breast conditions

Question 1

what is the occurrence of abscesses?

Answer 1

10 -33% of all lactating women

Question 2

which age group?

Answer 2

18-50 years of age

Question 3

what are the main causes?

Answer 3

infection/ mastitits
infection of mammillary ducts
s. aureus
s. epidermis

Question 4

RF?

Answer 4

poor nursing/hygiene
smoking
obesity
gestational age over 41 weeks
over 30 years of age
sores/cracks/ fissures
PMHx of mastitis

Question 5

symptoms?

Answer 5

painful hot swollen lump
myalgia
fever

Question 6

signs?

Answer 6

purulent discharge
axillary lymphadenopathy
erythema
unilateral swelling of breast- hard mass

Question 7

diagnosis?

Answer 7

USS

guided needle aspiration with culture

Question 8

treatment

Answer 8

surgical
drainage
pain relief
antibiotics depending on cause e.g. s aureus therefore fluoxacillin

Question 9

What is the most common proliferative change ?

Answer 9

Fibrocystic Breast disease

Question 10

Who is it seen in?

Answer 10

20-45 years

Question 11

When can incidence decrease?

Answer 11

After menopause incidence decreases

Unless on oestrogen

Question 12

Causes

Answer 12

Hormonal changes during mensturation

Question 13

Symptoms

Answer 13

Breast pain
Swelling 
Lump with COBBLESTONE appearance 
Smooth well defined
Itchy 
Size of lump
Fluctuating

Question 14

Signs

Answer 14

Axillary lymphodenpathy

Lump on examination

Question 15

Differentials

Answer 15

Fibroadenoma 
Phyllode tumour 
Atypical hyperplasia 
Adenomasis sclerosising 
Fat necrosis

Question 16

Discuss fibroadenoma

Answer 16

Most common tumour 
Seen in under 30s 
Benign 
Seen with those on cyclosporine treatment 
Circumscribed 
From breast lobule

Question 17

Discuss Phyllode tumour

Answer 17

40-50 years of age
Can be benign of malignant
strolls cells

Question 18

Atypical hyperplasia increased what?

Answer 18

Risk of carcinoma

Question 19

Fat necrosis is seen in who and what does it show as ?

Answer 19

Painless red lump bruised

In obese women

Question 20

Adenonsosis sclerosis presents as

Answer 20

Painful lump in breast

Due to extra growth of tissue

Question 21

Investigations

Answer 21

Mammmogram

Uss

MRI

FNA/biopsy

Question 22

Treatment

Answer 22

Progesterone therapy
Excision
Monitor for further changes

Question 23

Who are ductal papilloma seen in?

Answer 23

40 plus years old

Less common than fibroadenoma

Question 24

what does it look like

Answer 24

Wart like appearance projecting into ducts

Question 25

Appearance symptoms

Answer 25

Discharge Pain Enlargement of breast

Question 26

Diagnosis

Answer 26

Triple assessment Mammography FNA biopsy

Question 27

Treatment

Answer 27

Excision | Monitoring

Question 28

What is the most common cancer in women?

Answer 28

Breast

Question 29

Where do they arrive from?

Answer 29

Ductal 75% Lobular Inflammatory Pagets

Question 30

How common in males

Answer 30

1%

Question 31

How common is pagets of all breast cancers

Answer 31

1%

Question 32

Risk factors

Answer 32

``` Previous breast cancer Family history Western diet No children / not given birth/ first child after 30 Not breast feeding Braca 1 and 2 Early menarche late menopause Radiation Hrt oestrogen and progesterone Ocp ```

Question 33

Chr for braca 1 and 2

Answer 33

17 and 13

Question 34

Presentation

Answer 34

``` Lump Changing in size Colour changes Discharge Lump in axillstu area Nipple Changes Pain ```

Question 35

What can bloody discharge indicate

Answer 35

Intraductal carcinoma

Question 36

Diagnosis and management

Answer 36

Cxr Mammogram Uss Biopsy Refer to 2ww

Question 37

Treatment

Answer 37

Surgery - Mastectomy Lumpectomy ``` Oral Treatment - her2 monoclonal antibody agonists Selective oestrogen receptor modulator Aramatase inhibitors ```

Question 38

Name some

Answer 38

Trastumzimab Tamoxifen Anastrazole - prevent androgen to oestrogen