Breast Flashcards
Define fibroadenoma
Benign neoplasm of a lobule: arising from stroma (fibro) and glandular (adenoma) epithelium
Define breast cysts
Fluid filled sacs in the breast
Define duct ectasia
Dilatation of milk ducts due to blockage
Age of fibroadenoma
20-30s
Age of breast cysts
Peri-menopausal women (40–50s)
When do breast cysts hurt
Pain associated with the menstrual cycle
Age of duct ectasia
Peri/post menopausal women
RF of duct ectasia
Smoking
Size of a fibroadenoma
1-5cm
Uni or bilateral breast cysts?
Can be both
One or multiple lumps in a fibroadenoma
Single
One or multiple lumps in breast cysts
Single or multiple
What benign condition is a sub areolar mass usually (2)
Duct ectasia
Intraductal papilloma
What can cause nipple inversion apart from cancer
Duct ectasia
Is duct ectasia painful or painless
Painless
Is fibroadenoma painful or painless
Painless
Are breast cysts painful or painless
Painless but can be painful
What gives thick yellow-green nipple discharge
Duct ectasia
Is fibroadenoma mobile or fixed
Mobile
Is breast cyst mobile or fixed
Mobile
Is duct ectasia mobile or fixed
Fixed
Ix for fibroadenoma (3)
USS/mammography
Core biopsy
Ix for breast cyst (3)
USS/mammography
Fine needle aspiration (FNA)
Ix for duct ectasia (2)
USS/mammography
What colour fluid in breast cyst when drained
Straw
When does fat necrosis occur
Normally occurs secondary to trauma
Women of any age
Describe lump in fat necrosis (3)
Painful, irregular hard lump with overlying bruising/redness of the skin
Does fat necrosis hurt
YEs
Define intraductal papilloma
Benign neoplasm growing within ducts of the breast
Age of intraductal papilloma
Peri-post menopausal women
What kind of discharge from an intraductal papilloma
Bloody or clear nipple discharge
Causes of mastitis
inflammation of the breast
Milk stasis/over-production
Can be lactational or non-lactational
What causes breast abscess
Untreated mastitis, can rarely lead to:
Breast abscess = collection of pus in the breast tissue due to infection
Age of mastitis
15-45 y/o
Especially those who are breast-feeding
RF of mastitis
Smoking
Most common pathogen in mastitis
Staph aureus
What does a cracked nipple suggest
Mastitis
What systemic symptoms can mastitis cause (3)
Flu like symptoms: fever, aches,
chills, generally unwell
Mastitis Mx
If lactational: ENCOURAGE BREAST FEEDING
Analgesia
Abx sometimes required
Breast abscess Mx
IV or oral Abx US guided FNA Therapeutic + diagnostic uses FBC + blood cultures (if systemic infection) Surgical incision + drainage
A 60-year-old woman presents to the GP after noticing some changes in
her right nipple. On examination, the nipple is erythematous and crusty with
some apparent scaliness of the skin.
Pagets disease of the breast
Most common type of breast cancer?
Invasive ductal carcinoma
3 infiltrative breast cancers
infiltrative ductal carcinoma (75%), infiltrative lobular carcinoma,
Paget’s disease of the breast
Non-invasive breast cancer?
DCIS
Which grading system is commonly used in breast cancer
Nottingham
RF of breast cancer (9)
Age FHx – 1st degree relative Obesity ↑ Oestrogen exposure Early menarche (<11) Late menopause (>55) HRT/OCP EtOH consumption Fatty diet Previous radiation to the chest Nulliparity (not having any children) Familial breast cancer – 5% of cases BRCA1/2: harmful BRCA mutation 60-80% lifetime risk of developing Breast Ca Associations with Ovarian and Pancreatic Ca
Ways you can have increased oestrogen exposure (3)
Early menarche (<11) Late menopause (>55) HRT/OCP
What other cancers is breast cancer associated with (2)
Ovarian and pancreatic
Who gets a mammogram and who gets an USS
> 35yrs: mammogram
<35yrs: USS
Where do breast cancers commonly metastasise (3)
to liver, lungs and bones
What are deep neck lumps likely to be
Thyroid
What are superficial neck lumps likely to be (4)
lipoma, epidermal cyst, dermoid cyst, abscess
What are neck lumps that move on swallowing likely to be
Thyroid gland
What are neck lumps that move on tongue protrusion likely to be
Thyroglossal cyst
