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Med Finals - Surgery > Breast > Flashcards

Breast Flashcards

1
Q

What is the assessment of breast lumps?

A

Tripple assessment
Clinical examination
Imaging - Us or mammography
Histology - fine needle or core biopsy

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2
Q

Red flag signs of breast cancer

A

Lumps that are hard, irregular, painless or fixed in place
Lumps may be tehtered to the skin or chest wall
Nipple retraction - unilateral nipple changes
Skin dimpling - or oedema (peau d’orange)

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3
Q

Define fibroadenoma

A

Common bengn tumours of stromal/epithelial breast duct tissue. More common in younger womesn

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4
Q

Clinical signs of fibroadenoma

A

Painless
Smooth
Round
Well circumscribed mass
Firm
Mobile
3cm diameter

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5
Q

Define fibrocystic breast changes

A

Generalised lumpiness to the breast, is considered a variation of normal and not a disease. Connective tissues respond to oestrogen and progesterone becoming fibrous and cystic.

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6
Q

Clinical signs of fibrocystic breast changes

A

Lumpiness
Breast pain or tenderness
Fluctuating breast size..

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7
Q

Management of fibrocystic breast changes

A

Supportive bra
NSAIDs
Avoid caffeine
Apply heat
Hptmonal treatment

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8
Q

Define breast cysts

A

Benign individual fluid filled lumps. Most common cause of breast lumps and occur most often between ages 30 and 50.

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9
Q

Clinical signs of breast cysts

A

Smooth
Well circumscribed
Mobile
Possibly fluctuant

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10
Q

Define fat necrosis of breast

A

Causes a benign lump by localised degeneration and scaring of fat tissue in the breast. Often caused by trauma, radiotherapy or surgery.

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11
Q

Clinical signs of fat necrosis in breasts.

A

Painless
Firm
Irregular
Fixed in local structures
Skin dimpling or nipple inversion

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12
Q

Define lipoma

A

Benign tumours of fat tissue can occur anywhere including breasts.

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13
Q

Clinical signs of limpomas

A

Soft
Painless
Mobile
No skin changes

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14
Q

Define gynaecomastia

A

Refers to the enlargement of the glanduar breast tissue in males common in adolescents and older men.

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15
Q

Common causes of gynaecomastia

A

Hormone imbalance. Raised oestrogen.
Prolactin
Idiopathic
Obesity
Testicular cancer
Liver cirrhosis
Hyperthyroidism
hCG secreting tumour - SCLC
Reduction in testosterone - deficiency, hypothalamic pituitary issues, klinefelter, orchitis
Steroids, antipsychotics, digoxin, spirinolaction, GnRH agonist, opiates

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16
Q

Define mamary duct ectasia

A

Benign condition where there is dilation of the large ducts in the breasts. Inflammation of the ducts leads to nipple discharge - often grey/white. Occurs perimenopausaly in smokers

17
Q

History of mammary duct ectasia

A

Nipple discharge
Tenderness or pain
Nipple retraction
Breast lump

18
Q

Managemment of mammary duct ectasia

A

Reassurance
Symptomatic management of mastalgia
Abx if infection
Surgical excision

19
Q

Define intraductal papiloma

A

Warty lesion that grows within on of the ducts of the breast. Causes clear or blood stained nipple discharge.

20
Q

History of intraductal papiloma

A

35-55
Asymptomatic - identified on mammogram
Nipple discharge - clear or blood stained
Tenderness or pain
Palpable lump

21
Q

Management of intraductal papiloma

A

Complete surgical excision + further examination of lump for cancer

22
Q

Define lactational mastitis

A

Inflammation of breast tissue as a complication of breastfeeding. CAn be caused by obstruction or infection.

23
Q

History of lactational mastitis

A

Breast pain, or tenderness
Erythema in a focal area
Local warmth and inflammation
Nipple discharge
Fecer

24
Q

Management of lactational mastitis

A

Blockage - conservative, continue breasfeeding/expressing milk, heat packs and analgesia
Infection - abx (flucloxacillin) or sample and cultre breast milk. Encourage breastfeeding/expression

25
Q

Define breast abscess

A

Collection of pus within an area of the breast
Can be lactational or non-lactational

26
Q

History of breast abscess

A

Mastitis with infection
Nipple changes
Purulent nipple discharge
Localised pain
Warmth
Erythema
Hardening of the skin or breast
Swelling
Generalised systemic symptoms

Swollen fluctuant tender lump.

27
Q

Management of breast abscess

A

Abx
US
Drainage
Microscopy

28
Q

Risk factors for breast cancer

A

Female
Increased oestrogen exposure - early onset periods, late menopause
Dense breast tissue
Obesity
Smoking
FH
COCP
HRT (combined!)

29
Q

What genes are associated with breast cancer

A

BRACA1 and 2
TP53 and PTEN

30
Q

What are some common types of breast cancer

A

Ductal Carcinoma in Situ (DCIS)
Lobular carcinoma in situ (LCIS)
Invasive ductal cardinoma (NST no specific type)
Invasive lobular carcinoma (ILC)
Inflammatory breast cancer
Medullary
Mucinous
Tubular

31
Q

What is Paget’s disease of the nipple

A

looks like eczema of the nipple
Erythematous scaly rash
Indicates breast cancer involving nipple

32
Q

Red flags for breast cancer

A

Lumps that are hard, irregular, painless or fixed
Nipple retraction
Skin dimpling or oedema (peau d’orange)
Lymphadenopathy - axilla
B symptoms

33
Q

What type of lymph investigation is done in breast cancer

A

Sentinel lymph node biopsy

34
Q

What are the main types of breast cancer receptors

A

Oestrogen
Progesterone
HER2

35
Q

What are common sites of breast cancer metastasis

A

LLBB
Lungs
Liver
Bones
Brain

Med Finals - Surgery (7 decks)

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