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Surgery And General Principles > Breast > Flashcards

Breast Flashcards

1
Q

What is the most common cause of a benign breast lump ?

A

Fibroadenosis or fibrocystic change

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2
Q

What is the second most common cause of a benign breast lump ?

A

fibroadenoma

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3
Q

What age group are cysts common in ?

A

more common in females above the age of 30 (perimenopausal women; 30-50)

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4
Q

Give 3 characteristics of cysts

A
  • Cysts are smooth fluid filled sacs, which occur as multiple clusters
  • Cysts can occur simultaneously with a fibroadenosis or on its own (solitary)
  • They may be tender or non-tender
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5
Q

What are cysts when the pressure is low and what are they when the pressure is high ?

A

Soft and flatulent when the pressure is low and hard and painful when the pressure is high

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6
Q

Describe the management of a cyst

A

-Drained under USS guidance

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7
Q

Are cysts tender or non tender ?

A

They may be tender or non-tender

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8
Q

Can axillary lymph nodes be palpable in benign breast lumps ?

A

Axillary lymph nodes should be impalpable in benign breast disease

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9
Q

What is a fibroadenoma ?

A

Fibroadenoma is a benign outgrowth of the terminal duct lobule of the breast, usually solitary

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10
Q

Fibroadenoma are more common in young women between the ages of…

A

More common in you women under the age of 30; peak age(25-30)

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11
Q

State the 3 features of a fibroadenoma

A
  1. Fibroadenomas are rubbery, smooth, distinct and highly mobile within the breast- hence the name breast mice
  2. Usually painless, but can cause localised pain
  3. may be multiple. 1/3rd regress, 1/3rd stay the same and 1/3rd grow bigger
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12
Q

Describe the treatment of a fibroadenoma

A

They usually don’t require treatment unless they are bigger than 3cm, in which case they are removed

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13
Q

What is a fibroadenosis or fibrocystic change ?

A

Fibroadenosis or fibrocystic change is an irregular benign growth that can be bilateral or vary with the menstrual cycle, but are most prominent premenstrually and tend to subdue or fade way after menstruation.

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14
Q

Describe fibroadenosis in terms of pain

A

They classically cause breast pain and tenderness

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15
Q

What is the most common cause of cancer in women ?

A

breast cancer

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16
Q

What genetic abnormality is breast cancer due to ?

A

BRCA 1 (17q) and 2 (13q) genes

17
Q

Which age group In women is breast cancer rare in ?

A

rare in women under the age of 35 not it’s not impossible for it to occur

18
Q

Breast carcinomas are…, what ?

A

Breast carcinomas are oestrogen receptor positive and express HER 2 (GH receptor)

19
Q

State the 2 main groups of breast cancer

A

non-invasive in-situ and invasive adenocarcinomas

20
Q

State the 5 other types of breast cancers 😭

A
  1. Medullary, 2. Colloid/Mucoid, 3. papillary, 4. tubular and 5. adenoid cystic
21
Q

What carcinoma of the breast is impalpable and can only be detected by mammography ?

A

non-invasive in-situ adenocarcinoma

22
Q

What is the most common type of invasive adenocarcinoma?

A

ductal

23
Q

What is the rare type of invasive adenocarcinoma?

A

lobular

24
Q

What are the four pathological consequences of carcinoma of the breast ?

A
  1. Paget’s disease nipple of the nipple, erythematous itchy rash on nipple, which spreads outwards to areola
  2. local spread of the carcinoma to underlying skin tissue
  3. lymphatic spread
  4. vascular spread
25
Q

Local spread of carcinoma to underlying skin tissue causing the following 3…

A

Local spread of carcinoma to underlying skin tissue causing the following 3: 1, tethering to the skin, 2. unilateral nipple retraction or discharge and 3.deep fixation of the tumour to the skin

26
Q

What are the 4 (genetic and non-modifiable risk factors) for breast cancer ? 😭

A

25% due to Genetic and non-modifiable factors: 1. PH/FH of breast/ovarian cancer, 2. BRCA gene positive 3. Female gender, 4. Increasing age

27
Q

What are the 8 environmental risk factors for breast cancer ?

A

75% due to environmental factors: 1.early menarche/late menopause, 2. obesity, 3. oral contraceptive pill, 4. hormone replacement therapy, 5. null-parity or late age of having first child > 30, 6. No/Less time breast feeding, 7. Smoking 8. Non-Hodgkin’s disease.

28
Q

State the triple assessment for breast

A
  1. Clinical history and examination
    , 2. Breast USS and mammography if over the age of 35
  2. Cytology/Biopsy: Fine needle aspiration (FNA)(if cyst) or open/core biopsy (if solid)
29
Q

Why is mammography not done in females less than 35 ?

A

Mammography is not done in females less than the age of 35 As their breast tissue is denser. Furthermore, it is rare for a carcinoma to appear in females under the age of 35

30
Q

Why is fine needle aspiration no longer used as much and why are core biopsies preferred ? 😭

A

FNA cannot differentiate between in-situ and invasive adenocarcinomas. Whereas in core biopsies the architecture is preserved, so invasion can be determined along with grade

31
Q

Describe the vascular spread of breast carcinoma

A

Vascular spread: Mostly to the Bone causing hypercalcaemia and fractures, and also to the Liver and Lungs

32
Q

Describe the lymphatic spread of breast carcinoma

A

Lymphatic spread: Can prevent lymphatic drainage and thus cause peau d’orange. Can spread to lymph nodes in the axillary and clavicular region.

33
Q

Describe the treatment for fibroadenosis/fibrocystic change

A

reassurance
anti-inflammatories
Topical evening primrose oil

34
Q

Nipple

A

F

35
Q

Describe the treatment for fibroadenosis/fibrocystic change

A

F

36
Q

Describe the treatment for fibroadenosis/fibrocystic change

A

F

37
Q

Describe the treatment for fibroadenosis/fibrocystic change

A

F

38
Q

How to describe a LUMP

A 
She Cuts The Fish PERfectly
4S
3 Colour
contour
Consistency: 
4Ts
Tender
Temperature
Tethering
Transilluminable: hydrocele
3Fs: Flatulence, fixed or fields (LYMPH NODES)
Pulsatile or Expansitile (aneurysm)
Reducible (hernia)
39
Q

With regards to treatment for breast Cancer, what are the 3 mains forms ?

A

1.

Surgery And General Principles (5 decks)

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