Breast Conditions Flashcards
What is the most common benign neoplasm of the breast, usually occuring in women <30 years old?
Fibroadenoma
Mobile soft lump in the breast usually in young women
Fibroadenomas usually become non-palpable after the menopause. True/False?
True
What larger benign tumour can mimic fibroadenoma?
Phyllodes tumour
Mastalgia is usually unilateral. True/False?
False
Can be unilateral but usually bilateral
List conservative management that can improve mastalgia
Well-fitting firm bra
Regular exercise
Evening primrose oil
Tamoxifen
What is the most common aetiology of spontaneous nipple discharge?
Intraductal papilloma
Cauliflower extension forming in milk duct of breast
How does Paget’s disease usually present on the nipple?
Dry, eczematous, scaly lesion
Can be erythematous and weeping
What antibiotic should be administered as soon as mastitis is suspected?
Flucloxacillin or any Staph aureus sensitive antibiotic
Breastfeeding should be continued even if there is mastitis. True/False?
True
A tender lump in the breast, usually in women 30-50 years old is typically indicative of…
Benign cyst
Chronic mastitis in the breast which is resistant to antibiotics is typically indicative of…
Breast abscess
What term is used to describe the fact that most benign breast disorders are relatively minor aberrations of the normal processes of the breast?
Alterations in normal development and involution of the breast (ANDI)
What percentage of all symptomatic women typically have benign breast disease?
80%
List clinically relevant risk factors for breast cancer
Increasing age Gene mutation Early menarche Late menopause Nulliparity Obesity Previous breast cancer
List the most common clinical features of breast cancer
Dimpled/depressed skin Visible lump Nipple change (inversion) Bloody discharge Texture change Colour change
List management options for breast cancer
LOCAL: Surgery (reconstruction, lumpectomy, masectomy) Radiotherapy SYSTEMIC: Chemotherapy Harmonal therapies (oestrogen blockade) Targeted therapy (antibodies)
What is the preferred treatment for breast cancer - mastectomy or breast-conserving therapy?
Breast-conserving therapy involving radiotherapy/chemotherapy and/or wide local excision
What is the most common hormonal therapy for breast cancer?
Tamoxifen
HER2 overexpression is implicated in some breast cancer (15%) - what treatment targets this specifically?
Trastuzumab monoclonal antibody (Herceptin)
What is the screening schedule for breast cancer?
Mammogram every 3 years for women aged 50-70
What is carried out in the “one-stop” clinic?
Clinical (history and examination)
Imaging (mammogram, ultrasound)
Pathology (biopsy)
What adjuvant systemic treatment options are there for breast cancer?
HRT (tamoxifen, aromatase inhibitors e.g. letrozole)
Trastuzumab (if HER2 positive)
Letrozole can only be used in postmenopausal women. True/False?
True
Most women with breast cancer present with symptoms. True/ False?
False
50% asymptomatic via screening route
50% symptomatic and half with a lump
State the most common side effect of using radiotherapy in breast cancer
Lymphodema in the arm
List common side effects of using chemotherapy in breast cancer
Anorexia Malaise Neutropenia Alopecia Myalgia Peripheral neuropathy Axial skeleton pain
List common side effects of oestrogen blockade in the management of breast cancer
Hot flushes
Vaginal bleeding
Vaginal dryness
List common side effects of using herceptin in the management of breast cancer
Allergic reactions
Reversible cardiac failure
Detection of a new lump in breast cancer is usually indicative of breast cancer. True/ False
False
Typically fat necrosis
After treatment of breast cancer, how is a patient followed up?
Surgical review 1 year from surgery
Yearly mammogram for 3 years
Outline palliative management of breast cancer
Systemic treatment for widespread disease (oestrogen blockade, chemotherapy)
Radiotherapy for fungating disease or bone mets
Biphosphonates for bone mets as prevention
