Benign Breast Disease

Question 1

What are the four types of benign breast tumours?

Answer 1

Fibroadenoma

Intraductal Papilloma

Fat Necrosis

Phyllodes Tumour

Question 2

What is another name for fibroadenomas?

Answer 2

Breast mouse

Question 3

What is the most common benign growth of the breast?

Answer 3

Fibroadenoma

Question 4

At what age do fibroadenomas tend to develop? What is the peak age?

Answer 4

Women of a reproductive age

Third decade

Question 5

What are fibroadenomas?

Answer 5

They are defined as proliferations of stromal and epithelial tissue of the duct lobules

Question 6

What are the four features of fibroadenomas on clinical examination?

Answer 6

Firm

Mobile

Well-circumcised

Non-tender

Question 7

What is the malignant potential of fibroadenomas?

Answer 7

Low

Question 8

How do we manage fibroadenomas? Why?

Answer 8

It involves routine follow up appointments over a two year period

In most cases, these benign masses will regress with age in the absence of treatment

Question 9

When do we consider excision of fibroadenomas?

Answer 9

When the lump measures more than 3cm in diameter

Patients preference

Question 10

At what age do intraductal papillomas tend to develop?

Answer 10

40s and 50s

Question 11

What are intraductal papillomas?

Answer 11

They are defined as local areas of epithelial proliferation in the lactiferous ducts

Question 12

Where are intraductal papillomas located?

Answer 12

They arise in the subareolar region – less than 1cm away from the nipple

Question 13

What are the clinical features of intraductal papillomas?

Answer 13

Nipple discharge - clear/bloody

However, larger papillomas can also initially present as a mass

Question 14

How do we diagnose intraductal papillomas?

Answer 14

Mammograms - however, they can appear similar to ductal carcinomas

We therefore usually require biopsy to ensure there are no atypical or neoplastic cells present

Question 15

How do we manage intraductal papillomas?

Answer 15

We usually conduct surgical excision

This is via microdochectomy

Question 16

What is microdochectomy?

Answer 16

This is a surgical procedure involving the removal of one or all lactiferous ducts

Question 17

What is fat necrosis?

Answer 17

A process in which benign breast lesions form in adipose tissue

Question 18

Which patients tend to be affected by fat necrosis?

Answer 18

Obese women with large breasts

Question 19

What does fat necrosis tend to follow from? How?

Answer 19

Trauma exposure

This trauma initiates an inflammatory response, producing mass

Question 20

What are the two features of fat necrosis lumps?

Answer 20

Firm

Round

Question 21

How do we diagnose fat necrosis?

Answer 21

Mammograms - however, they appear similar to liposarcomas

Therefore they usually require biopsy to ensure there are no atypical or neoplastic cells present

Question 22

What are the three histological features of fat necrosis?

Answer 22

Foamy histiocytes

Lipid-filled cysts

‘Egg-shell’ calcifications

Question 23

What are Phyllodes tumours?

Answer 23

They are rare fibroepithelial tumours of the breast, comprised of both epithelial and stromal tissue

Question 24

Which patient group tend to be affected by Phyllodes tumours?

Answer 24

Older women

Question 25

What are the two histological features of Phyllodes tumours?

Answer 25

They can be identified by their characteristic leaf-like projections of fibrous tissue

These masses consist of both connective tissue and epithelial elements

Question 26

What is the malignant potential of Phyllodes tumours?

Answer 26

High

Question 27

How do we manage Phyllodes tumours?

Answer 27

They are widely excised, and patients receive regular follow up appointments

In cases of large lesions, mastectomies are considered