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Exam - M - Reproduction System (Megan and Rachel) > benign breast conditions > Flashcards

benign breast conditions Flashcards

1
Q

what is fibrocystic change

A

the stroma ducts and lobules of the breast respond to oestrogen and progesterone and become fibrous and cystic

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2
Q

why do the symptoms of fibrocystic change fluctuate

A

because the changes are in response to oestrogen and progesterone which fluctuate with the menstrual cycle

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3
Q

how does fibrocystic change present

A

lumpiness
mastalgia
fluctuation of breast size

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4
Q

how do you manage fibrocystic change

A 
wear supportive bra 
NSAIDs
avoid caffiene 
apply heat 
danazol (GnRH inhibitor)
tamoxifen (anti-oestrogen)
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5
Q

what is a fibroadenoma

A

benign tumour of stromal/epithelial cells of breast

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6
Q

what age group are fibroadenomas common in

A

adolescents

young adults

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7
Q

why do fibroadenomas regress in menopause

A

they respond to oestrogen and progesterone which decline in menopause

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8
Q

how does fibroadenoma present

A 
small mobile lump 
painless 
well circumscribed 
firm 
up to 3cm
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9
Q

what is an intraduct papilloma

A

benign tumour of milk duct

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10
Q

how does an intraduct papilloma present

A

lump
discharge
pain

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11
Q

what age group is usually effected by intraduct papillomas

A

middle aged

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12
Q

what investigations could you do in intraduct papilloma

A

FNA - epithelial hyperplasia

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13
Q

how do you manage intraduct papilloma

A

excision

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14
Q

what is fat necrosis of the breast

A

localised degeneration and scarring of fat tissue creates a benign lump
can be associated with an oil cyst
can cause fibrosis and necrosis

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15
Q

what causes fat necrosis

A

triggered by trauma

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16
Q

how does fat necrosis present

A

painless, firm, irregular lump
fixed
skin dimpling
nipple retraction

17
Q

what investigations could you do in fat necrosis

A

FNA - foamy cytoplasm

18
Q

how do you manage fat necrosis

A

conservative management

surgical removal if needed

19
Q

what is duct ectasia

A

dilation of large ducts in breasts
inflammation leads to discharge
and spooning leads to forking

20
Q

what are symptoms of duct ectasia

A 
discharge 
tenderness 
pain 
nipple retraction 
lump
21
Q

how could you manage duct ectasia

A 
exclude breast cancer 
reassure 
supportive bra 
warm compress 
antibiotics if needed 
surgical excision if needed
22
Q

what is phyllodes tumour

A

tumour of stroma cells in breast

large and fast growing

23
Q

what age group is phyllodes tumour common in

A

40-50yrs

24
Q

what are complications of phyllodes tumour

A

can metastasise - this requires chemo +/- surgical removal

25
Q

what are symptoms of phyllodes tumour

A

firm painless fast growing lump

26
Q

what is gynaecomastia

A

enlargement of glandular breast tissue in males

27
Q

what causes gynaecomastia

A

imbalance between oestrogen and androgens

28
Q

what are conditions that cause gynaecomastia by increasing oestrogen levels

A 
obesity (oestrogen stored in fat cells)
testicular cancer - leydig cell tumours 
liver cirrhosis/failure 
hyperthyroidism 
hCG secreting tumour
29
Q

what are conditions that cause gynaecomastia by decreasing testosterone

A 
testosterone deficiency in old age 
hypothalamus or pituitary conditions that decrease FSH and LH
klinefelter syndrome 
orchitis 
testicular damage
30
Q

what are drugs that cause gynaecomastia

A 
dopamine agonists 
anabolic steroids 
digoxin 
spironolactone 
GnRH analogues 
opiates 
marijuana 
alcohol
31
Q

how do you differentiate between gynaecomastia and fat on examination

A

gynaecomastia has firm tissue behind the areolas

fat is softer

32
Q

how do you manage gynaecomastia

A

bloods and imaging to find and treat underlying cause

tamoxifen and surgery in problematic cases

Exam - M - Reproduction System (Megan and Rachel) (45 decks)

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