Breast Disease Flashcards
What is gynaecomastia?
breast development in males
What can cause gynaecomastia?
cannabis
exo/endogenous hormones
prescription drugs e.g. spironolactone
liver disease
What is fibrocystic change?
cysts with intervening fibrosis
How does fibrocystic change present?
incidental finding/screening
smooth discrete lumps
cyclical pain
sudden pain
What can cause fibrocystic change?
menstrual abnormalities e.g. early menarche, late menopause
How is fibrocystic change treated?
often resolve/diminish post menopause
reassure/exclude malignancy
excise if necessary
How do fibroadenoma present?
incidental finding/screening
painless, discrete, mobile, firm mass
How are fibroadenomas treated?
diagnose and reassure
excise if necessary
What are fibroadenomas?
benign breast lumps
biphasic - stromal and epithelial tissue
How are breast lumps investigated?
triple assessment
What is triple assessment?
1 - history and exam
2 - imaging - USS, mammogram
3 - cytology/histology (FNA, core biopsy)
What is a hamartoma?
benign breast lesion
cell types normal to breast but in high numbers
painless lump
diagnose and reassure
What are the 2 types of sclerosing lesions?
radial scar
sclerosing adenosis
What is a radial scar?
benign, disorderly proliferation of acini and stroma
How do sclerosing lesions mimic carcinoma?
calcification on mammogram
How does a radial scar present?
mass
incidental finding - calcification on Mx
How are sclerosis lesions treated?
excise them
How does sclerosing adenosis present?
lumpiness
mass
pain, tenderness
incidental finding
What is duct ectasia associated with?
smoking
What is duct ectasia?
periductal inflammation and fibrosis
How does duct ectasia present?
nipple retraction, distortion, discharge (bloody, purulent)
pain
How do you treat duct ectasia?
excise ducts
smoking cessation
treat acute infections
What is fat necrosis?
damage and disruption of adipocytes
infiltration by acute inflame cells causing fibrosis and scarring
What can cause fat necrosis?
warfarin
local trauma e.g. seatbelt injury
How does fat necrosis present? How is it treated?
lump
reassure
What are the 2 main aetiologies of acute mastitis?
duct ectasia
lactation
What are the symptoms of acute mastitis?
pain redness swelling warmth of breast fever and chills
What is the treatment of acute mastitis?
lactation - fluclox and advise to continue breastfeeding
antibiotics, incision and drainage if abscess
