Benign Breast Disease Flashcards
What are the four types of benign breast tumours?
Fibroadenoma
Intraductal Papilloma
Fat Necrosis
Phyllodes Tumour
What is another name for fibroadenomas?
Breast mouse
What is the most common benign growth of the breast?
Fibroadenoma
At what age do fibroadenomas tend to develop? What is the peak age?
Women of a reproductive age
Third decade
What are fibroadenomas?
They are defined as proliferations of stromal and epithelial tissue of the duct lobules
What are the four features of fibroadenomas on clinical examination?
Firm
Mobile
Well-circumcised
Non-tender
What is the malignant potential of fibroadenomas?
Low
How do we manage fibroadenomas? Why?
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
When do we consider excision of fibroadenomas?
When the lump measures more than 3cm in diameter
Patients preference
At what age do intraductal papillomas tend to develop?
40s and 50s
What are intraductal papillomas?
They are defined as local areas of epithelial proliferation in the lactiferous ducts
Where are intraductal papillomas located?
They arise in the subareolar region – less than 1cm away from the nipple
What are the clinical features of intraductal papillomas?
Nipple discharge - clear/bloody
However, larger papillomas can also initially present as a mass
How do we diagnose intraductal papillomas?
Mammograms - however, they can appear similar to ductal carcinomas
We therefore usually require biopsy to ensure there are no atypical or neoplastic cells present
How do we manage intraductal papillomas?
We usually conduct surgical excision
This is via microdochectomy
What is microdochectomy?
This is a surgical procedure involving the removal of one or all lactiferous ducts
What is fat necrosis?
A process in which benign breast lesions form in adipose tissue
Which patients tend to be affected by fat necrosis?
Obese women with large breasts
What does fat necrosis tend to follow from? How?
Trauma exposure
This trauma initiates an inflammatory response, producing mass
What are the two features of fat necrosis lumps?
Firm
Round
How do we diagnose fat necrosis?
Mammograms - however, they appear similar to liposarcomas
Therefore they usually require biopsy to ensure there are no atypical or neoplastic cells present
What are the three histological features of fat necrosis?
Foamy histiocytes
Lipid-filled cysts
‘Egg-shell’ calcifications
What are Phyllodes tumours?
They are rare fibroepithelial tumours of the breast, comprised of both epithelial and stromal tissue
Which patient group tend to be affected by Phyllodes tumours?
Older women
What are the two histological features of Phyllodes tumours?
They can be identified by their characteristic leaf-like projections of fibrous tissue
These masses consist of both connective tissue and epithelial elements
What is the malignant potential of Phyllodes tumours?
High
How do we manage Phyllodes tumours?
They are widely excised, and patients receive regular follow up appointments
In cases of large lesions, mastectomies are considered
