Breast

Question 1

What breast condition is like to present as a mobile breast lump in women ages 15-35yrs?

Answer 1

Fibroadenoma-
hyperplastic benign growth of the collagenous mesenchyme
if in doubt do FNA

Question 2

What is the most common organism responsible for breast abscesses?

Answer 2

Staph aures - treat with flucocillin

Usually follows from masitis in the lactating breast - breast is hot painful red tender breast.

treat with antibiotics and incision and drainage

Question 3

Is an intraductal pepilloma malignant or benign?

Answer 3

It is benign.
Usually a single lesion in one duct close to the nipple.
Results in blood stained discharge from one nipple and occasionally a small mass will be palpable.

Question 4

What is ductal ectasia?

Answer 4

Dilatation of the ducts behind the nipple with a periductal inflammation reaction rich in plasma cells.
Normally occurs in 5th decade.
Results in painful areolar with thick greenish/ brownish discharge.

Cancer needs to be excluded

Mammillary fistular may be a complication

Question 5

What is Paget’s disease of the nipple?

Answer 5

Red eczematous lesion of nipple, which will erode it eventually.
Is assocaited with intraduct carcinoma of the breast with the tumour cells spreading within the epithelium on to the nipple.

Question 6

Is ductal carcinoma in situ or lobular carcinoma in situ a true precancerous lesion?

Answer 6

DCIS - dysplasia reaching but not involving the basement membrane.
May need mastectomy.

LCIS does not turn into lobular carcinoma. Invasive lobular carcinoma is caused by loss of E-cadherin.

Question 7

What is a phyllodes tumour?

Answer 7

A rapidly growing highly cellular varient of a fibroadenoma.
Rarely metasastasizes but does recur locally frequently.