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Year 3 core conditions > breast > Flashcards

breast Flashcards

1
Q

who gets breast abscesses?

A

3-11% of women with mastitis

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2
Q

who gets mastitis?

A

lactating women

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3
Q

causes of breast abscess

A

complication of mastitis

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4
Q

why do lactating women get mastitis?

A

milk stasis causes inflammatory response - may or may not progress to infection

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5
Q

2 catagories of infection accompanying mastitis

A

central/subareolar - secondary to periductal mastitis or duct ectasia

peripjeral nonlactating infection - associated w DM, RA, trauma, corticosteorids treatment and granulomatoius lobulsr mastitis

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6
Q

risk factors obreast abscess

A

risk of mastitis:
- lactating women w poro infant attahcment, reduced feed numbers

smoking, nipple damage, trauma, breast abnormality, immunosuppression, shaving, foreign body

previous mastitis
cessation of breast feeding
staph A carriage
poor socioeconomic status
poor hygiene
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7
Q

presentation of breast abscess

A

prev hsitory of mastitis
fever or general malaise
painful swollen breast lump
redness heat and swelling of overlying skin

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8
Q

signs on examination of breats abscess

A

lump may be fluctuant with skin discolouration

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9
Q

investigations for breast abscess

A

USS

culture fluid from asbcess

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10
Q

tretment of breast abscess

A

drainage of abscess by US guided needle aspiration or surgcal drainage

advise lactating women to continue breastfeeding if possible - or with hand or pump

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11
Q

who gets fibrocystic disease

A

women on child bearing age

30-60% women, 70-90% lifetime prevlence

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12
Q

causes of fibrocystic disease

A

hormone levels probably as susbsides after menopause

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13
Q

risk factors for fibrocytsic disease

A

women 30-50 yo
birth control lowers liklihood
HRT increases risk

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14
Q

presentation of fibrocystic disease

A 
non cancerous breast lumps
sometimes discomfort
periodically - related to menstrual cycle
breast or nipples tender or itchy
thickening of tissue
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15
Q

signs on examiantion of fibrocystic disease

A

smooth lumps with defined edges and free moving

found upper outer section of breast

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16
Q

investigations of fibrocystuc disease

A

possibly mammogram or MRI if really suspicisus

17
Q

treamtent of fibrocystic disease

A

most dont require invasive treatment

symptomatic treatment mainly - painjillers, supportive bra, warm or cold compression

18
Q

ductal papilloma - who gets it

A

2-3% incidence
women over 40 yo
develop naturall as breast changes

19
Q

what is ductal papilloma

A

benign breast tumour

20
Q

causes of ductal papilloma

A

breast aging and changes 0- small benign tumour forms in milk duct in breast
made of gland and fibrous tissue as well as blood vessels

21
Q

risk factors of ductal papilloma

A

central types develop near the nipple

women nearing menopause

peipheral types are often multiple papillomas in younger omwne

22
Q

presentation fo ductal pailloma

A

bloody nipple discharge (20-40yo)
dont show up on mamography de to size + cant be palpated

notice small lump or discharge or blood stained fluid from nipple
intraductal papillomas arent normally painful
dont increase risk of breast cancer

23
Q

investigations for ductal papilloma

A

found by chance on routine breast screening
refer for triple assessment
FNA or core needle biopsy

24
Q

treatment of ductal papilloma

A

excision sometimes
microdochectomy (removal of breast duct) is treatment of choice
total duct excision is possibility to find all ducts

25
Q

who gets breast carcinoma

A

200x more in females
50,000 new cases per year in UK
v common

26
Q

risk factors of breast carcinoma

A 
family history
increasing age
alcohol
diethylstilboestrol (syntheitc oestrogen - prostate cancer)
oestrogen-progesterone contraceptives
HRT
radiation
obesity
genetics - BRCA1/2
early menarche
short or longer cycles
first baby over 30 yo
27
Q

what reduces risk of breast carcinoma

A

breast feeding

28
Q

presentation of breast carcinoma

A

breast lump

  • painless (most of time)
  • nipple symptoms - changes in shape, nipple bleeding
  • changes in skin - tethering, peau d’orange
29
Q

signs on examination of breast carcinoma

A

breast lump or thickening
change in size, shape or appearanc eof breast
changes in skin - dimpling
newly inverted nipple
peeling, scaling or flaking of areola or breast
redness or pitting of skin

30
Q

investigations for breast carcinoma

A

triple assessment
imaging
FNA or biopsy
clinical examination

31
Q

P1-5

A

Examination - inspection , palpation

32
Q

M1-5

A

imaging - mammogrpahy, ultrasound

33
Q

B1-5

A

histology - core biopsy, invasive vs in situ

34
Q

treatment of breast carcinoma

A

excision - wide or local or mastectomy
followed by chemo and/or radiotherapy
tamoxifen for 5 years after - competitively competes w oestrogen for ER in breast tissue

aromatase inhibitors instead which block production of oestrogen

Year 3 core conditions (15 decks)

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