Breast Flashcards
What is a breast abscess?
A localised area of infection with collection of pus, if it ruptures a fistula will form.
What are the main causes of breast abscess?
Staphylococcus Aureus, MRSA, E. coli Inflammation causing dilated ducts Smoking Diabetes or corticosteroids lactation TB
Which group of people is a breast abscess most common in?
Breast feeding women
What are the risk factors for a breast abscess?
Poor breastfeeding technique Milk stasis Prolonged mastitis Prior abscess Nipple piercing Foreign body Immunosupression Smoking
What are the signs and symptoms of a breast abscess?
Fever Breast tenderness/ firmness/ swelling Warmth Erythema Pain Nipple discharge Low milk output
What are the investigations completed to diagnose a breast abscess?
Breast Ultrasound (hyperechoic lesion) Needle aspiration Biopsy and culture Histopathology Mammogram FBC, blood cultures
What is the management for a breast abscess?
Lactational - milk removal, antibiotics, warm compress, analgesia
Non lactational - antibiotics, analgesia, needle aspiration and culture.
What is the nickname for fibrocystic breasts?
Lumpy breast
What causes fibrocystic breast?
Hormonal and reproductive changes that fluctuate with the menstrual cycle (doesn’t indicate cancer unless genetic component present)
What are the risk factors for fibrocystic breast?
Late onset menopause
Late age of first birth or nulliparity
Obesity
Oestrogen replacement therapy
What are the signs and symptoms of fibrocystic breast?
Mastalgia
Diffuse symmetrical lumpiness
Nipple discharge
What are the investigations completed to diagnose a fibrocystic breast?
Mammogram
Ultrasound
Cyst aspiration
Biopsy
What is the management of fibrocystic breast?
Reassurance Avoid caffeine Supportive bra Analgesia Modify HRT If cyst - drain
What is a fibroadenoma?
A benign, non cancerous breast tumour
What causes a fibroadenoma?
HRT
Pregnancy
What are the signs and symptoms of a fibroadenoma?
Highly mobile Clear defined edges Small Move under skin Rubbery
What are the investigations for a fibroadenoma?
Ultrasound
Mammogram
Breast examination
Fine needle biopsy/aspiration
What is the management for a fibroadenoma?
Watch and wait if small
If larger or growing - removal, lumpectomy, excision biopsy. cryoablation.
What are the risk factors for breast cancer?
Family history Increasing age Genetic - BRCA1, BRCA2 Not breastfeeding Early menarche Radiation to chest Obesity HRT
What are the signs and symptoms of breast cancer?
Lump Nipple change/discharge Skin contour changes Mastalgia Axillary lumps
What are the investigations for breast cancer?
Mammography Ultrasound Core Needle biopsy (US guided) Fine needle aspiration ER, PR, HER2 status CA 15-3
What is the management for breast cancer?
Surgery
Adjuvant therapy (Tamoxifen if ER +ve)
Chemotherapy
Bisphosphonates
