Breast

Question 1

what are you looking for when you get woman to raise her arms in breast exam?

Answer 1

does dimple appear when breast moves - due to tethering

Question 2

what’s the difference between tethering and fixation (breast)?

Answer 2

fixation - immobile - direct infiltration of pectoral muscles or skin + subcutaneous tissues - skin cannot move over the lump
tethering - has some immobility - invaded ligament of astley cooper - dimples on some movement (eg arms up)

Question 3

benign differentials for a breast lump

Answer 3

fibroadenoma (common <35y, small round firm)
cyst (common >35y, small round firm)
generalised nodularity - fibroadenosis
mastitis or abscess
lipoma

Question 4

malignant differentials for a breast lump

Answer 4

non-invasive DCIS
invasive DCIS (commonest)
invasive lobular carcinoma
colloid/mucinous carcinoma
paget's disease of nipple

Question 5

what is the difference between grading and staging?

Answer 5

grading - histology

staging - spread

Question 6

what can peau d’orange indicate?

Answer 6

inflammatory breast cancer

due to skin oedema

Question 7

how can you help distinguish nipple eczema vs paget’s disease of the nipple?

Answer 7

eczema usually fades to surrounding skin but paget’s doesn’t

paget’s starts in nipple and spreads laterally to areola etc - eczema does opposite