Benign conditions of the breast Flashcards
What are the main symptoms of breast conditions
Pain
Lump
Discharge
What are the most common causes of breast pain
Fibroadenosis
Costochondritis/Tietz syndrome
Infections
What are breast lumps commonly caused by
- Fibroadenosis
- Fibroadenoma
- Cysts
- Mammary duct ectasia
- Infections: abscess
- Phylloides tumours
- Fat necrosis
- Cancer
What are nipple discharges commonly caused by
Breast feeding
Prolactinoma
Mammary duct ectasia
Intraduct papillomas
Cancer
Explain fibroadenosis/ANDI
It is a normla physiological response that is associated with the menstrual cycle and PMS.
Caused by elevated levels of progesterone
Leads to pain and nodularity
Explain costochondritis/Tietz syndrome
It is pain from the chest wall that is referred to the breast and back
Can mimic angina
It is caused by trauma but frequently no cause
Explain mastitis
It is found in the breast feeding population.
Caused by normal commensal skin organisms as breast milk is a good culture medium
Organisms gain access through cracks and fissures in nipple
Painful lactation and stasis develops
Cellulitis of breast
Treat with antibiotics and emptying the breast
Explain mammary duct ectasia
It is due to the degeneration of myo-epithelial cell layer of the breast seen in older patients.
In non-lactating breast function mostly to empty ducts of desquamated endothelial cells
Dead cells build up leading to keratin plugs.
Inflammatory reaction can follow leading to nipple discharge
Secondary infection leads to peri-areolar mastitis - treat with broad spectrum antibiotics
Chronic inflammation can lead to fibrosis and inversion or retraction of the nipple - mimics breast cancer
Diagnosed with ultra sound
Explain fibroadenomas (breast mouse)
It is found mostly in young women and is associated with hormonal irregularities
Rubberhard, mobile and smooth outline
If enlarging rapidly has to be distinguised from phylloides tumour
Doesnt have to be removed unless enlarged or cosmetic problem
Explain cysts
It is usually found in younger patients and is associated with hormones.
Can be painful due to pressure
Can be aspirated
Can be confirmed with ultrasound
No need to be removed unless fluid is blood stained and cyst fills immediately after aspiration
Explain fat necrosis
Usually preceded by trauma - damage causes necrosis and fibrotic scar tissue
Can mimic breast cancer
Frequently needs core needle biopsy
Explain prolactinoma
It is a tumour of the pituitary fossa and produces prolactin
Diagnosed with elevated prolactin levels
Confirmed and localised with MRI
Treated by surgical excision
Explain intraduct pailloma
Intermittent bloody discharge especially in older patients
Growth of duct wall and when it outgrows its blood supply it causes bleeding
Treated by surgical excision
