Breast Conditions Flashcards
Who is most likely to be affected by breast abscess and mastitis?
Women who are within the first few weeks postpartum
What are the most likely causes of breast abscess and mastitis?
Milk stasis in lactating women
Staph. aureus as a result of accumulated milk.
In non-lactating women, damage to sub-areolar ducts can cause infection.
Breast abscess is usually a severe complication of mastitis.
What are some of the main risk factors of mastitis?
Poor infant attachment to breast Reduced number/duration of feeds Age Smoking Nipple damage/ trauma Previous mastitis Poor hygiene
What are some of the symptoms of mastitis?
Painful breast, fever/ general malaise, tender, red, swollen, warm area.
What are the clinical signs of mastitis?
Unilateral oedema
Erythema in the wedged shaped area
Fluctuant tender lumps with overlying oedema
What are the differential diagnoses of mastiitis?
Full engorged breasts, blocked ducts, galactocoele, mammary duct infection, cancer, cellulitis, fibroadenosis, ruptured breast cyst, necrotizing fasciitis.
What are the best investigations for breast mastitis?
IMAGING- USS to show pus collection
BIO- culture of breast milk
What is the treatment for breast mastitis/breast abscess?
Continue breast feeding, improve milk removal.
ANTIBIOTICS- flucloxacillin, erythromycin
SURGERY- abscess removal, needle aspiration
What are some of the causes of breast carcinoma?
Carcinoma arising in epithelial lining of the ducts, epithelium of the terminal ducts of the lobules.
What are the key risk factors of breast carcinoma?
NON-MODIFIABLE- Increasing age, family history of breast cancer, genetic factors, never having had a child/children born after age 30, early menarche, late menopause.
MODIFIABLE- obesity, alcohol
PMH- Previous history of breast cancer
IATROGENIC- HRT, combined oral contraception
What are the key symptoms that will present with breast carcinoma?
BREAST LUMP change in nipple shape nipple bleeding tethering of the skin of the breast peau d'orange axillary lumps
What are the clinical signs of breast carcinoma?
Swelling of all or part of a breast
Skin irritation
Nipple discharge other than breast milk
What are the differential diagnoses that are associated with breast carcinoma?
FIBROADENOSIS
BREAST CYSTS
MASTITIS
Which investigations are done in suspected breast carcinoma cases?
IMAGING: Mammography, USS, MRI, CXR
SAMPLE: Biopsy, fine needle aspiration.
What are the appropriate treatments for breast carcinoma?
SURGERY: wide local excision, mastectomy
CHEMOTHERAPY
RADIOTHERAPY
HORMONAL THERAPY- Tamoxifen, bisphosphonates
When is ductal papilloma likely to present?
In women who are over the age of 40
What are the main symptoms associated with ductal papilloma?
A breast lump (usually too small to palpate)
Nipple discharge with some bleeding
What are the differential diagnoses associated with ductal papilloma?
Ductal carcinoma Invasive ductal carcinoma Papillary carcinoma of the breast Breast abscess with debris Fat necrosis
Which investigations are necessary in suspected ductal papilloma?
IMAGING: Mammography, USS, MRI, CXR
SAMPLE: Biopsy, fine needle aspiration.
What treatment is available for ductal papilloma?
SURGERY to remove the lump
Who is typically affected by fibrocystic disease?
It’s common in women aged 30-50 and affects about 50% of women
What is the common cause of fibrocystic disease?
Excess growth of fibrous tissue and hormone imbalance are the main causes.
What are the risk factors associated with fibrocystic disease?
NON-MODIFIABLE- family history of breast cancer, genetic factors, increasing age, early/late menarche, never having a child/children born age 30, not having breastfed.
PMH- Previous history of breast cancer
IATROGENIC- HRT, combined oral contraception
MODIFIABLE- obesity, alcohol
What are the symptoms of fibrocystic disease?
BREAST LUMP change in nipple shape nipple bleeding tethering of the skin of the breast peau d'orange axillary lumps
