Benign Breast Conditions Flashcards
most common breast lesion
fibrocytic change
ill defined thickening/lumpiness of breast in female 40-55 yrs.
most likely?
fibrocytic change
microscopic appearance of fibrocystic change
combination of cyst formation, apocrine metaplasia, fibrosis, epithelial proliferation
describe the cysts in fibrocystic change
localised dilatation of lobular + terminal ductules
multiple + <1cm
thin walled
blue appearance on microscope
presentation of fibrocystic change
ill defined thickening/lumpiness
painless, firm, mobile mass in female <30
most likely?
fibroadenoma
pathology of fibroadenoma
localised hyperplasia – well defined mass
- proliferation of intralobular stroma
who is fibroadenoma common in
young females
more common in africans
what is a tubular adenoma
benign circumscribed lesion
similar presentation to fibroadenoma
who gets a tubular adenoma
30-40 year olds
40% related to pregnancy
what is a hamartoma
disordered collection of lobules, stroma + fat
presentation of hamartoma
well defined mass - often impalpable + detected by mammogram
can occur at any age but more common pre menopause
presentation of sclerosis adenosis
often detected by mammogram
but can present as pain, tenderness, lumpiness/thickening
sclerosis adenosis on mammogram
microcalcification - can be mistaken for invasive carcinoma
appearance of a radial scar on mammogram
spiculate mass
pathology of radial scar
central fibrous scarring + entrapped tubular structures
presentation of duct papilloma
nipple discharge - might be blood stained
describe a central duct papilloma
usually larger, single, occurs in main nipple ducts
describe a peripheral duct papilloma
smaller, multiple, associated with hyperplasia
– increased risk of carcinoma
presentation of phyllodes tumour
fast growing, unilateral well defined mass.
middle aged-elderly females
microscopic appearance of phyllodes tumour
‘leaf like’ clefts of epithelium
most common organism in acute pyogenic mastitis
staph aureus
most common cause of acute pyogenic mastitis
lactation – infection via ducts/abrasion of the nipple
Tx of acute pyogenic mastitis
send them home with hot compress + encourage breast feeding
give flucloxacillin if not improved with 24 hours
percutaneous drainage if abscess
presentation of TB in the breast
caeseating lesion
presentation of duct ectasia
nipple discharge -bloody and/or purulent
pathology of duct ectasia
dilatation of ducts containing foamy macrophages + surrounding chronic infiltrate + periductal fibrosis
feels like a ‘bag of worms’
duct ectasia
what is duct ectasia associated with
smoking
what is a galactocele
cystic swelling of a lactiferous duct that develops during lactation
NOT PAINFUL
what is contained in a galactocele
contains creamy, lipid rich fluid that gradually becomes watery
Tx of galactocele
drainage via FNA
who are breast abscesses most common in
lactating postpartum women
presentation of abscess
tenderness, pain, swelling
Tx of breast abscess
drainage with no.18 gauge needle
- repeat every 3 days if >10ml pus
- flucloxacillin
what is periductal mastitis
non-lactational/pregnancy related mastitis
who gets periductal mastitis
smokers
Tx of periductal mastitis
augmenting 625mg orally every 8hrs for 7 days
OR
Cephalexin 500mg orally every 6-7hrs for 7 days
what is fat necrosis
damage + disruption of adipocytes due to injury to fatty breast parenchyma
presentation of fat necrosis
hard lump
- granulomatous response with subsequent fibrosis + calcification
what is mastalgia
breast pain
presentation of cyclical mastalgia
premenopausal women- average age 34
discomfort/fullness/heaviness
can be unilateral/bilateral
presentation of non-cyclical mastalgia
older women - average age of 43
continuous burning pain
Tx of mastalgia
good fitting bra
topical NSAID
primrose oil
gamolenic acid/tamoxifen/bromocriptine if severe
what does bilateral milky discharge suggest
galactorrhea
drugs that can cause gynaecomastia
digoxin
spironolactone
anti-oestrogens
