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Reproduction SOH > Benign Breast Disease > Flashcards

Benign Breast Disease Flashcards

1
Q

What is involved in triple assessment?

A

Clinical
Radiology
Cytopathology/histopathology

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2
Q

Triple assessment - clinical

A

History

Examination

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3
Q

Triple assessment - radiology

A

Mammography - over 40

US - under 40

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4
Q

Triple assessment - cytopathology / histopathology

A 
FNA - uncommon 
Needle core biopsy - common
Vacuum assisted biopsy 
Skin biopsy
Incisional biopsy
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5
Q

Gynaecomastia - definition

A

Breast development in the male

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6
Q

Gynaecomastia is related to breast cancer. True or false?

A

False

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7
Q

Gynaecomastia - lobular/ductal growth without lobular/ductal development

A

DUCTAL growth without LOBULAR development

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8
Q

Gynaecomastia - causes

A

Cannabis
Hormones
Prescription drugs: spironolactone
Liver disease

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9
Q

Fibrocystic change - who gets it

A

Commonest cause of a breast lump in women age 30-50

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10
Q

Fibrocystic change - is it related to the menstrual cycle?

A

Yes, usually occurs at the end of period when breast fills up with fluid

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11
Q

Fibrocystic change - how does it occur?

A

During the evolution of breast tissue, the breast changes

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12
Q

Fibrocystic change usually persists through menopause. True or false?

A

False

- often resolves after menopause

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13
Q

Fibrocystic change - clinical features

A 
Clearly defined
Palpable 
Soft 
Tender
Smooth lump 
Menstrual cycle related pain
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14
Q

Fibrocystic change - what do the cysts look like?

A

vary in size (from 1mm -> several cm).
Blue domed with pale fluid.
Usually multiple and bilateral

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15
Q

Fibrocystic change - investigation

A

FNA

  • aspirate as much fluid as possible
  • only grossly bloody fluid needs to be sent for cytological evaluation
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16
Q

Fibrocystic change - routine management is to excise. True or false?

A

False

- only need to reassure patient that it is nothing to worry about

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17
Q

Hamartoma - definition

A

Collection of normal breast structures that present in an abnormal and disorganised distribution

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18
Q

What is the most common cause of a breast lump in under 30 year olds?

A

Fibroadenoma

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19
Q

Fibroadenoma - clinical presentation

A 
Painless 
Palpable mass
Firm
Smooth
Mobile mass
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20
Q

Fibroadenoma - pathology

A 
Well rounded
Rubbery 
Soft appearance 
Grey-white colour 
Biphasic tumour/lesion
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21
Q

Fibroadenoma investigations in under 40 year old

A

US (looks solid)

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22
Q

Fibroadenoma investigations in over 40 year old

A

Mammography

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23
Q

Fibroadenoma - routine management is excision. True or false?

A

False

  • reassure patient
  • commonly becomes non-palpable after menopause
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24
Q

Fibroadenoma - what are 2 methods of excision?

A

Lumpectomy

Vacuum assisted core biopsy

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25
Q

Sclerosing lesions - what are the 2 types?

A

Sclerosing adenosis

Radial scar

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26
Q

Sclerosing adenosis - clinical features

A

Pain
Lumpiness
May be asymptomatic

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27
Q

Sclerosing adenosis - who commonly gets it?

A

20-70 year olds

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28
Q

Radial scar - clinical features

A

Often an incidental finding
Central puckering
Radiating fibrosis

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29
Q

In situ or invasive carcinoma may occur within radial scars. True or false?

A

True

30
Q

Which clinical condition may mimic a carcinoma radiologicallly?

A

Radial scar

31
Q

Radial scar - routine management is to excise. True or false?

A

True

32
Q

What is mastalgia?

A

Breast pain

33
Q

Mastalgia is not usually related to the menstrual cycle. True or false?

A

False

- it is

34
Q

Mastalgia in a patient over 35

A

Investigate with mammogram

35
Q

Mastalgia - management

A

Well fitting bra

Regular exercise

36
Q

How does fat necrosis occur?

