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Y3 > Breast > Flashcards

Breast Flashcards

1
Q

What is duct ectasia?

A

When central ducts become dilated with ductal secretions

Secretions may leak into periductal tissues and caused an inflammatory reaction (periductal mastitis)

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2
Q

Summarise the epidemiology of duct ectasia

A

Peri- or post-menopausal women

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3
Q

Explain the aetiology of duct ectasia

A

Caused by normal breast changes that happen with age

Ducts behind the nipple shorten and widen

Smoking

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4
Q

What are the risk factors for duct ectasia?

A

Smoking

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5
Q

What are the presenting symptoms and signs of duct ectasia?

A 
Nipple retraction
Nipple inversion
Nipple pain
Classic green-brown discharge
Lump behind nipple
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6
Q

What are the appropriate investigations for benign ductal disease?

A 
Breast examination
Mammogram
US
FNA
Core biopsy
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7
Q

What is an intraductal papilloma?

A

A wart-like lump that develops in 1 or more of the milk ducts in the breast

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8
Q

Summarise the epidemiology of intraductal papilloma

A

Most common in women over 40

Very rare in men

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9
Q

Explain the aetiology of intraductal papilloma

A

Develops naturally as breast ages and changes

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10
Q

What are the presenting symptoms of intraductal papilloma?

A

Small, wart-like lump
Clear or blood-stained nipple discharge
Usually not painful

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11
Q

Summarise the epidemiology of breast cancer

A

Most common cancer in women - 1/9 in UK

Peak incidence: 40-70 years

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12
Q

Explain the aetiology of breast cancer

A

Genetics - BRCA-1 and BRCA-2

Environmental factors

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13
Q

What are the risk factors for breast cancer?

A 
Age
Prolonged exposure to oestrogen:
- nullparity - no kids
- early menarche
- late menopause
- obesity
- COCP
- HRT
FHx
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14
Q

What are the presenting symptoms of breast cancer?

A 
Painless breast lump
Changes in breast shape
Nipple discharge - may be bloody
Axillary lump
Malignancy: weight loss, bone pain, paraneoplastic syndromes
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15
Q

What are the signs of breast cancer O/E?

A

Breast lump:

  • firm
  • irregular
  • fixed to surrounding structures
Peau d'orange
Skin tethering
Fixed to chest wall
Skin ulceration
Nipple inversion
Paget's disease of nipple - eczema-like hardening of nipple skin (usually caused by ductal carcinoma in situ infiltrating nipple)
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16
Q

What are the appropriate investigations for breast cancer?

A

TRIPLE ASSESSMENT:

  1. Clinical examination
  2. Imaging: US < 35yo, mammogram > 35yo
  3. Tissue diagnosis: FNA or Core biopsy

Also:
Sentinel LN biopsy
Staging - CXR, liver US, CT brain/thorax
Bloods: FBC, U+Es, Ca, bone profile, LFTs, ESR

17
Q

What is the most common type of breast cancer?

A

Invasive ductal carcinoma

18
Q

What is a breast cyst?

A

Fluid-filled sac in breast tissue

19
Q

Who are breast cysts most common in?

A

Women over 35
Women approaching menopause
Women using HRT after menopause

20
Q

What do breast cysts feel like?

A

Soft or hard
Any size - mm to cm
Uncomfortable/painful

21
Q

How do breast cysts change before a period?

A

Become larger
Sore
Tender

22
Q

What is fine needle aspiration?

A

A type of biopsy procedure

A thin needle is inserted into an area of abnormal-appearing tissue or body fluid

Sample taken can help make a diagnosis or rule out conditions

23
Q

What are the indications for fine needle aspiration?

A

Swellings or lumps just under the skin

Cysts - fluid-filled lumps
Nodules or masses - solid lumps
Enlarged LNs

24
Q

What are the possible complications of fine needle aspiration?

A

Infrequent
Infection
Haematoma

25
Q

What is a fibroadenoma?

A

A benign breast tumour characterised by an a mixture of stromal and epithelial tissue

26
Q

Summarise the epidemiology of fibroadenoma

A

More frequent in higher socioeconomic classes and darker-skinned people
Comprise about 50% of all breast tissue samples taken, 75% for tissue samples in women under 20 years old

27
Q

Explain the aetiology of fibroadenoma

A

Idiopathic (unknown)

28
Q

What are the risk factors for fibroadenoma?

A

Had no children (nullparity)
Low intake of fruit and veg
High use of OCP
Lack of exercise

29
Q

What are the presenting symptoms and signs of fibroadenoma?

A 
Breast lump:
Solid
Painless
Firm or rubbery
Mobile
Solitary-round with distinct, smooth borders

Y3 (20 decks)

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