breast disease Flashcards
what is the most common cancer in women
breast
what is the most common type of breast cancer
ductal
what are relatively low risk factors for breast cancer
early menarche late menarche nulliparity proliferative benign disease obesity alcohol HRT
what are medium risk factors for breast cancer
age >35 at first birth
1st degree relative with breast cancer
radiation exposure
previous breast cancer
what are high risk factors for breast cancer
gene mutation
lobular carcinoma in situ
ductal carcinoma in situ
atypical hyperplasia
what are protective factors against breast cancer
routine vigorous physical activity
maintenance of healthy body weight
what are some of the most common breast cancer symptoms
dimpled or depressed skin visible lump nipple change eg inversion bloody discharge texture change colour change
which cancer accounts for around 80% of breast malignancies
ductal
what are typical characteristics of a ductal carcinoma
stellate solid mass
pleomorphic casting micro calcifications
what imaging modality is best for young woman
USS
what is needed for definitive diagnosis
core-needle biopsy
vacuum assisted biopsy
lobular carcinoma in situ is a tumour marker for which type of cancer
ductal
what is the preferred treatment option for breast cancer
breast-conserving surgery
what is removed during a total mastectomy
entire breast
overlying skin
axillary lymph nodes
what should be preserved during mastectomy to allow for reconstruction
pectoralis major
indications for post-mastectomy radiotherapy
involvement of more than 3 nodes
positive surgical margins
tumours >5 cm
what is tamoxifen
ER antagonist
what drug targets HER2
trastuzumab (Herceptin)
monoclonal Ab
what is the most common benign neoplasm
fibroadenoma
when is fibroadenoma most common
20-30
characteristics of a fibroadenoma
rubbery to firm mobile smooth distinct borders non tender
how do phyllodes tumours differ from fibroadenoma
larger
older women
tend to increase in size
how does management of phyllodes tumour differ from fibroadenoma
they should be excised with 1 cm margins and followed up
clinical characteristics of a breast cyst
palpable clearly defined soft mobile smooth tender
when to suspect intracyctis carcinoma
grossly bloody fluid aspirated from a cyst
residual mass after aspiration of cyst
what is nipple discharge most commonly a sign of
intraductal papilloma (benign)
management of intraductal papilloma
excisions and histologically examined to rule out intraductal carcinoma
investigations of pathological nipple discharge
mammography
USS
surgical excision of the discharging ducts
erythematous weeping lesion on the surface of the nipple and the areola
Paget’s disease
common presentation of Paget’s disease
dry, scaly, eczematous lesion of nipple
clinical signs of mastitis
fever erythema induction tenderness swelling
treatment of mastitis
fluclox
co-amoxiclav
treatment of breast abscess
aspiration
may need repeated every 3 days
open surgical drainage if aspiration not effective
management of non-puerperal mastitis
co-amoxiclav
