breast - benign lesions

Question 1

causes nipple discharge

Answer 1

physiological // medications // prolactinoma // duct ectasia // cancer // papilloma

Question 2

invx unexplained nipple discharge

Answer 2

examination + triple assessment

Question 3

which breast imaging is preferred in women <40

Answer 3

USS

Question 4

which breast imaging is preferred in women >40

Answer 4

mammogram

Question 5

what is breast triple assessment

Answer 5

clinical + imaging + FNA (biopsy)

Question 6

what age do breast cysts usually occur

Answer 6

perimenopause

Question 7

symptoms breast cyst

Answer 7

smooth, discrete lump

Question 8

mx breast cyst

Answer 8

FNA // if blood or refill –> biopsy or excision

Question 9

symptoms fibroadenoma

Answer 9

african // mobile, form, smooth breast lump // breast mouse

Question 10

mx breast fibroadenoma

Answer 10

if >3cm excise

Question 11

what type of disease is fibroadenosis

Answer 11

fibrocystic disease

Question 12

symptoms fibroadenosis

Answer 12

middle aged women // lumpy or hard breast // painful // worse before menstruation

Question 13

symptoms sclerosing adenosis

Answer 13

fibrous changes –> breast lump or pain

Question 14

invx slcerosing adenosis

Answer 14

mammogram can mimic carcinoma

Question 15

radial scar vs complex sclerosing lesion

Answer 15

radial scar <9mm // sclerosing lesion ?9mm

Question 16

who commonly gets fat necrosis

Answer 16

obese women or large breasts // follows local trauma (may be very non-descript) or warfarin therapy

Question 17

symptoms fat necrosis

Answer 17

initially firm and round but develops into hard, irregular breast lump

Question 18

invx fat necrosis

Answer 18

mammogram soap bubbles // may mimic breast cancer –> further investigation required

Question 19

what is duct ectasia

Answer 19

dilation and shortening of terminal breast ducts

Question 20

symptoms duct ectasia

Answer 20

common in menopause // tender lump around nipple // green, creamy discharge // nipple retraction

Question 21

duct ectasia vs periductal mastitis

Answer 21

duct ectasia = older women // periductal mastitis = younger + smplers

Question 22

who gets phyllodes tumour

Answer 22

40-50

Question 23

symptoms phyllodes tumour

Answer 23

unilateral, slow growing

Question 24

symptoms duct papilloma

Answer 24

no lumps or skin changes // bleeding from nipple

Question 25

symptoms mastitis

Answer 25

breastfeeding women // painful, tender, hot breast // fever and malaise

Question 26

1st line mx mastitis

Answer 26

keep breastfeeding // analgesia //

Question 27

medical mx mastitis

Answer 27

oral fluclox 10-14 days (keep on breasfeeding)

Question 28

orgnaism mastitis

Answer 28

staph A

Question 29

what can mastitis progress too

Answer 29

abscess

Question 30

symptoms breast abscess

Answer 30

tender, fluctuant mass

Question 31

mx breast abscess

Answer 31

USS + drain

Question 32

who is breast TB common in

Answer 32

affrican women

Question 33

mx cyclical mastalgia

Answer 33

supportive bra // analgesia // if 3 months –> refer (bromocriptine or danazol)

Question 34

what is galactocele

Answer 34

build up of milk in women who have recently stopped breastfeeding –> cyst (painless and no infection)