Breast Disease Flashcards
Name 4 types of Non Malignant Breast Disease
Mammary Duct Ectasia
Periductal Mastitis
Intraductal Papilloma
Breast Abscess
Define Mammary Duct Ectasia
Describes a dilatation and shortening of the terminal breast ducts within 3cm of the nipple.
Inflammation in the ducts leads to intermittent discharge from the nipple (may be white, green or grey).
(Ectasia = Dilation)
In whom does mammary duct ectasia most commonly present?
Perimenopausal women (Older Women)
Name 1 significant risk factor for Mammary Ductal Ectasia
Smoking
Gave 4 presenting features of Mammary Duct Ectasia
Nipple discharge (thick and green)
Tenderness or Pain
Nipple retraction or inversion
Breast Lump (pressure on lump may cause discharge)
What does the triple assessment for exclusion of breast cancer involve?
Clinical assessment (history and examination)
Imaging (ultrasound, mammography and MRI)
Histology (fine needle aspiration or core biopsy)
What seen on mammography is considered a robust marker of breastcancer?
Microcalcifications
Define Periductal Mastitis
Describes a benign breast condition commonly affecting younger women who smoke.
Give 4 clinical features of Periductal Mastitis
Tender, hot or reddened breast
Bloody Discharge
Lump felt behind the nipple or Nipple inversion
High temperature/fever
What is periductal mastitis strongly associated with?
Smoking
How is periductal mastitis managed? (2)
Antibiotics
Abscesses require drainage
Describe Intraductal Papilloma (3)
Describes a warty lesion growing within one of the ducts in the breasts.
Occurs due to proliferation of epithelial cells.
Are benign tumours but can be associated with atypical hyperplasia or breast cancer.
How does Intraductal Papilloma typically present? (3)
Typically presents with clear or blood-stained nipple discharge
Tenderness or pain
A palpable lump
How are intraductal papilloma’s managed?
Complete surgical excision.
Describe a breast abscess
Describes a collection of pus within an area of the breast, usually caused by bacterial infection.
Name 2 types of breast abscess
Lactational abscess (associated with breastfeeding)
Non-lactational abscess (unrelated to breastfeeding)
What is the most common bacteria causing breast abscesses?
Staphylococcus aureus
Give 4 presenting features of breast abscess
Infection (tenderness, warmth, redness)
Nipple changes
Purulent nipple discharge (pus from the nipple)
Swollen, fluctuant (fluid filled), tender lump within the breast
How are breast abscesses managed? (3)
Antibiotics (flucloxacillin)
Ultrasound Guided Aspiration (drainage)
Microscopy, culture and sensitivities of drained fluid.
How is lactational breast mastitis managed? (3)
Continue breast feeding, expressing milk and breast massage.
Heat packs, warm showers and simple analgesia for symptoms.
Antibiotics (Flucloxacillin or Erythromycin/Clarithromycin)
How is non-lactational mastitis managed? (3)
Analgesia
Antibiotics (Co-amoxiclav)
Treat underlying cause (eczema or candida)
Define Mammary Duct Fistula
Describes a connection between the skin and a major subareolar breast duct.
Give 3 causes of mammary duct fistula
Complication of incision and drainage of non-lactating abscess.
Complication of spontaneous discharge of a peri areolar mass.
Complication following biopsy of a periductal inflammatory mass.
Define fibroademoma
Describes common benign tumours of stromal/epithelial breast duct tissue.
Often small and mobile within the breast tissue (can move)
In whom are breast fibroadenomas most common and why?
Most common in younger women (20-40).
Respond to female hormones (oestrogen and progesterone) so tend to regress after menopause.
Give 3 clinical features of breast fibroadenoma on examination.
Smooth, Firm, Round and Painless lump
Mobile (a breast mouse)
Well circumscribed (well defined borders)
When are breast fibroadenomas surgically removed?
When >3cm
Define Fibroadenosis (Fibrocystic breast disease)
Describes a benign breast condition characterised by multiple lumps within breast tissue
Give 4 clinical features of Fibrocystic Breast Disease
Lumpiness
Breast Pain or Tenderness (mastalgia)
Fluctuation in breast size
Symptoms occur prior to menstruation and resolve once menstruation begins.
Give 3 management options for fibrocystic breast disease
NSAIDs
Supportive bra and warm compress
Hormonal treatments (danazol and tamoxifen) under specialist guidance.
Describe a fat necrosis of breast tissue
Describes a benign lump formed by localised degeneration and scarring of fat tissue in the breast
What is common cause of fat necrosis in the breast?
Localised trauma, radiotherapy or surgery.
In whom is fat necrosis common?
Obese women with large breasts
