Breast conditions

Question 1

How does a breast abscess usually present?

Answer 1

painful, warm, red, swollen.

patient can have fever and general malaise too.

Question 2

Who mainly gets breast abscesses?

Answer 2

Breastfeeding women or those with a history of breast abscesses.

Question 3

How is a breast abscess treated?

Answer 3

Flucoxacillin, erythromycin or co-amoxiclav (Antibiotics)

Question 4

What are the differentials for breast abscess? (related to lactation and not related to lactation)

Answer 4

full breasts, engorged breasts, galactocele and infected mammary ducts

OR

cellulitis, fibroadenosis or a ruptured cyst

Question 5

What is fibrocystic breast disease? How does it present?

Answer 5

Breast tissue becomes lumpy and has a rope like texture

Question 6

What is FCB disease caused by?

Answer 6

fluctuating hormone levels (high oestrogen and progesterone) during the menstrual cycle that can cause lumpy and tender tissue to form.

Question 7

What types of tissues can form in fibrocystic breast disease?

Answer 7

1. cysts
2. scar tissue
3. overgrowth of cells
4. enlarged lobules

Question 8

Does fibrocystic breast disease increase the risk of cancer?

Answer 8

NO

Question 9

when is the fluctation of breast tissue texture suspicious?

Answer 9

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

Question 10

Symptoms and signs of fibrocystic breasts include:

Answer 10

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

Question 11

How is fibrocystic breast disease treated?

Answer 11

NSAIDs

Oral contraceptive pill that controls the oestrogen and progesterone levels

Question 12

What is a ductal papilloma?

Answer 12

Benign breast tumour of the lactation duct

Lumps are made of glands, fibrous tissues and blood vessels

Question 13

Who gets ductal papillomas?

Answer 13

Mainly women between the ages of 35-55

Question 14

What are the symptoms of a ductal papilloma?

Answer 14

Lumps of the nipple that are usually 1-2cm wide

enlarged breasts, nipple discharge that is not clear or bloody

pain or discomfort

Question 15

a single papilloma carries no risk of breast cancer BUT…

Answer 15

multiple papillomas have been linked to atypical hyperpasia which is a precancerous condition.

Question 16

pappillomatosis…

Answer 16

carries a higher risk of breast cancer

Question 17

What are the 3 tests used in breast conditions?

Answer 17

Examination
Mammography
Biopsy

Question 18

Papillomas are generally treated using…

Answer 18

surgical excision under general anaesthesia

Question 19

What are the 3 most suggestive symptoms of breast carcinoma?

Answer 19

1. Unilateral bleeding from nipple
2. Peau d’orange
3. Lumps in the axilla for women over 30

Question 20

In patients over 50 years of age, what are the main red flag signs?

Answer 20

nipple discharge and nipple retraction

Question 21

How is a diagnosis of breast cancer reached?

Answer 21

mammogram and tissue biopsy

urgent = 2 weeks

very urgent = 48 hours

Question 22

What types of surgery can be used for breast carcinoma treatment?

Answer 22

Breast conserving surgery
Mastectomy
Sentinel node removal

Question 23

What are the different types of radiotherapy used in breast cancer treatment? (4 types)

Answer 23

• 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

Question 24

How many cycles of chemotherapy are usually performed in breast cancer treatment?

Answer 24

8 cycles, done via IV

Question 25

Hormone treatment in breast carcinoma treatment is used to

Answer 25

lower oestrogen levels

an example of a drug is Tamoxifen

Question 26

What medicine is used for ovarian suppression?

Answer 26

goserelin (luteinising hormone-releasing hormone agonist (LHRHa

Question 27

white, cloudy, yellow, pus indicates

Answer 27

infection e.g. mastitis

Question 28

green discharge indicates

Answer 28

cysts

Question 29

brown or cheese like discharge indicates

Answer 29

mammary duct ectasia

Question 30

clear discharge indicates

Answer 30

breast cancer if unilateral, papilloma if bilateral

Question 31

bloody discharge indicates

Answer 31

breast cancer if unilateral,

papilloma if bilateral