Breast Flashcards
What is the assessment of breast lumps?
Tripple assessment
Clinical examination
Imaging - Us or mammography
Histology - fine needle or core biopsy
Red flag signs of breast cancer
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)
Define fibroadenoma
Common bengn tumours of stromal/epithelial breast duct tissue. More common in younger womesn
Clinical signs of fibroadenoma
Painless
Smooth
Round
Well circumscribed mass
Firm
Mobile
3cm diameter
Define fibrocystic breast changes
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.
Clinical signs of fibrocystic breast changes
Lumpiness
Breast pain or tenderness
Fluctuating breast size..
Management of fibrocystic breast changes
Supportive bra
NSAIDs
Avoid caffeine
Apply heat
Hptmonal treatment
Define breast cysts
Benign individual fluid filled lumps. Most common cause of breast lumps and occur most often between ages 30 and 50.
Clinical signs of breast cysts
Smooth
Well circumscribed
Mobile
Possibly fluctuant
Define fat necrosis of breast
Causes a benign lump by localised degeneration and scaring of fat tissue in the breast. Often caused by trauma, radiotherapy or surgery.
Clinical signs of fat necrosis in breasts.
Painless
Firm
Irregular
Fixed in local structures
Skin dimpling or nipple inversion
Define lipoma
Benign tumours of fat tissue can occur anywhere including breasts.
Clinical signs of limpomas
Soft
Painless
Mobile
No skin changes
Define gynaecomastia
Refers to the enlargement of the glanduar breast tissue in males common in adolescents and older men.
Common causes of gynaecomastia
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
Define mamary duct ectasia
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
History of mammary duct ectasia
Nipple discharge
Tenderness or pain
Nipple retraction
Breast lump
Managemment of mammary duct ectasia
Reassurance
Symptomatic management of mastalgia
Abx if infection
Surgical excision
Define intraductal papiloma
Warty lesion that grows within on of the ducts of the breast. Causes clear or blood stained nipple discharge.
History of intraductal papiloma
35-55
Asymptomatic - identified on mammogram
Nipple discharge - clear or blood stained
Tenderness or pain
Palpable lump
Management of intraductal papiloma
Complete surgical excision + further examination of lump for cancer
Define lactational mastitis
Inflammation of breast tissue as a complication of breastfeeding. CAn be caused by obstruction or infection.
History of lactational mastitis
Breast pain, or tenderness
Erythema in a focal area
Local warmth and inflammation
Nipple discharge
Fecer
Management of lactational mastitis
Blockage - conservative, continue breasfeeding/expressing milk, heat packs and analgesia
Infection - abx (flucloxacillin) or sample and cultre breast milk. Encourage breastfeeding/expression
