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Year 3 MedEd > Breast > Flashcards

Breast Flashcards

Breast

1
Q

What are the relevant anatomical structures for breast-related pathologies?

A

Nipple
Lobules
Milk ducts
Fatty tissue

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2
Q

What is duct ectasia?

A

Blockage of the milk ducts

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3
Q

What is the epidemiology of duct ectasia?

A

Peri/post menopausal women (40-50+)

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4
Q

What is a fibroadenoma?

A

Benign breast tumour

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5
Q

What is the epidemiology of fibroadenomas?

A

Young women of child-bearing age

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6
Q

What is a breast cyst?

A

Fluid filled sac in the breast

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7
Q

What is the epidemiology of breast cysts?

A

Pre-menopausal women (30-40s)

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8
Q

What should you ask when a Pt presents with a breast lump?

A

Site, size, skin, single
Colour, contour, consistency
Tenderness, temperature, transilluminable
Fluctuant, fixed

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9
Q

What are the characteristics of duct ectasias?

A

Small lump behind nipple, nipple inversion
Discharge (watery/thick/blood stained/green), firm consistency
Tender
Fixed

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10
Q

What are the characteristics of fibroadenomas?

A

1-5cm, single
Well demarcated, firm consistency, highly mobile
Non-tender

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11
Q

What are the characteristics of breast cysts?

A

Single
Well demarcated, highly mobile
Non-tender, transilluminable
Fluctuant

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12
Q

What are the investigations for duct ectasias?

A

Biopsy

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13
Q

What are the investigations for fibroadenomas?

A

FNA

USS/mammography

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14
Q

What are the investigations for breast cysts?

A

FNA

USS/mammography

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15
Q

What is the management for duct ectasias?

A

Self limiting

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16
Q

What is the management for fibroadenomas?

A

Surgical- cryoablation, excision

Medical- ormeloxifene

17
Q

What is the management for breast cysts?

A

FNA/fluid drain

18
Q

What is the epidemiology of breast cancer?

A

Most common cancer in the UK
Most common cause of death in women 35-55yrs
1 in 8 are diagnosed with breast cancer

19
Q

What are the risk factors for breast cancer?

A FROG MAN

A 
Age
FHx
Radiation exposure
Obesity and OCP
Genetics
Menarche/menopause
Alcohol
Nulliparity (not having children)
20
Q

What are the characteristics of breast cancer?

A

Increased size, lump in breast/armpit, skin thickening, peau d’orange, skin dimpling, discharge, inversion.
Hard lump, irregular margin, redness.
Tenderness, warm, tethered to underlying tissue.

21
Q

What are the investigations for breast cancer?

A

Triple assessment:

  • history and exam
  • mammography/USS (if young)
  • fine needle aspiration cytology
22
Q

What is the management for breast cancer?

A 
Removal of tumour and LNs
ER antagonists (tamoxifen)
Aromatase inhibitors (letrozole)
Chemotherapy (cyclophosphatamide, doxorubicin)
Monoclonal antibodies (trastuzumab)
Radiotherapy to reduce recurrence
23
Q

What is mastitis?

A

Inflammation of the breast

Can develop into an abscess

24
Q

What is the epidemiology of mastitis?

A

Breastfeeding women- milk stasis
Immunocompromised- HIV/AIDS, diabetes, chronic illness
Primiparous (given birth to 1 child)
Over 30

25
Q

What is the characteristics of mastitis?

A

Generalised swelling of the breast
Red, firm, very tender, warm to touch
Flu-like symptoms (fever, aches, chills, fatigue)

26
Q

What are the investigations for mastitis?

A

Clinical diagnosis

Can do USS/biopsy

27
Q

What is the management for mastitis?

A

Encourage breastfeeding
Analgesia
Antibiotics

28
Q

What is the management for breast abscesses?

A

US guided FNA

Surgical excision and drainage

29
Q

A 60 year old obese woman presents to her GP with a lesion on her breast. The lesion is red, crusted, around her right nipple. The most likely diagnosis is:

A. Breast cyst
B. Breast abscess
C. Paget’s disease of the breast
D. Fibroadenoma
E. Fibrocystic disease
A

C. Paget’s disease of the breast

30
Q

22 year old woman presents to clinic with a single lump in her right breast. Examination reveals a mobile, firm, smooth and non-tender lump of 2cm in the lower outer quadrant that is not attached to the overlying skin. No axillary lymph nodes are palpable. The most likely diagnosis is:

A. Acute mastitis
B. Breast abscess
C. Breast cyst
D. Fibroadenoma
E. Periductal mastitis
A

D. Fibroadenoma

31
Q

A 21 year old woman presents to her GP with pain in her right breast. She has just given birth to her first child. On examination, right breast appears swollen, red and there is tenderness on palpation. You do not suspect there are any abscesses present. The most appropriate management plan would be:

A. Antibiotics
B. Refer to surgeon for incision and drainage
C. Refer to breast feeding support group and prescribe analgesia
D. Watch and wait
E. Confirm diagnosis with USS

A

C. Refer to breast feeding support group and prescribe analgesia

32
Q

Risk factors for developing breast cancer include:

A. Having only one child
B. Early menarche
C. Early menopause
D. Anaemia
E. HIV/AIDS
A

B. Early menarche

33
Q

A 56 year old woman presents to her GP after noticing a breast lump 3 weeks ago. On examination, the lump is 3 cm in diameter, firm and tethered to the skin and immobile. There are no overlying skin changes. The next most appropriate investigation is:

A. Total mastectomy
B. Urgent mammogram
C. Urgent USS
D. FNAC
E. Core biopsy
A

B. Urgent mammogram

34
Q

A 22 year old medical student presents to her GP complaining of ‘lumpiness’ in her breasts and nipple discharge for 2 weeks. She is concerned as her mother, who had breast cancer, had the same symptoms before she was diagnosed. What is the next most appropriate investigation?

A. Refer for urgent mammogram
B. Refer for urgent USS
C. Blood hCG levels
D. Reassure and discharge
E. CT Head
A

C. Blood hCG levels

35
Q

BRCA gene mutations are associated with breast and which other type of cancer?

A. Biliary
B. Uterine
C. Gastric
D. Ovarian
E. Colon
A

D. Ovarian

36
Q

A 30 year old female presents with a bruise on her breast. O/E The underlying tissue is tender and lumpy. When asked about trauma, she says she was injured whilst playing a rugby match. What is the most likely diagnosis?

A. Fibroadenoma
B. Fat necrosis
C. Paget’s disease of the breast
D. Mastitis
E. Duct ectasia
A

B. Fat necrosis

37
Q
  1. Which of the following statements regarding breast disease is FALSE?

A. Orange peel skin may be a sign of inflammatory breast cancer
B. Ulcerated breast lumps are generally not concerning
C. Alcohol intake is a modifiable risk factor for breast cancer
D. Women ages 50-70 are offered routine screening every 3 years
E. USS are more suitable for women aged <35 years

A

B. Ulcerated breast lumps are generally not concerning

Year 3 MedEd (29 decks)

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