Breast conditions Flashcards
How does a breast abscess usually present?
painful, warm, red, swollen.
patient can have fever and general malaise too.
Who mainly gets breast abscesses?
Breastfeeding women or those with a history of breast abscesses.
How is a breast abscess treated?
Flucoxacillin, erythromycin or co-amoxiclav (Antibiotics)
What are the differentials for breast abscess? (related to lactation and not related to lactation)
full breasts, engorged breasts, galactocele and infected mammary ducts
OR
cellulitis, fibroadenosis or a ruptured cyst
What is fibrocystic breast disease? How does it present?
Breast tissue becomes lumpy and has a rope like texture
What is FCB disease caused by?
fluctuating hormone levels (high oestrogen and progesterone) during the menstrual cycle that can cause lumpy and tender tissue to form.
What types of tissues can form in fibrocystic breast disease?
- cysts
- scar tissue
- overgrowth of cells
- enlarged lobules
Does fibrocystic breast disease increase the risk of cancer?
NO
when is the fluctation of breast tissue texture suspicious?
a. the lumps are new and persistent
b. there are specific areas of continuing pain
c. breast changes persist after menstruation
d. the lump has increased in size
Symptoms and signs of fibrocystic breasts include:
areas of thickening that blend into the surrounding breast tissue
generalised pain and tenderness
lumpy tissue
green/dark nipple discharge that is NOT BLOODY
breast changes is BILATERAL
monthly increase in breast pain and lumpiness with anticipation of period
How is fibrocystic breast disease treated?
NSAIDs
Oral contraceptive pill that controls the oestrogen and progesterone levels
What is a ductal papilloma?
Benign breast tumour of the lactation duct
Lumps are made of glands, fibrous tissues and blood vessels
Who gets ductal papillomas?
Mainly women between the ages of 35-55
What are the symptoms of a ductal papilloma?
Lumps of the nipple that are usually 1-2cm wide
enlarged breasts, nipple discharge that is not clear or bloody
pain or discomfort
a single papilloma carries no risk of breast cancer BUT…
multiple papillomas have been linked to atypical hyperpasia which is a precancerous condition.
pappillomatosis…
carries a higher risk of breast cancer
What are the 3 tests used in breast conditions?
Examination
Mammography
Biopsy
Papillomas are generally treated using…
surgical excision under general anaesthesia
What are the 3 most suggestive symptoms of breast carcinoma?
- Unilateral bleeding from nipple
- Peau d’orange
- Lumps in the axilla for women over 30
In patients over 50 years of age, what are the main red flag signs?
nipple discharge and nipple retraction
How is a diagnosis of breast cancer reached?
mammogram and tissue biopsy
urgent = 2 weeks
very urgent = 48 hours
What types of surgery can be used for breast carcinoma treatment?
Breast conserving surgery
Mastectomy
Sentinel node removal
What are the different types of radiotherapy used in breast cancer treatment? (4 types)
- breast radiotherapy–after breast-conserving surgery, radiation is applied to the whole of the remaining breast tissue
- chest-wall radiotherapy–after a mastectomy, radiotherapy is applied to the chest wall
- breast boost–some women may be offered a boost of high-dose radiotherapy in the area where the cancer was removed; however, this may affect the appearance of your breast, particularly if you have large breasts, and can sometimes have other side effects, including hardening of breast tissue (fibrosis)
- radiotherapy to the lymph nodes –where radiotherapy is aimed at the armpit (axilla) and the surrounding area to kill any cancer that may be in the lymph nodes
How many cycles of chemotherapy are usually performed in breast cancer treatment?
8 cycles, done via IV
Hormone treatment in breast carcinoma treatment is used to
lower oestrogen levels
an example of a drug is Tamoxifen
What medicine is used for ovarian suppression?
goserelin (luteinising hormone-releasing hormone agonist (LHRHa
white, cloudy, yellow, pus indicates
infection e.g. mastitis
green discharge indicates
cysts
brown or cheese like discharge indicates
mammary duct ectasia
clear discharge indicates
breast cancer if unilateral, papilloma if bilateral
bloody discharge indicates
breast cancer if unilateral,
papilloma if bilateral
