Breast Flashcards
management of mastitis
symptom relief with NSAIDs and warm compress
if not improving consider flucloxacillin or clindamycin for 7-10 days
blood stained discharge from nipple with no palpable lump
intraductal papilloma
menopausal woman, discharge thick and green
smoker
mammary duct ectasia
when to refer for surgery with a fibroadenoma
> 3cm
hormonal therapy for breast carcinoma
tamoxifen in pre-menopausal patients
aromatase inhibitors are advised for post-menopausal patients
- anastrozole
- letrozole
management of mastalgia
after completely ruling out malignancy
evening primrose oil and tamoxifen
mechanism of action of aromatase inhibitors
reduce peripheral synthesis of oestrogen
mechanism of action of tamoxifen
partial antagonism of the oestrogen receptors
common sites of breast cancer metastasis
bones, liver, lung and brain
inflammatory benign breast disease
fat necrosis
duct ectasia
acute mastitis/abscess
presentation of gynaecomastia
typically enlarging breast(s) or sub-areolar mass
- in men
ductal growth without lobular development
presentation of fibrocystic change
smooth discrete lumps
sudden pain
cyclical pain
lumpiness
incidental finding
screening
what is a hamartoma
circumscribed lesion composed of cell types normal to the breast but present in an abnormal proportion or distribution
pathology of fat necrosis
damage and disruption of adipocytes
infiltration by acute inflammatory cells
foamy macrophages/histicoytes
calcification
pathological features of duct ectasia
periductal inflammation
periductal fibrosis
scarring and distortion
management of duct ectasia
treat acute infections
exclude malignancy
stop smoking
excise ducts
clinical features of phyllodes tumour
age 40-50
slow growing unilateral breast mass
- cystosarcoma phyllodes
- stromal overgrowth
malignant phyllodes tumour
sarcomatous
pathological features of phyllodes tumour
tumour border
stromal cellularity
stromal atypia
mitotic activity
stromal overgrowth
presentation of intraductal papilloma
age 35-60
nipple discharge +/- blood
asymptomatic at screening
nodules
calcification
what are in situ carcinomas
confined within basement membrane of acini and ducts
cytologically malignant but non-invasive
- lobular
- ductal
two types of lobular in situ neoplasias
atypical lobular hyperplasia (ALH)
lobular carcinoma in situ > 50% of breast involved
which hormone stimulates the lactiferous duct system to grow at puberty
oestrogen
which hormone stimulates the mammary glands to produce milk
prolactin
which hormone stimulates myoepithelial cells lining the milk ducts to contract
oxytocin
what is the most common histological type of breast cancer
invasive ductal cancer
what would microcalcifications seen on mammogram mean
ductal carcinoma in situ
woman presents with a painless, firm, discrete, mobile mass, which has a solid appearance on ultrasound scan
sclerosing adenosis
