benign breast disease Flashcards
what is mastalgia
breast pain
what are the 2 main patterns of mastalgia
cyclic and non-cyclic
when does cyclic mastalgia usually present
immediately before period starts
investigation of mastalgia
clinical exam
mammography or ultrasound - especially in women over 40
hormone profile to check for imbalances
supportive management of mastalgia
supportive bra, topical NSAID, simple analgesia
what is gynaecomastia
males develop breast tissue due to an imbalanced ratio of oestrogen and androgen activity
when does physiological gynaecomastia commonly occur and why
adolescence due to delayed testosterone surge relative to oestrogen at puberty
what are the 3 main groups of causes of pathological gynaecomastia
lack of testosterone
increased oestrogen
medications
name some causes of lack of testosterone in men
klinefelter’s syndrome, androgen insensitivity, testicular atrophy, renal disease
name some causes of increased oestrogen in men
liver disease, hyperthyroidism, obesity, adrenal tumours
what medication most commonly causes gynaecomastia
spironolactone
name some other drugs which might cause spironolactone
cimetidine, digoxin, cannabis
pathophysiology of gynaecomastia
ductal growth without lobular development
clinical presentation of gynaecomastia
rubbery or firm mass that starts underneath the nipple
medical management of gynaecomastia
tamoxifen
what is the most common benign breast growth
fibroadenoma
when do fibroadenomas usually present
women in their 20s
what is another name for a fibroadenoma
breast mouse
what do fibroadenomas feel like
mobile, well-defined, rubbery
what is a radial scar
benign sclerosing breast lesion
where do intraductal papillomas typically occur
subareolar region
how might intraductal papillomas present
nipple discharge - may be blood stained
management of radial scar
excise or sample extensively
what is the most common benign breast disorder
fibrocystic changes
