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Reproduction SB > Breast Conditions > Flashcards

Breast Conditions Flashcards

1
Q

what are risk factors for breast cancer

A 
Age
Previous breast cancer
FHx 
BRCA1 and BRCA2
Early menarche and late menopause
Late or no pregnancy
HRT
Alcohol
Weight
Radiotherapy Tx for cancer
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2
Q

presentation of breast cancer

A 
lump
mastalgia (persistent unilateral pain)
nipple discharge (blood-stained)
nipple changes (Paget’s disease, retraction)
change in breast contour
lymphaeodema (swelling of the arm)
dimpling of the breast skin
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3
Q

what is the triple assessment seen in the breast clinic

A
  1. CLINICAL:
    History and Examination
  2. RADIOLOGICAL:
    Bilateral mammograms / USS
  3. CYTO-PATHOLOGICAL:
    FNA- cells only (cytology)
    Core Biopsy- tissue (histo-pathol.)
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4
Q

what is the most sensitive breast imaging technique

A

mammogram

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5
Q

why is sensitivity of a mammogram reduced in young women

A

presence of increased glandular tissue (<40yrs)

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6
Q

when is breast ultrasound useful

A

in the assessment of breast lumps

- can differentiate between solid and cystic lesions

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7
Q

what are the invasive breast cancers

A

Ductal carcinomas 80%
Lobular carcinomas 10%
Others 10%

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8
Q

what are the “others” of the invasive breast cancers

A

Mucinous 5%
Papillary <5%
Medullary <5%

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9
Q

what are the non invasive breast cancers

A

Ductal Carcinoma In Situ [DCIS]

Lobular Carcinoma In Situ [LCIS]

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10
Q

where are common mets for breast cancer

A

local
- chest wall, skin, nipple

distant
- contra-lateral breast, lung, liver, bone, brain,

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11
Q

what are Tx options for breast cancer

A

Surgery
+/- radiotherapy
+/- chemotherapy
+/- hormonal therapy

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12
Q

what are surgical options for breast cancer

A

mastectomy

wide local excision

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13
Q

what patient always receive radiotherapy as part of their treatment

A

All patients after WLE as adjuvant treatment

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14
Q

what is the principle of Tx of hormone therapy in breast cancer

A

oestrogen deprivation

- only in ER positive tumours

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15
Q

what does ER positive mean

A

the tumour contains oestrogen receptors

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16
Q

what are the available chemical HT

A

tamoxifen

aromatase inhibitors

17
Q

what are the available surgical HT

A

oophorectomy

18
Q

Tx for fibroadenoma

A

if proven on US and FNA cytology = do not have to excise

Excision- if unable to obtain pathological diagnosis, increasing in size, deforming

19
Q

Tx of duct papilloma

A

Excision by Microdochectomy (Single Duct Excision) or Total Duct Excision

20
Q

what is mastalgia

A

breast pain

21
Q

who gets cyclical breast pain

A

premenopausal women

average age 34

22
Q

how does cyclical mastalgia feel

A

Heightened awareness, discomfort, fullness, heaviness

Classically – outer half of each breast

Can be unilateral

23
Q

who gets non-cyclic mastalgia

A

older women

average age 43

24
Q

how does non-cyclical mastalgia feel

A

Pain can arise from chest wall, breast or outside breast

Continuous/Random

Burning/Drawing

25
Q

Tx of mastalgia

A 
reassurance 
well fitting bra
topical NSAIDs
drug treatment
can stop OCP
26
Q

what are the drug treatment options for mastalgia

A

Danazol - more useful in cyclical.

Gamolenic acid

Bromocriptine

27
Q

when Ix nipple discharge what can be done if suspicious

A

Duct Excision

28
Q

what should be Ix if there is bilateral milky discharge

A

galactorrhoea

- Ix = Drug history, prolactin levels

29
Q

what drugs cause Gynaecomastia

A

digoxin
spironolactone
androgens
anti-oestrogens

30
Q

Tx options for Gynaecomastia

A

reassure
Tx underlying cause
surgery = rarely

danazol or tamoxifen - symptomatic improvement

31
Q

2 main aetiologies for acute mastitis/abscess

A

duct ectsaisa

lactation

32
Q

Sx of acute mastitis/abscess

A 
pain, swelling, tenderness of the breast 
breast warmth + erythema
mastitis 
decreased milk outflow 
flu-like Sx, malaise + myalgia
fever
33
Q

Ix of acute mastitis/abscess

A

USS + FNA

34
Q

Tx of acute mastitis/abscess

A

Flucloxacillin +/- aspiration
or
Co-amoxicillin

Reproduction SB (30 decks)

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