Breast Core Conditions Flashcards

1
Q

Who gets mastitis?

A

Primarily occurs in breast feeding women (up to 1 in 3)

Typically in the first few weeks

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2
Q

What causes mastitis?

A

Bacterial infection (often Staph aureus) typically through a tear in the skin or piercing
Infection invades the fatty tissue causing swelling and blockage of milk ducts
Abscesses form if severe/untreated

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3
Q

Risk factors for mastitis?

A
Inconsistent feeding schedule
Skipping feeds
Weaning too soon 
Bras too tight 
Stress
Exhaustion 
Obesity 
Being of childbearing age
Smoking 
Hx of breast abscesses
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4
Q

Differentials for mastitis?

A
Blocked duct 
Galactolcele
Infection of mammary duct 
Dermatitis
HSV of the nipple 
BCa 
Cyst
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5
Q

Symptoms of mastitis?

A

Breast tenderness
Red/warm skin in wedge shape
Malaise/fever
Pain on breast feeding

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6
Q

Investigations for mastitis?

A
General exam (look for skin infections)
Breast exam
US (biopsy for unusual cases)
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7
Q

Treatment for mastitis?

A

Mild should resolve itself
Broad spectrum Abx (ceph, erythromycin, penicillins)
Drainage for abscesses

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8
Q

Who is most likely to have fibrocystic disease?

A

Younger women of childbearing age

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9
Q

Causes of breast lumps?

A
Physiological fibrocystic change with menses
Fibroadenoma
Breast cysts
Infection
Fat necrosis following trauma
Lipoma 
BCa
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10
Q

Risk factors for fibrocystic disease?

A

30-50
Young women (for fibroadenomas)
HRT

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11
Q

Symptoms of fibrocystic disease?

A
Breast swelling/thickening/lumps
Tenderness
Itching
Aching
Nipple discharge
Typically worst before menses and then symptoms ease
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12
Q

Differentials for fibrocystic disease?

A
BCa
Fibroadenoma
Costochondritis 
Chest pain causes
Cyst
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13
Q

Investigations for FCD?

A

Breast exam
US and mammogram
Fine needle aspiration
Core biopsy

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14
Q

Treatment for FCD?

A

Pain relief
NSAID gel
Heat/ice
Better fitting bra

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15
Q

At what age do women present with ductal papilloma?

A

35-55

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16
Q

What causes ductal papilloma?

A

Unknown

17
Q

Risk factors for ductal papilloma?

A

None known

18
Q

Symptoms of ductal papilloma?

A

Clear or bloody discharge from a nipple
Breast lump near or behind the nipple
Breast enlargement/pain

19
Q

Differentials for ductal papilloma?

A
Ductal carcinoma in situ 
Invasive ductal carcinoma with an in situ component 
Papillary carcinoma of the breast 
Fat necrosis 
Complex breast abscess with debris
20
Q

Investigations for ductal papilloma?

A

Breast exam
Mammography
Galactography
US

21
Q

Treatment for ductal papilloma?

A

Mastectomy

Surgical removal of papilloma and affected ducts (microdochectomy)

22
Q

Where does BCa rank in common cancers?

A

2nd most common cancer in women

23
Q

Who gets BCa?

A

Women >50

Rarely in younger women

24
Q

Causes of BCa?

A

FHx/genetics (1 in 20 due to BRCA)
High breast density
Higher oestrogen exposure (nullparity, late menopause)
HRT and OCP

25
Q

Risk factors for BCa?

A
Age
Obesity 
Excess alcohol 
Menopause >55 
Being tall
FHx
Not breast feeding 
Chest radiation exposure
26
Q

Symptoms of BCa?

A
Painless, growing mass 
Nipple discharge/changes 
Skin changes 
Ulcerations
Lump in armpit
27
Q

Differentials for BCa?

A
Fat necrosis 
Abscess 
Cyst 
Atypical ductal hyperplasia 
Fibrocystic disease
28
Q

Investigations for BCa?

A
Breast exam (inc armpit)
US + mammogram
MRI
Fine needle aspiration and cytology 
Biopsy
29
Q

Treatment for BCa?

A

Surgical resection