breast Flashcards
thick green nipple discharge
duct ectasia
mx of ER+ breast ca
pre- or peri-menopausal - Tamoxifen
post-menopausal - Anastrozole
when to make 2ww referral
women >30 years with unexplained breast lump
women >50 years with unilateral nipple symptoms such as discharge, retraction or other changes of concern
adverse effects of aromatase inhibitors
osteoporosis
hot flushes
arthralgia and myalgia
insomnia
most common type of breast cancer
invasive ductal carcinoma (no special type)
inheritance of BRCA mutations
autosomal dominant
all children have 50/50 chance of inheriting BRCA if mother is affected
mx if patients with breast cancer have clinically palpable lymphadenopathy
axillary node clearance at primary surgery, this can be radiotherapy
features of fibroadenosis
‘lumpy’ breasts which may be painful
symptoms often worsen prior to menstruation
post-surgery mx of metastatic axillary disease
cytotoxic chemotherapy (FEC-D)
features of duct ectasia
most common in peri- and postmenopausal women
ducts shorten and dilate - ‘symmetrical slit like retraction’ occurs
small amount of cheese like discharge
features of breast cyst
most common in perimenopausal women
soft, fluctuant swellings
‘halo appearance’ on imaging
features of periductal mastitis
common in smokers
recurrent infections
when is a fibroadenoma removed
if >3cm
blood stained nipple discharge
duct papilloma
mx of mastitis
encourage to continue breastfeeding
flucloxacillin only if systemically unwell