A

When there is damage and disruption of adipocytes ->
Infiltration by acute inflammatory cells ->
subsequent fibrosis and scarring

37
Q

What causes fat necrosis?

A

Local trauma (eg seatbelt injury)

38
Q

Duct ectasia - definition

A

Peri-ductal inflammation which affects sub-areolar ducts

39
Q

Duct ectasia - clinical features

A

Pain
Acute episodic inflammatory changes
Bloody and/or purulent discharge

40
Q

Duct ectasia - management

A

Treat acute infection with antibiotics
Exclude malignancy
Excise ducts

41
Q

Duct ectasia - what is it associated with?

A

Smoking

42
Q

What are the 2 causes of acute mastitis?

A

Duct ectasia

Pregnancy/lactation

43
Q

Duct ectasia - causative organisms

A

Mixed organisms

Anaerobes

44
Q

Duct ectasia - which antibiotics do you use?

A

Metronidazole

45
Q

Pregnancy/lactation related acute mastitis - what are the causative organisms?

A

Staph aureus

Strep pyogenes

46
Q

Pregnancy/lactation related acute mastitis - breast feeding should not be continued. True or false?

A

False

- breast feeding should be continued

47
Q

Acute mastitis - clinical features

A

Fever
Erythema
Tenderness
Swelling

48
Q

Acute mastitis - management

A

US guided drainage
Antibiotics
Incision and drainage

49
Q

Pregnancy/lactation related acute mastitis - which antibiotics should you use?

A

Flucloxacillin for 7 days

50
Q

Abscess - definition

A

Floculent mass usually located in the central area of mastitis

51
Q

Abscess - investigations

A

US - reveals a fluid filled (pus) centre

52
Q

Abscess - management

A

US guided drainage

Aspiration with an 18 gauge needle

53
Q

Phyllodes tumour - definition

A

Slow growing unilateral breast mass
Biphasic tumour
Stromal overgrowth

54
Q

Phyllodes tumour - why must it be adequately excised?

A

It is prone to local recurrence

55
Q

What other benign breast condition does a phyllodes tumour resemble?

A

Fibroadenoma

56
Q

Phyllodes tumour is only benign and has no malignant potential. True or false?

A

False

- there are benign, intermediate and malignant types

57
Q

Phyllodes tumour - management

A

Excision with wide 1cm clear surgical margins

58
Q

Intraduct papilloma affects which ducts?

A

Sub-areolar ducts

59
Q

Intraduct papilloma - clinical features

A

Bloody nipple discharge

60
Q

Intraduct papilloma - possible features on screening

A

Calcification

61
Q

Intraduct papilloma - pathology

A

Cauliflower like extension of a cyst

May have cancer cells inside of it

62
Q

Intradcut papilloma - investigations

A

Mammography

US guided core needle biopsy

63
Q

50 year old presents with bloody nipple discharge - most likely to be which condition?

A

Intraduct papilloma

64
Q

45 year old presents with a unilateral breast mass. Pathology report reveals a stream overgrowth. What is the likely diagnosis?

A

Phyllodes tumour

65
Q

32 year old female develops a red, swollen, tended left breast. She is currently breast feeding. What is the likely diagnosis? How should she be managed?

A

Acute mastitis

Management

  • antibiotics: flucloxacillin
  • continue breast feeding or use pump to express until mastitis clears
66
Q

Which benign breast disease is commonly associated with smoking?

A

Duct ectasia

67
Q

Post menopausal female with greenish nipple discharge and associated mastalgia. Her nipple looks distorted. What is the likely diagnosis?

A

Duct ectasia

68
Q

Star shaped breast mass which has central puckering. What is the diagnosis?

A

Radial scar

69
Q

Which benign breast disease is most likely to mimic cancer?

A

Radial scar

70
Q

27 year old female presents with a painless palpable, smooth, firm mobile mass. What is the likely diagnosis?

A

Fibroadenoma

71
Q

40 year old woman with breast lump. What is the most likely diagnosis?

A

Fibrocystic change (breast cyst)

Reproduction SOH (50 decks)

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