Breast Flashcards
What 5 symptoms of breast disease are red flags and need urgent attention?
A new discrete lump Nipple discharge - blood stained, unilateral or persistent Nipple retraction or distortion altered breast contour or dimpling Suspected pagets disease
What can cause blood stained discharge from the nipple?
Duct papilloma
Intraduct carcinoma
Pagets disease
Invasive carcinoma
What can cause non cyclical breast pain?
Abscess
Carcinoma
Tietze’s syndrome - chondritis of the costal cartilage
Chest wall lesions such as herpes zoster
What medications can help with cyclical breast pain?
Gamma - linolenic acid
danazol
Tanoxifen
LHRH analogues
What is duct ectasia?
Involutional change in the ducts associated with the menopause. The terminal ducts become dilated and angorged with secretions . Seondary infection can lead to retroareolar absecess and fibrosis may result in nipple retraction
Painless irregular firm lump in the breast with a history of trauma
fat necrosis
How would you investigate a painless irregular firm lump in the breast with a history of trauma?
Ultrasound
Core biopsy
What organism most commonly causes acute bacterial mastitis?
Staph aureus (this infection most commonly occurs during lactation)
What antibiotics are used for mastitis?
Flucloxacillin or clindamycin (if not improving after 12 - 24 hours) for 7 - 10 days
How do you treat a breast abscess?
Drain pus and send for culture
Flucloxacillin + Clindamycin for 7 - 10 days
What is periductal mastitis?
An inflammatory proces sthan occurs around the dilated milk dutcs near the nipple. It occurs in pre menopausal woman
When are breast cysts most common?
Perimenopause (rare after the menopause
Short history of a painful, tender sweilling that fluctuates in size
Breast cyst
How owuld you investigate and treat a suspected breast cyst?
Ultrasound
Aspiration +/- cytology
What is a fibroadenoma?
Lumps that arise from an entire lobule and have both stromal and epithelila components
What is a breats hamartoma?
A lump that is a welld efined capsule that apear to be a ‘breast within the breast’ as theuy are a mix of breast lobules, stroma and fat
What are some causes of gynocomastia?
Drugs - digoxin, spironolactone, cimetidine, oestrogens or androgens Liver cirrhosis Renal failure Hypogonadism Suprrenal tumours Testicular tumours idiopathic
What cells do phyllodes tumours arise from?
Stromal cells - classified as low, medium or high grade depending on their characteristics
How are phyllodes tumours treated?
Wide exision
May need mastectomy with immediate reconstruction
What is your lifetime risk of developing breast cancer if you have a premenopausal first degree relative with breast cancer?
25%
What is your lifetime risk of developing breast cancer if you have a premenopausal first degree relative with breast cancer?
14%
What is the inheritence pattern of BRCA1 and BRCA2?
Autosmal dominant
What is your risk of breast cancer if you have a BRCA1 or 2 gene?
80 - 90%
What does breasr cancer in situ mean?
the cancer has not penetrated the basement membrane
