Breast Disease Flashcards
minor factors on history for someone with breast changes?
any children before? breastfeed menarche menopause (natural/artificial) HRT past medical of breast disease radiation therapy (hodkin's lymphoma) smoking, ETOH allergies
breast lump history type that are worrying?
atypical ductal hyperplasia
if mastalgia and varies with menstrual cycle, should we be worried?
less so
differential for young woman with breast lump that doesn’t vary with menstrual cycle?
fibroadenoma (usu younger age group)
cyst
redness and tenderness/pain around a lump in breast ddx??
inflammatory breast cancer
abcess
fibroadenomas and cysts painful?
just on palpation, mild tenderness
which nodes to examine in breast exam?
axilla
supraclav
quick breast cancer screen to rule out metastatic disease
hepatomegaly
lung
spine punch
how to investigate new breast lump in young woman?
U/S both breasts
38 year old 3/12 hx, breast tenderness that varies with menstrual cycle ddx? inv?
fibrocystic change (30s-40s pre-menopausal)
mammogram
U/S
breast pain rx?
not caffeine
vitamin B6
can try evening primrose oil
tamoxifen/androgens but has side effects
U/S for breast screening?
Nope, better for lumps
screen with mammogram
send off the breast cystic fluid?
yes if there’s blood
otherwise discard
could have any colour
nipple discharge questions?
blood? pus? milk? clear/yellow any masses?
spontaneous or express-able (which duct)
investigations for nipple discharge
mammogram
U/S focused retro-areola
if bloody discharge from nipple, why investigate so fiercely?
- papilloma (growth inside duct)
- cancer
- duct ectasia (dilation of ducts)
- green,
what to ask someone who presents with breast lump?
nipple changes growing? family history: 1st and secondary degree lymph node tenderness ovarian cancers BRCA1 BRC2
when you want to use adjuvant therapies?
high grade
lymph involvement
or HER2
