Benign breast disease

Question 1

What are the modes of investigation for benign breast disease

Answer 1

mammogram

OR ultrasound and core biopsy (fine needle aspiration not used anymore)

Question 2

Patient has bilateral nipple discharge. What are you worried about?

Answer 2

benign breast disease, unlikely to be cancerous as it’s bilateral. If unilateral with blood/is clear then concern

Question 3

Which is the only benign breast disease where you might perform surgery?

Answer 3

mammary duct fistula. Abscess unlikely to require surgery

Question 4

List three signs of paget’s disease of the breast?

Answer 4

flaky skin around nipple, itching, redness, straw coloured/bloody discharge, lump

Question 5

Which condition is Paget’s disease most likely associated with?

Answer 5

most will have underlying ductal breast cancer

Question 6

List three benign inflammatory breast diseases

Answer 6

trauma- fat ncerosis
periductal mastitis
abscess

Question 7

List three proliferative benign breast diseases

Answer 7

fibroadenoma
cysts
fibrocystic disease
papilloma 
sclerosing adenosis

Question 8

What is a common presentation of fibroadenoma?

Answer 8

young woman, single firm smooth and mobile lump. Benign

Question 9

What is a common presentation of breast cyst?

Answer 9

may be multiple and can affect both breasts, occur in pre-menopausal women. Firm smooth lump ID on USS

Question 10

What is a common presentation of breast abscess?

Answer 10

usually post-partem, painful, red, hot, unwell and fever

Question 11

What is a common presentation of fibrocystic change?

Answer 11

very common, normal changes. Pre-menopausal women and has cyclical pattern. Diffuse lumpiness often in upper outer qaudrant associated with breast pain

Question 12

What is a common presentation of fat necrosis?

Answer 12

associated with prev trauma. Some bruising, may feel firm and irregular and be clinically suspicious of breast cancer

Question 13

List three differentials for breast pain

Answer 13

normal pre-menstrual cyclical pain
fibrocystic change/cysts
breast trauma
infection
MSK

Question 14

List three differentials for nipple discharge

Answer 14

pregnancy
duct ectasia
intra-duct papilloma
breast cancer
galactorrhoea- pituitary tumour

Question 15

List three differentials for gynaecomastia

Answer 15

chronic liver disease
adrenal tumour
drugs
physiological-puberty
testicular failure

Question 16

Phyllodes tumour arises where?

Answer 16

stromal tissue of the breast

Question 17

Name two inflammatory benign breast diseases

Answer 17

acute mastitis
fat necrosis
duct ectasia- common with aging (blockage of milk ducts)
periductal mastitis

Question 18

Patient is lactating and has painful red breast. Which inflammatory benign disease does she likely have?

Answer 18

acute mastitis

Question 19

Patient is a smoker and has painful erythematous sub-areolar mass. Which benign breast disease is this likely to be?

Answer 19

periductal mastitis

Question 20

25 y/o female with painless, mobile, rubbery mass in breast. Diagnosis?

Answer 20

fibroadenoma

Question 21

Define mastitis

Answer 21

Mastitis is inflammation of the tissue of the breast that occurs most frequently during the time of breastfeeding, often associated with infection

Question 22

Name two pre-cancerous breast conditions

Answer 22

Paget’s
LCIS
DCIS