Breast Flashcards
What is the most common cause of brown-green nipple discharge?
Duct ectasia
Which group is mammary duct ectasia most common in?
Menopausal women
Smokers
What are the guidelines for referring patients under the suspected cancer pathway (<2 weeks) for breast cancer?
- Aged 30 and over and have an unexplained breast lump with or without pain
- Aged 50 and over with any of the following symptoms in one nipple only: discharge, retraction or other changes of concern
When is tamoxifen indicated?
Oestrogen-receptor-positive breast cancer in men and pre-menopausal women, and is typically given for 5 years following removal of a tumour to reduce recurrence
Anovulatory infertility
When is herceptin prescribed?
HER2+ breast cancer
What is the adjuvant hormonal therapy for ER+ breast cancer?
Pre-menopausal = tamoxifen
Post-menopausal = anastrozole
What are some common side effects of anastrozole?
Hot flushes, insomnia and low mood
What are the side effects of tamoxifen?
Increased risk of endometrial cancer, venous thromboembolism and menopausal symptoms
What is the first line imaging choice in patients under 30 with an unexplained breast lump?
Ultrasound scan (breast tissue is too dense for a mammogram)
What is a side effect of anastrozole?
Osteoporotic fracture
What drug can reduce the efficacy of tamoxifen?
Fluoxetine
What type of neoadjuvant chemotherapy is used in nodal positive patients?
FEC-D chemotherapy
What is the most common type of breast cancer?
Invasive ductal carcinoma (no special type)
Describe the presentation of periductal mastitis
Ducts under the nipple become infected. It presents with pain, periareolar mass and discharge from the nipple. It often occurs in younger patients and smoking is a risk factor.
Which breast lump typically fluctuates within a menstrual cycle?
Fibrocystic disease
