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Core Conditions AJL (minus renal and respiratory) > Breast > Flashcards

Breast Flashcards

1
Q

How common is breast carcinoma?

A

20% of women affected

Very rare in males

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2
Q

What are the causes of breast carcinoma?

A

Genetic mutations in ductal or normal breast cells

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3
Q

What are the risk factors for breast carcinoma?

A 
Smoking
Early menstruation and late menopause
Family history
Hormone replacement therapy 
Obesity
BRCA gene
Oral Contraceptive Pill
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4
Q

What are the symptoms of breast carcinoma?

A

Hard breast lump
Indrawn nipple
Pain (rare)

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5
Q

What are the signs of breast carcinoma on examination?

A 
Tethered lump
Peau d'orange
Puckered skin
Inverted nipple (+/- bloody discharge) 
Axillary lymph nodes
Paget's disease of the nipple (eczema on nipple/areolar)
Ulceration
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6
Q

What are the possible differential diagnoses for breast carcinoma?

A

Fibrocystic changes (fibroadenima + cyst)
Abscess
Mastitis

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7
Q

What investigations are necessary to diagnose breast carcinoma?

A

Triple assessment

1) clinical examination
2) imaging (ultrasound/mammography)
3) Biopsy (FNA cytology/core/punch biopsy)

Staging

  • CT/MRI
  • CXR
  • Bone Scan

Oestrogen receptor +ve

HER2 +ve = more aggressive, treat with herceptin

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8
Q

What are the treatments for breast carcinoma?

A

Drugs/Endocrine - Tamoxifen, Herceptin

Radiotherapy

Chemotherapy

Surgery

  • lumpectomy
  • mastectomy and reconstruction
  • axillary clearance
  • total ductal excision
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9
Q

What are fibrocystic changes?

A

Fibroadenoma - fibrous tissue, benign lump

Cysts - fluid filled sacs

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10
Q

How common are fibrocystic changes?

A

30-60% of women
50% of childbearing age
Accounts for 60% of all breast lumps in females

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11
Q

What are the causes of fibrocystic changes?

A

Monthly hormonal changes

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12
Q

What are the risk factors for fibrocystic changes?

A

Hormone therapy exacerbates

Oral Contraceptive Pill relieves symptoms

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13
Q

What are the symptoms of fibrocystic changes?

A

Swelling or thickening
Lumps
Cysts enlarge and become more painful during menstruation

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14
Q

What are the signs of fibrocystic changes?

A 
Fibroadenoma = smooth, mobile lump, painless, multiple 
Cysts = mobile lump, +/- pain, multiple
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15
Q

What are the differential diagnoses of fibrocystic changes?

A

Dense, normal breast tissue

Carcinoma

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16
Q

What investigations are necessary to diagnose fibrocystic changes?

A

Triple Assessment

17
Q

What are the treatments for fibrocystic changes?

A

100% benign = no treatment needed
Exclude carcinoma
Cysts aspirate if big
Surgery - excise a large fibroadenoma

18
Q

What is a breast abscess?

A

Fluid filled sac in the breast

19
Q

Who is affected by breast abscesses?

A

Breastfeeding women

20
Q

What are the causes of breast abscess?

A

Unresolved infection of mammary duct

- associated with lactation ➡️ bacteria introduced through child’s mouth

21
Q

What are the risk factors for breast abscess?

A

Nipple fissures, cracks + sores
Maternal age, previous history of mastitis, improper nursing technique
Smoking/obesity

22
Q

What are the symptoms of a breast abscess?

A

Hot, painful swelling of breast segment

- unilateral, one quadrant = hot + painful to touch

23
Q

What are the signs of breast abscess on examination?

A 
Unilateral oedema 
Wedge shaped erythema
Pus on aspiration
Breast mass
Axillary lymphadenopathy
24
Q

What investigations are necessary to diagnose breast abscess?

A

Triple assessment

Culture aspirate

25
Q

What are the treatments for breast abscess?

A 
Stop breastfeeding
Open incision or percutaneous drainage
Antibiotics
Needle aspiration
Investigate sinister causes if non-resolving
26
Q

What is a ductal papilloma?

A

Benign lesion behind areolar

27
Q

How common is ductal papilloma?

A

Most common introduction breast lesion

28
Q

What are the causes of ductal papilloma?

A

Causes unknown

Develop as natural age related changes

29
Q

What are the symptoms of ductal papilloma?

A

Unilateral
Sticky/bloody nipple discharge
Small lump
(Painful)

30
Q

What are the signs of ductal papilloma on examination?

A

Mammography ➡️ duct ectasia, microcalcifications

31
Q

What investigations are necessary to diagnose ductal papilloma?

A

Triple assessment

Ductography = inject contrast

32
Q

What is the treatment for ductal papilloma?

A

Surgical excision even if benign

MAY DEVELOP INTO CARCINOMA

33
Q

What types of breast carcinoma are there?

A

Ductal - most common 70%

Lobular - 15%, commonly multi focal or bilateral

Core Conditions AJL (minus renal and respiratory) (10 decks)

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