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Breast > Benign Breast Lumps > Flashcards

Benign Breast Lumps Flashcards

1
Q

What are common breast lumps

A 
Fibroadenoma
Fibrocystic change
Breast cyst
Breast abscess
Breast calcification
Periductal mastitis
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2
Q

What are less common causes of breast lump

A 
Intraductal papilloma
Duct ecstasia
Fat necrosis
Phyllodes
Hyperplasia 
Mondor's 
Sclerosis
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3
Q

What is most common in young

A

Fibroadenoma

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4
Q

What is Mondor’s

A

Thrombophlebitis of veins

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5
Q

What causes breast cyst

A

Common as breast change due to oestrogen + menstrual
Stop after menopause
Common >35-60

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6
Q

What do cysts contain

A

Ducts fill up with clear fluid

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7
Q

How do cysts present

A

Cyclical pain
Lump - soft / hard / fluctuate
Usually oval or round

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8
Q

How do you investigate

A 
Triple assessment 
Examination 
USS
Mammogram
FNA if can easily feel 
FNA. / biopsy
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9
Q

What does USS show

A

Fluid

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10
Q

What does mammogram show

A

Halo

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11
Q

What do you do if FNA and no blood

A

No cytology needed

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12
Q

When do you send for biopsy / cytology

A

Indeterminate

Symptomatic

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13
Q

What is most common cause of breast lump in all ages

A

Fibrocystic change
Related to hormonal changes around menstrual cycle
Usually resolves after menopause

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14
Q

How does fibrocystic change present and how do you treat

A

Micro-cyst in breast
Bilateral lumpy breast
Bilateral breast pain / tenderness
Seen on USS

Rx

  • NSAID
  • Supportive clothing / bra
  • Weight loss
  • Hormones may worsen so consider stopping
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15
Q

What is fibroadenoma

A

Proliferation of epithelial and stroll elemenets
ONE BREAST LOBULE (not cell)
Hormone dependent
Can present up to menopause

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16
Q

How does fibroadenoma present

A 
Cirumscribed freely mobile
Smooth + rubbery
Firm 
Painless - can have pain
Can have multiple
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17
Q

What makes fibroadenoma increase in size

A

Pregnancy

18
Q

How do you investigate

A

Routine referral for triple asessment
Examine
USS / mammogram
Core biopsy

19
Q

When do you do biopsy and why

A 
If >3cm - also remove 
Exclude phyllodes (FNA can't differentiate)
20
Q

What is intraductal papilloma

A

Wart like small lump in lactiferous ducts

Epithelial hyperplasia

21
Q

How does it present

A

Discharge from single duct
Golden rich colour
Can be blood - found on dipstick if test
Middle age

22
Q

How do you Rx

A

Remove and assess as difficult to tell if malignant or not from triple assessment
Vigilant breast screening

23
Q

What causes fat necrosis

A 
Fibrosis and calcification after trauma = hard lump 
Trauma
Surgery
RT
Biopsy
24
Q

How does fat necrosis present

A

Firm round fixed lump
Painless
May cause skin dimpling or nipple inversion
May looked bruised / red / dimpled mimc cancer

25
Q

How do you Dx and Rx

A

Triple assessment to exclude cancer
Looks radiologically similar to cancer
Histology shows necrotic fat + lipid filled cyst

Rx = conservative or surgery

26
Q

What is a lactating adenoma

A

Enlarging mass in lactation and pregnancy

27
Q

What is a lipoma

A

Radiolucent common lesion
Benign collection of fat
Soft, painless and mobile lump up to 20cm

28
Q

What is a galactocele

A

Milk fluid filled cyst on aspiration due to occlusion of lactiferous duct
No pain / systemic Sx which differentiate from abscess

29
Q

When are galactocele common and how do you Dx

A

Pregnancy
Common after cease breast feeding
Increased prolactin
Can usually be Dx on clinical alone without need for further investigation if clear history

30
Q

When are haematoma in breast common

A 
Trauma
Biopsy
FNA
Anti-coagulant 
Can bleed into nipple
31
Q

Can you feel breast calcification

A

No
Radiologist decide if benign or malignant
May need biopsy
Can mark so know if been dealt with before

32
Q

What do all lumps require

A

Triple assessment

Biopsy if unsure

33
Q

What is normal LN

A

<0.5cm

34
Q

What is a skin cyst

A

Attached to skin NOT breast

35
Q

Polymastia

A

Extra breast

36
Q

Polythelial

A

Extra nipple

37
Q

What is Poland syndrome

A

Chest wall deformity

Absence of pec muscles so unilateral absence of breast

38
Q

Who is fat necrosis more likely I

A

Obesity

39
Q

How should you image bloody discharge e.g. intraductal papilloma

A

USS

40
Q

What else can you get

A

Lipoma
Soft and mobile
Excision based on patient prefernec e

Breast (6 decks)

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