Benign breast conditions

Question 1

Two types of breast infection?

Which bugs?

Management?

Answer 1

Commonly S. aureus
Then anaerobes

Lactational:

• Flucloxacillin
• Pen allerg: Erythromycin

Non-lactational:

• augmentin or flucloxacillin (or erythromycin if pen allerg)
• AND metronidazole

Question 2

Causes of benign breast lumps? Who gets them?

Answer 2

1. nodularity: normal, cyclical, more prominent pre-menses
2. fibroadenoma: common, benign, young women
3. Cysts: response to hormones, 40-60 years

Question 3

What is a fibroadenoma?

On examination?

Management?

Answer 3

A benign growth of stromal (connective) and epithelial cells

Common, not precancerous

Seen in young women

Mobile

1/3 shrink, 1/3 stay same, 1/3 enlarge

Only need surgical treatment if bigger than 3cm

Question 4

What are breast cysts?

OE?

How do we know its benign and not cancerous?

Answer 4

An abnormal response to hormonal stimulation

Commonly in ages 40-60

Smooth well defined lump

Benign if:

• not blood stained
• cyst doesn’t refill
• no residual lump

Drain it, monitor for signs of Ca

Question 5

What is gynaecomastia?

Causes?

Answer 5

> 2cm breast tissue behind male nipple

Physiological: slight imbalance of oestrogen or testosterone

Drugs: spironolactone, digoxin, anabolic steroids

Liver, renal failure

Question 6

What is a duct papilloma?

How do they present?

Answer 6

Benign lesion growing within duct of breast tissue

Often present with nipple discharge, can present as mass if bigger.