Breast Conditions

Question 1

What is mastalgia, and how common is it?

Answer 1

Mastalgia refers to breast pain, a common concern that is benign in 90% of cases. It is often cyclic and occurs premenstrually due to hormonal changes.

Question 2

What characterizes noncyclic mastalgia?

Answer 2

Typically unilateral, localized pain that is sharp or burning. More common in women aged 40 and older. Rarely a principal sign of breast cancer.

Question 3

What are common treatments for mastalgia?

Answer 3

Reassurance as the first-line approach. Supportive bras, modifying hormone therapy, topical NSAIDs, or alternative contraceptives. Surgery is rarely indicated.

Question 4

What types of nipple discharge may indicate malignancy?

Answer 4

Nonmilky, spontaneous, unilateral discharge from a single duct. Clear or bloody in color. Accompanied by a mass or abnormal mammogram in women over 50.

Question 5

What are benign causes of nipple discharge?

Answer 5

Pregnancy and lactation. Galactorrhea (not related to breast pathology). Intraductal papilloma and mammary duct ectasia.

Question 6

What should be assessed for nipple discharge?

Answer 6

Duration, color, and occurrence (spontaneous vs. manipulation). Medication history. Other breast symptoms and signs of hypothyroidism.

Question 7

What are examples of benign breast masses?

Answer 7

Fibroadenomas, cysts, lipomas, fat necrosis, phyllodes tumors, hamartomas, galactoceles.

Question 8

What diagnostic tests are used for breast masses?

Answer 8

Mammogram and ultrasound. Biopsy to confirm the diagnosis.

Question 9

What are the differential diagnoses for a breast mass?

Answer 9

Fibrocystic changes. Infection or abscess. Malignancy.

Question 10

What is the lifetime risk of a woman being diagnosed with breast cancer?

Answer 10

1 in 8 women.

Question 11

What are the types of breast cancer?

Answer 11

Carcinoma in situ. Invasive breast cancer. Paget’s disease. Inflammatory carcinoma.

Question 12

What symptoms might suggest metastases in breast cancer?

Answer 12

Bone pain, arthralgias, jaundice, abdominal pain, headaches, visual disturbances, fatigue, weight loss, and malaise.

Question 13

What does the TNM system assess?

Answer 13

Tumor size. Lymph node involvement. Metastatic spread.

Question 14

What are common treatments for breast cancer?

Answer 14

Surgery (lumpectomy/mastectomy). Chemotherapy (before or after surgery).

Radiation therapy (after breast-conserving surgery).

Hormonal therapy, bisphosphonates, and monoclonal antibodies.

Question 15

How long is tamoxifen therapy recommended for?

Answer 15

10 years.

Question 16

What are special considerations for breast cancer management?

Answer 16

Breast tissue density. Pregnancy status.

Question 17

What is carcinoma in situ?

Answer 17

Noninvasive breast cancer. Cancer cells are confined to the ducts (ductal carcinoma in situ, DCIS) or lobules (lobular carcinoma in situ, LCIS). Has not spread beyond the basement membrane.

Question 18

What is invasive breast cancer?

Answer 18

Cancer that has spread beyond the ducts or lobules into surrounding breast tissue. Can metastasize to lymph nodes and other parts of the body. Most common type of breast cancer.

Question 19

What is Paget’s disease of the breast?

Answer 19

Rare form of breast cancer affecting the nipple and areola. Presents with eczematous changes, redness, crusting, itching, or discharge. Often associated with underlying DCIS or invasive cancer.

Question 20

What is inflammatory carcinoma?

Answer 20

Aggressive and rare form of breast cancer. Characterized by redness, swelling, and a peau d’orange (orange peel) appearance of the skin. Rapidly progresses and often indicates advanced-stage disease.