Benign Breast Disorders Flashcards
What is an infection of the breast
Mastitis
What is the most common organism causing mastitis
S. aureus
What is the main risk factor of developing mastitis
Breast feeding
What are some symptoms of mastitis
Fever, tenderness, erythema, induration, unilateral, warmth
What is the treatment for mastitis
Dicloxacillin 500mg
Can a patient who has mastitis still breastfeed
Yes
What is a complication of mastitis and what is the treatment
Breast abscess you will need to I&D
What are the worrisome signs with nipple discharge
Serous, bloody Spontaneously comes out Unilateral Secretes from one duct Mass present
What is a common cause of bloody nipple discharge
Intraductal papilloma, invasive papillary carcinoma
What is a common cause of galactorrhea
Pregnancy, pituitary adenoma, thyroid disease, meds, stress
What is a common cause of serous nipple discharge
Normal menses, OCP, early pregnancy, fibrocystic changes
What is a common cause of yellow tinged nipple discharge
Fibrocystic changes, galatocele
What is a common cause of green and sticky nipple discharge
Duct ectasia
What is a common cause of purulent nipple discharge
Breast abscess
Name the dx.
A patient comes to you with milky nipple discharge from both breast. On exam there are no masses noted. Patient stated that she is not breastfeeding
Galactorrhea
What is galactorrhea due to
High levels of prolactin (Hyperprolacinemia)
What do you want to do to work up a patient with bilateral milky discharge in a non-lactating women
This is galactorrhea want to get the following;
TSH, prolactin level, and review meds
Consider MRI
Is breast pain a common symptom of breast cancer
No
How do you normally treat breast pain
Tylenol or NSAIDS
What are some sx of a worrisome breast mass
Dominant mass, dense/firm, irregular, immobile, LN>1cm, firm, matted, more than one, bloody discharge
What can an US tell you on a breast mass
Helps distinguish if its solid or cystic
What type of masses and mammograms evaluate
Solid
What hormone is known to commonly cause fibrocystic changes
Estrogen
What type of sx does someone with fibrocystic changes of their breast have
Breast pain/tenderness that is cyclic
Focal or multiple areas
Worse in perimenstrual phase
May have serous nipple discharge
What do you want to do to dx a fibrocystic changes in the breast
US or mammogram
Why cant you use mammograms in a younger women
Not as acccuarate because younger women have more Dense breast tissue
What is the treatment for fibrocystic changes of the breast
Wear a supportive bra
NSAIDS/Tylenol
What is the most common benign breast tumor in young women
Fibroadenoma
When can a fibroadenoma increase in size
During pregnancy or estrogen use
How does a typical fibroadenoma feel
Round, well-circumsized, mobile, rubbery mass, non-tender
How do you treat a fibroadenoma
After benign imaging can follow-up in 3-6 months with repeat US
What is an uncommon fibroepitheal breast tumor
Phyllodes tumor
What does a phyllodes tumor look like
Large mass (4-7cm) bulky, overlaying skin warm and red, grow rapidly
What do you need to do for a phyllodes tumor
core needle biopsy bc of risk of malignancy
What is the treatment of a phyllodes tumor
Wide local excision with 1cm margins
What is the most common cause of bloody discharge
Intraductal papilloma
What is a benign solitary lesion involving epithelial lining of lactiferous ducts
Intraductal papilloma
What is the treatment of a intraductal papilloma
Diagnosis and treatment is excision of involved ducts
In what age do intraductal papilloma occur in
Post menapausal women
What is acute/chronic inflammation of the ductal system that causes dilation of mammary ducts
Mammary duct ectasia
Name the dx.
A 50 y/o women presents to you with a green sticky nipple discharge that is bilateral. She is having some tenderness and redness surrounding her nipples
Mammary duct ectasia
How do you diagnose mammary duct ectasia
Mammo and excisional biopsy to rule out malignancy
What is the treatment for mammary duct ectasia
Local excision of the inflamed area and sometimes needs duct excision
What is a milk filled cyst from a plugged milk duct, during pregnancy, breastfeeding, or weaning
Galactocele
Name the dx.
A breastfeeding patient comes to you with a round mobile mass in her left breast. She has noticed a whitish, yellow discharge from that breast. There is no pain associated with her sx
Galactocele
How do you diagnose a galactocele
US-helps to differenciate from other causes
aspiration of fluid-confirms the dx
How do you treat a galactocele
Repeated aspiration or excision if bothersome
Can you continue breastfeeding during treatment of a galactocele
Yes
