Benign Breast Disease

Question 1

define breast abscess

Answer 1

a localised collection of pus within the breast, usually caused by bacterial infection

Question 2

describe a lactational breast abscess

Answer 2

associated with breast feeding

found in peripheral breast region in outer and upper quadrants

Question 3

describe a non-lactational breast abscess

Answer 3

not associated with breast feeding

tend to be located in central and subareolar and lower quadrant of the breast

Question 4

common causes of breast abscesses

Answer 4

staph aureus
streptococcal
enterococcal
anaerobic bacteria

Question 5

risk factors of breast abscesses

Answer 5

smoking
nipple damage
trauma to breast
immunosuppression

Question 6

clinical features of breast abscess

Answer 6

history of recent mastitis or abscess
fever
general malaise
painful swollen breast lump

Question 7

investigation of breast abscess

Answer 7

US of breast

Question 8

medical management of breast abscess

Answer 8

antibiotics

• flucloxacillin for gram +ve
• co-amoxicalv for anaerobic

Question 9

surgical management of breast abscess

Answer 9

US-guided needle aspiration or surgical damage

- culture fluid

Question 10

define fat necrosis of the breast

Answer 10

a benign pathology of the breast that often occurs due to tissue trauma

Question 11

clinical features of fat necrosis of the breast

Answer 11

history of trauma
lumps of breast tissue
overlying skin inflammation and bruising

Question 12

investigations of fat necrosis of the breast

Answer 12

triple assessment to rule out malignancy

Question 13

management of fat necrosis of breast

Answer 13

reassurance as often resolve spontaneously

Question 14

define a fibroadenoma

Answer 14

benign tumour of fibrous and epithelial tissue arising from breast tissue lobules

Question 15

clinical features of fibroadenomas

Answer 15

20-40yr old women with:

firm + non tender lumps
rounded with smooth edge
highly mobile

Question 16

investigations of fibroadenomas

Answer 16

triple assessment to rule out underlying malignant pathology

Question 17

management of fibroadenomas

Answer 17

watchful waiting or surgical excision

Question 18

define mastalgia

Answer 18

pain of the breast that comes and goes with the menstrual cycle

Question 19

clinical features of mastalgia

Answer 19

bilateral and generalised breast pain occurring 2 weeks prior to menstruation
associated with feelings of breast heaviness and aching

Question 20

investigations of mastalgia

Answer 20

breast pain diary

Question 21

conservative management of mastalgia

Answer 21

reassurance
advise better fitting bra
advise heat application to area

Question 22

first-line management of mastalgia

Answer 22

analgesia

topical diclofenac

Question 23

second-line management of mastalgia

Answer 23

anti-gonadotrophin

tamoxifen