Breast Flashcards
What is Ductal ectasia
Blockage of the milk ducts usually affecting peri/post menopausal women
What are signs and symptoms of Ductal ectasia
S: Small lump behind nipple, nipple inversion
C: Nipple discharge (watery/thick/blood stained/green/yellow), firm consistency
T: Tender
F: Fixed
How is Ductal ectasia investigated
Biopsy
What is Fibroadenoma
Benign breast tumours usually in young women of child-bearing age
What are signs and symptoms of Fibroadenoma
S: 1-5 cm, single
C: Smooth, Well demarcated, firm consistency, highly mobile
T: Non-Tender
How is Fibroadenoma investigated
Triple assessment (FNA)
How is Fibroadenoma treated
Surgical:
- Cryoablation - US guided,
- Excision
Medical:
- Ormeloxifene
What is a Breast cyst
This is a fluid filled sac within the breast usually affecting pre-menopausal women (30-40)
What are signs and symptoms of Breast cysts
S: Single
C: Well demarcated, highly mobile
T: Non-tender, transilluminable
F: fluctuant
How are Breast cysts investigated
Triple assessment (FNA)
What is Mastitis
This is inflammation of the breast and can lead to the formation of a breast abscess which is a collection of pus within the tissue - This is rare
Usually Staph A or Strep infection
Who is usually affected by Mastitis
- Breastfeeding women - Milk stasis
- Immunocompromised - HIV, DM, Chronic illness
- Primiparous (given birth to 1 child)
- Over 30 years old
What are the signs and symptoms of Mastitis
S: Generalised swelling of the breast
C: Redness, firm
T: Very tender, warm to touch
F: Flu like symptoms - fever, aches, fatigue, chills
How is Mastitis investigated
Clinical diagnosis
US to distinguish tumour and abscess
FNA
How is Mastitis treated
Management of Mastitis:
- Encourage breastfeeding
- Analgesia
- Antibiotics (not needed in most cases)
Management of breast abscesses:
- US guided FNA
- Surgical incision and drainage
Outline features of other benign breast diseases
Fat necrosis - Prior breast trauma, surgical reduction, or augmentation - Firm mass irregular borders
Intraductal papilloma - Bloody nipple discharge - Usually small and not palpable
Fibrocystic breast - Breast pain, symptoms fluctuate with menstrual cycle - Rubbery, well circumscribed mobile mass
How is Breast cancer staged
Histopathology - Most are derived from epithelium lining of ducts/lobules (ductal/lobular carcinoma)
Grading - Appearance of breast Ca cells compared to normal tissue
TMN staging:
0 - in situ, Paget’s disease of the breast, DCIS
1-3 - Within breast, region LNs
4 - Metastatic cancer
What are the risk factors for Breast cancer
Age
FHx Radiation exposure Obesity and OCP Genetics - BRCA 1 and 2 - Ovarian and pancreatic Menarche <11 and Menopause >55 Alcohol Nulliparity - No children
What are the signs and symptoms of Breast cancer
S: Increased size, Lump in breast or armpit skin thickening, peau d’orange, skin dimpling, nipple discharge (bloody), nipple inversion.
C: Hard lump, irregular margins, redness
T: Tenderness, warm (inflammatory breast Ca)
F: Tethered to underlying tissue
How is Breast cancer diagnosed
TRIPLE ASSESSMENT
1. History and Clinical Examination
- Imaging
- Breast screening – early detection of breast Ca
- Women ages 50-70 invited for screening every 3 years
- Mammography
- USS – better for denser breast tissue (younger patients)
- 2 week wait criteria - Pathology
- FNAC
- Core biopsy
What is the most common types of breast cancer
Invasive ductal carcinoma
