Breast Flashcards
Red flags for gynaecomastia
Testicular mass
Suspicion of breast ca: rapidly enlarging, > 5cm, hard or irregular breast tissue
Ix for gynaecomastia
May not need if obvious cause/ physiological
Bloods: U&Es, LFTs, TFTs, LH/FSH, hCG, oestradiol, testosterone, prolactin
Karyotype
US: testes, breast - FNA/ biopsy
CXR
Breast screening
Age 50-70 every 3 years
Above 70 every 3-yearly on request
Mx mastalgia
NSAIDs - evening primrose oil - reduce caffeine - danzol - bromocriptine
If non-cyclical mastalgia, what could be cause?
Tietze’s syndrome (costochondritis)
Who is affected by periductal mastitis?
Smokers, caused by anaerobes
Abscess may form, that can discharge spontaneously to form fistula discharging to areolar margin
Mx periductal mastitis
abx
may need total duct excision and fistulectomy for recurrent discharge
Green, black or cream d/c from nips usually caused by what?
Duct ectasia
(shortening and dilatation of ducts)
Reassurance or duct excision if copious
What sort of nipple d/c needs investigating?
Bloodstained from single duct
?duct ectasia, ?ductal CIS
Differential for nipple eczema
Paget’s
Breast mouse
Fibroadenoma
Benign breast lump in older women, similar to breast lump
Phyllode’s tumour
has potential to develop into sarcoma
Examples of cystic lummps
Cyst!
Galactocoele
Breast trauma lump
Fat necrosis (looks craggy)
how many women will get breast ca?
1 in 10