Benign Breast Conditions Flashcards
What are the 4 types of benign breast lumps?
Fibroadenoma
Cyst
Traumatic fat necrosis
Phylloides tumour
What are 3 main inflammatory benign breast conditions?
Periductal mastitis
Acute bacterial mastitis
Abscess
What is a fibroadenoma?
What would be the characteristics of fibroadenoma lump?
What is the management?
Most common breast lesion (tends to occur in 2nd decade of life)
Hyperplastic or proliferative process in single terminal ductal unit (TDLU) in stromal and glandualr tissue
Termed a “breast mouse”
- rubbery
- firm
- painless
- oval/smooth/well-defined borders
- mobile + not attached to skin
Reassurance + monitoring (can grow or regress)
What is a breast cyst?
How would someone typically present?
What is the management?
Fluid-filled lobule
Presentation:
- perimenopause>post-menopause
- changes related to menstrual cycle i.e. increased size and pain before menstruation
- single/multiple fluctuations smooth lumps
- short hx
- pain and tender
Management:
- Reassurance and advice
- Aspiration
What is traumatic fat necrosis?
How does it typically present? What is significant about this?
What is the management?
Iatrogenic or blunt trauma causes breakdown of adipose tissue (fat necrosis)
Presents:
-mimics breast carcinoma (painless irregular firm lump)
-itching and retraction
-+/- bruising
NOTE: Biopsy only way to confirm as imaging v similar to carcinoma
Management:
-conservative as should resolve (may leave fat cyst)
What is Phyllodes tumour?
How does it present?
How is it managed?
Rare tumour arising from stromal cells which has “leafy” appearance on histopathology (can be benign/borderline/malignant)
Presentation:
- F 40-50
- firm mobile, well-circumscribed
- non tender
- short hx-> grow fast
Management:
- wide excision
- regular mammograms-> monitor for progression to malignancy
Why does gynaecomastia occur in males?
What would be the typical presentation?
How are they managed?
Alternated oestrogen-androgens balance which causes proliferation of breast tissue in males
Due to:
-drugs (spironalactone/digoxin/cimetidine)
-liver cirrhosis
-testicular tumour
-hypogonadism
-idiopathic
Presentation:
- small rubbery/firm mass extending behind the nipple
- diffuse soft swelling
- uni or bilateral
Management:
- manage cause-> usually resolve
- liposuction/excision/cosmetic surgery
What is periductal mastitis?
What is a risk factor for this?
How does it typically present?
How is it managed?
Inflammation around dilated milk ducts due to duct ectasia (dilation of major ducts in subareolar region)
Smoking- damages the subareolar ducts
Presentation:
- pain
- nipple discharge/retraction
- cellulitis
- subareolar mass
- mammary duct fistula
Management:
- antibiotics
- total duct excision +/- excision of fistula
What is acute bacterial mastitis and why does it usually occur + which organism are associated?
How does it present?
How it managed?
Bacterial infection which can cause cellulitis and abscess formation
Causes:
-associated with lactation= staph aureus
-Immunocompromised= diabetes and steroid therapy (streptococci, enterococci, bacteroides)
Presentation:
- breast inflammation (erythema/pain/swelling/tender/warmth)
- localised or wide-spread
- fluctant mass if abscess formed
- signs if systemic infection
Management:
- Abx
- advice to continue breast feeding
- aspiration of abscess
- Incision +Drainage (I+D) if abscess doesn’t resolve with aspiration
