giant fibroadenoma

2. Cystosarcoma phylloides “serocystic disease of Brodie”.

42
Q

Age of presentation of Giant fibroadenoma in Other clinical variants for soft fibroadenoma in Clinical Picture of Fibroadenoma In Benign tumours of the female breast

A

Occur during puberty

43
Q

Cystosarcoma phylloides in Other clinical variants for soft fibroadenoma in Clinical Picture of Fibroadenoma In Benign tumours of the female breast

A
  • Alternative name
  • The reason why it’s called so
  • Pathology
  • Differential diagnosis
44
Q

Alternative name for Cystosarcoma phylloides in Other clinical variants for soft fibroadenoma in Clinical Picture of Fibroadenoma In Benign tumours of the female breast

A

serocystic disease of Brodie

45
Q

The reason why it’s calledCystosarcoma phylloides “serocystic disease of Brodie” in Other clinical variants for soft fibroadenoma in Clinical Picture of Fibroadenoma In Benign tumours of the female breast

A

lt was so named by Brodie who used the term phylloides

because the cut surface resembles a leaf of fern.

the term cystosarcoma is misnomer as many are not cystic and it’s not malignant

46
Q

Pathology of Cystosarcoma phylloides in Other clinical variants for soft fibroadenoma in Clinical Picture of Fibroadenoma In Benign tumours of the female breast

A
  • This is highly cellular type of fibroadenoma that grows rapidly
  • The tumour tends to enlarge and to reach a large size, 20-30 cm in diameter
  • causing pressure necrosis of the overlying skin without infiltrating it & the tumour fungates from it.
47
Q

Differential diagnosis of Cystosarcoma phylloides in Other clinical variants for soft fibroadenoma in Clinical Picture of Fibroadenoma In Benign tumours of the female breast

A

Fungating carcinoma

48
Q

to differentiate between cystosarcoma phylloides and fungating carcinoma do :

A

Probe test

positive in cystosarcoma phylloides

49
Q

Differential diagnosis of Soft Fibroadenoma In Benign tumours of the female breast

A

medullary breast carcinoma

50
Q

Investigations of Fibroadenoma In Benign tumours of the female breast

A
  1. The clinical features are usually enough for diagnosis of hard fibroadenoma.
  2. however triple assessment is done in both types.
51
Q

Treatment of Fibroadenoma In Benign tumours of the female breast

A

Treatment of :

Hard fibroadenoma

Soft fibroadenoma

Giant fibroadenoma

cystosarcoma phylloides

52
Q

Treatment of hard fibroadenoma in Treatment of Fibroadenoma In Benign tumours of the female breast

A
  • Excision via a circumareolar incision.

* sent for histopathology

53
Q

Treatment of soft fibroadenoma in Treatment of Fibroadenoma In Benign tumours of the female breast

A
  • Excision

* sent for histopathology

54
Q

treatment of Giant fibroadenoma in Treatment of Fibroadenoma In Benign tumours of the female breast

A
  • Gillard thomas incision

* sent for histopathology.

55
Q

Gillard thomas incision in treatment of Giant fibroadenoma in Treatment of Fibroadenoma In Benign tumours of the female breast

A

Wide local excision via a submammary incision to treat Giant fibroadenoma

56
Q

Treatment of cystosarcoma phylloides in Treatment of Fibroadenoma In Benign tumours of the female breast

A

a. If not huge: Wide local excision and sent for histopathology.
b. If very huge or fungating: Simple mastectomy.

57
Q

Mondor’s disease

A

It is thrombophlebitis of the superficial veins of the breast and anterior chest wall of unknown cause.

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

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