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Surgery - DONE > BREAST > Flashcards

BREAST Flashcards

1
Q

What is the tumour marker for breast cancer?

A

CA 15-3

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2
Q

What is galactorrhoea?

A

Milk discharge not associated with lactation

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3
Q

What is the most common cause of galactorrhoea?

A

Hyperprolactinaemia

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4
Q

What typically causes hyperprolactinaemia?

A

Pituitary adenoma

Drugs (SSRI, anti-psychotics)

Hypothyroidism (High TRH stimulates prolactin release)

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5
Q

What investigations are there for patients with galactorrhoea?

A

Pregnancy test

Serum prolactin levels

TFT

LFTs

MRI head (if pituitary tumour suspected)

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6
Q

What is the treatment of galactorrhoea caused by pituitary tumour?

A

Dopamine agonist therapy

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7
Q

What does mastalgia mean?

A

Breast pain (cyclical / non-cyclical)

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8
Q

What is the breast triple assessment?

A

History + examination

Imaging (Mammography >35 / Ultrasound <35)

Histology (Core biopsy = full histology / FNA - for cyst)

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9
Q

Name some benign breast lumps?

A

Fibroadenoma

Adenoma

Papilloma

Lipoma

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10
Q

How does a fibroadenoma present?

A

20-40 year old

Highly mobile

Well-define and rubbery

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11
Q

What is an indication for excision of a fibroadenoma?

A

>3cm in diameter

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12
Q

What is an adenoma?

A

Benign glandular tumour in typically older females

Lesions are nodular

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13
Q

What is a papilloma?

A

Lesions occurring in 40-50 year olds in sub areolar area

Bloody / clear nipple discharge

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14
Q

What is a lipoma?

A

Soft and mobile benign adipose tumour

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15
Q

What is Gynaecomastia?

A

Condition in which male breast tissue develops (usually reversible)

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16
Q

What are the physiological causes of gynaecomastia?

A

Delayed puberty

Less testosterone with aging

17
Q

What are pathological causes of gynaecomastia?

A

Lack of testosterone (e.g. Klinefelter’s)

Renal disease

Medication (e.g. digoxin, metronidazale and spironolactone)

18
Q

What is pseudogynaecomastia?

A

Adipose tissue in breast associated with being overweight

19
Q

What medication can help alleviate symptoms of gynaecomastia?

A

Tamoxifen

20
Q

When is non-lactational mastitis seen?

A

With other conditions e.g. duct ectasia, tobacco smoking is a risk factor

21
Q

How is mastitis managed?

A

Antibiotic therapy and simple analgesia

22
Q

What is a breast abscess and when is it seen?

A

Collection of pus lined with granulation tissue most commonly from acute mastitis

23
Q

How does a breast abscess present?

A

Tender, erythematous masses, pyrexia

24
Q

How is a breast abscess diagnosed?

A

USS

25
Q

How do breast cysts appear and at what age?

A

Distinct smooth mass

Peri-menopausal

HALO SHAPE on mammography

26
Q

What is duct ectasia?

A

Dilatation and shortening of major lactiferous ducts

Presents in perimenopausal women

27
Q

How does duct ectasia present?

A

Green/yellow nipple discharge

28
Q

How can duct ectasia be identifies on mammography?

A

Dilated and calcified ducts

29
Q

What causes fat necrosis of the breast?

A

Trauma

Previous surgery

30
Q

How does fat necrosis of the breast present?

A

Lump, fluid discharge

31
Q

How is fat necrosis managed?

A

Pain relief and reassurance

32
Q

What is the most common type of non-invasive breast cancer (pre-malignant condition)?

A

Ductal carcinoma in situ (not lobar)

33
Q

What are the risk factors for invasive ductal carcinoma?

A

Female sex

Increasing age

Mutation to TSGs BRAC1 and BRAC2

FH (1st degree relative)

34
Q

What are the features of breast cancer?

A

Lump

Asymmetry

Nipple discharge

Nipple retraction

Skin changes

35
Q

What screening programmes are there for breast cancer?

A

Women 50-70 have mammogram every 3 years

36
Q

How can Paget’s disease be distinguished from Eczema?

A

Paget’s always affects the nipple whereas eczema spares it

Surgery - DONE (9 decks)

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