Breast

Question 1

RF for breast cancer

Answer 1

Nulliparous
Early menarche
Late menopause
No breast feeding

Obesity
Smoking
Alcohol
Age

Fam Hx - 1st deg relli (pre-menopause)
BRCA

HRT
COCP

Question 2

When to refer breast lump

Answer 2

always

Question 3

∆∆ for breast lump (just the list)

Answer 3

Fibroadenoma 
Cyst 
Abscess 
Fibroadenosis 
Breast cancer 
Duct papilloma 
Fat necrosis 
Mammary duct ectasia

Question 4

Fibroadenoma

Pres
Rx

Answer 4

MICE
Non-tender, mobile lump
More common in <30

Can surgically excise if >3cm

Question 5

Cyst

Pres
Rx

Answer 5

Presentation
Smooth non-tender lump
Small increased risk of breast cancer

Rx
Aspirate -if blood or refilling –> biopsy

Question 6

Fibroadenosis

Answer 6

Painful breast lump - worse before period

Question 7

Breast cancer symptoms

Answer 7

Hard, irregular lump - may be non-mobile

Peau d’orange
Tethering
Nipple discharge/bleeding/ inversion

Systemic features - weight loss etc

Question 8

Mammary duct ectasia

Answer 8

Widening of the duct
Green nipple discharge
Common in menopause

Question 9

Duct papilloma

Answer 9

Epithelial proliferation in the mammary duct
Blood and discharge

Rx
Microdochectomy

Question 10

Fat necrosis

Answer 10

Post trauma
Common in obese women with large breasts
Can become irregular so image and biopsy

Question 11

Breast abscess

Answer 11

fever, tender, erythema, hot

Common in breast feeding women

Question 12

Where does breast met to

Answer 12

Bone
Brain
Liver
Lung

Question 13

Breast cancer prognosis

Answer 13

Nottingham prognostic index

Size of tumour x 0.2 + node status + grade

Looks at 5 year survival rate if only surgery