Benign Breast Disease Flashcards
What are fibroadenomas?
Fibroepithelial tumours which involve proliferation of the stromal and epithelial tissues of the gland
They are the most common benign breast tumour
What are the clinical features of a fibroadenoma?
Breast lump
Painless, smooth, rubbery and mobile
Usually <5cm
What is the management of a fibroadenoma?
Triple assessment
Once the diagnosis is confirmed, they can be left in-situ as they are likely to self-resolve or reduce and they are monitored over 2 years
Larger adenomas may require a surgical excision
What is fibrocystic disease?
The commonest cause of breast lumpiness in premenopausal women
Characterised by an overgrowth of the fibrous stroma and epithelial elements within the duct
It is caused by an imbalance of the sex hormones. The symptoms are cyclical and tend to peak before menstruation.
How is fibrocystic disease treated?
Conservative
Medical: analgesia, aspiration, medications to alter hormones e.g. bromocriptine
Surgical: mastectomy for severe mastalgia
What is a breast cyst?
A cyst is an epithelial-lined fluid-filled cavity. In the breast, they are formed in the presence of ductal blockage which causes the distension of lobules.
They are most common in perimenopausal women.
How do breast cysts present?
Breast lump (single or multiple)
They can be painful
Halo shape on mammogram, clear fluid on aspiration with resolution of the mass
What is fat necrosis?
Pathology associated with trauma to the breast
Acute inflammation of the breast leading to ischaemic necrosis of the fat lobules
It is usually self-limiting, but excision biopsy may be needed if it persists or if there is diagnostic uncertainty
What is duct ectasia?
Benign disease characterised by involution and dilatation of the subareolar ducts
Typically affects older women and strongly associated with smoking
Green or blood-stained nipple discharge, microcalcifications on mammogram
What is an intraductal papilloma?
Benign polyp of the ductal epithelium which tends to lie close to the nipple
Presents with bloody or clear nipple discharge
They only increase the risk of breast cancer if they are multiductal
How is intraductal papilloma managed?
Microdochectomy
