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breast medicine > Benign conditions > Flashcards

Benign conditions Flashcards

1
Q

3(4) types of benign breast conditoins

A

Inflammatory
Proliferative
Benign neoplastic
(other)

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2
Q

Inflammatory Breast Conditions (3)

A

Fat Necrosis
Infection
Mammary duct ectasia

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3
Q

Proliferative Breast Conditions (2)

A

Fibrocystic change

Gynaecomastia

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4
Q

Benign Neoplastic Conditions (2)

A

Fibroadenoma

Duct Papilloma

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5
Q

“Other” Condtitions (3)

A

Peri-ductal mastitis
Galactocele
Mondor’s disease

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6
Q

Aetiology of Fat necrosis

A

Trauma>inflammatory response>mass

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7
Q

Characteristics of Fat necrosis

A

Firm, round irregular lump (may mimic ca.)

PAINLESS

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8
Q

Main groups affected by fat necrosis

A

Obese women with large breasts

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9
Q

Aetiology of mastitis

A

Infection of mammary duct with Staph. Aureus.

Associated with breast feeding.

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10
Q

Ix in Mastitis

A

USS to assess severity

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11
Q

Rx of mastitis

A

flucloxacillin

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12
Q

Characteristics and Rx of Breast abscess

A

hot, tender, painful swelling

excise and drain

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13
Q

Aetiology of Mammary duct ectasia

A

mammary duct blocked>secretions accumulate>dilatation>inflammation

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14
Q

At risk group of duct ectasia

A

peri-menopausal women

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15
Q

Presentation of duct ectasia (4)

A

Brown/bloody/green THICK nipple discharge (often bilateral)
Nipple RETRACTION+slit-like appearance
Lump
pain +erythema (ca. less likely)

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16
Q

Mx of duct ectasia

A

Usually no Rx needed.

17
Q

Features of fibrocystic change

A

Lumpy breasts and cobblestone texture

commonest cause of breast lumps

18
Q

Pathophysiology (2) and Epidemiology (1) of fibrocystic change

A

Affected by hormone levels (stops post-menopause)
Several years of fluctuating hormone levels>formation of multiple fibrous areas and cysts.
Mainly affects peri-menopausal women

19
Q

Presentation of fibrocystic change (3)

A 
Nodularity
Discrete lump (cyst)
Diffuse/ill-defined thickening
20
Q

Types of Fibrocystic change (7)

A

Adenosis(enlarge lobules, increased number of adeni, breast lump/pain, more common in young women)
Cysts (smooth discrete lump, halo sign on imaging, can be aspirated if symptomatic, may be fluctuant)
Epithelial hyperplasia (can have increased malignancy risk)
Lipoma
Apocrine metaplasia
Papillomatosis (finger-like projections)
Fibrosis

21
Q

Features(1)/Pathophysiology of gynaecomastia

A 
Benign enlargement of male breast-75% unilateral
Ductal proliferation (male breast has no lobules)
22
Q

Causes of gynaecomastia (7)

A

Physiological e.g. puberty (usually unilateral)
Endocrine disorders e.g. Kleinfelter’s (usually bilateral)
Endocrine therapy
Drugs (spironolactone,5-ARIs, ketoconazole, antipsychotics)
Malnutrition
Cirrhosis
Obesity (increased oestrogen)

23
Q

Pathophysiology of Fibroadenomas

A

Benign proliferation of collagenous mesenchyme

develop from a whole lobule

24
Q

Presentation of Fibroadenomas (4)

A 
Usually single lump
Mobile-"breast mice"
Smooth
Painless
(may grow rapidly in pregnancy)
25
Q

USS appearance of fibroadenomas

A

well-defined, oval lump

26
Q

Epidemiology of fibroadenomas

A

usually <30 yrs (most common lesion <35)

27
Q

Management of fibroadenomas

A

Observe

If suspicious USS +/-FNAC

28
Q

Features of duct papilloma (4)

A

Single
CENTRAL
finger-like projection
surrounded by benign epithelium

29
Q

Presentation of duct papilloma (2)

A

Nipple discharge-secretion +/- blood

Palpable breast lump

30
Q

Imaging and histology of duct papilloma

A

lump seen protruding into duct

31
Q

Rx of duct papilloma

A

microdochectomy (surgical removal of lactiferous duct)

32
Q

Presentation of peri-ductal mastitis

A

Presents at younger age than ductal ectasia

may present with features of inflammation, abscess or mammary duct fistula

33
Q

Associations of peri-ductal mastitis

A

associated with nipple inversion and purulent discharge.

STRONG association with smoking

34
Q

Treatment of peri-ductal mastitis

A

antibiotics

incision and drainage of abscesses

35
Q

Galactocele pathophysiology

A

Lactiferous duct blocked by milk protein

36
Q

Features of galactocele (3)

A

similar to fibroadenoma-smooth, mobile lump
in breast-feeding woman
mild pain
(fibroadenoma+breast feeding=galactocele)

37
Q

Definition of Mondor’s disease

A

Thrombophlebitis of superficial veins of the breast

Causes tender, subcutaneous cords

38
Q

Acute and Chronic Features of Mondor’s Disease

A

Acute phase: erythema, redness and cord-like structure

Chronically: heals to form area of fibrosis that may be tethered to skin.

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