Breast disease Flashcards

1
Q

What r some presenting feautures of breast disease?

A
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2
Q

How is breast disease divided? & explain their future risk of cancer?

A
  • Non-proliferative disorders - no increased risk.
  • Proliferative disorders without atypia - mild to moderate increase in risk.
  • Atypical hyperplasias - substantial increase in risk (relative risk in the order of 4.1-5.3).
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3
Q

Causes for physiological swelling and tenderness

A

Puberty

• Breast enlargement, sometimes initially unilateral, is the first obvious sign of puberty in girls. Breast buds may initially be unilateral. Pubertal breast development is known as thelarche.

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4
Q

What is the most common benign breast disorder

how does it present?

when r the symptoms at its greatest? When do the decrease?

examination?

treatment?

A

Fibrocystic change

• This usually affects women aged 20-50 and appears to be hormonal in aetiology.

Most often presents with pain and nodularity.

The symptoms are greatest about one week BEFORE menstruation and decrease when it starts.

Examination may reveal an area of nodularity or thickening, poorly differentiated from the surrounding tissue and often in the upper outer quadrant of the breast.

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5
Q

If the changes are bilaterally or unilateral symmetrical, they are rarely pathological.

Choose one

A

Bikateral

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6
Q

Cyclical mastalgia

A

The breasts are active organs that change throughout the menstrual cycle and some degree of tenderness and nodularity in the premenstrual phase is so common that it may be considered as normal, affecting up to two thirds of all menstruating women. It rapidly resolves as menstruation starts.

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7
Q

Most benign lumps will be either _____or_______

A

cysts or fibroadenomas

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8
Q

Describe how a benign mass feels?

A

Smooth, hard,mobile, regualr borders, solid or cystic in consistency

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9
Q

Breasts cysts

commin in ages?

treatment

A

common ages of 35 & 50.

milk glands can fill up with fluid

palpable lumps and may be recurrent. (sometimes painful)

They cannot be reliably distinguished from solid tumours on clinical examination

aspirate it and the patient says its gone

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10
Q

Name 2 stromal tumors

type of patient, presentation, treatment

A

stromal (are connective tissue cells of any organ,)

WLE >> wide local excision

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11
Q

Most common breast lesion?

age?

where do they arise from? Composed of?

presentation?

what increases the incident?

A

Fibroadenomas

  • benign tumours that are common in young women, peak at 20-24 years of age.
  • They are the most common type of breast lesion.
  • Fibroadenomas arise in breast lobules and are composed of fibrous and epithelial tissue.
  • They present as firm, non-tender, highly mobile palpable lumps.
  • Hormones seem to be involved in aetiology, & (HRT) increases the incidence.
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12
Q

Wsh tha?

A

Fibroadenoma

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13
Q

In terms of nipple discharge,

is unilateral or bilatera discharge likely to be breast cancer?

A

Unilateral

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14
Q

What is intraductal papilloma?

how does it cause nipple discharge?

A

wart-like lump that develops in one or more of the milk ducts in the breast

Benign growth causes imflammation>> reach end of nipple>> discharge

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15
Q

Mammary duct ectasia

A

near menopuase > major ducts behind nipple DILATE + SHORTEN & fill w/ creamy secretion w/ periductal inflammation.

COMMON IN SMOKERS!

Symptoms

  • may be asymptomatic
  • nipple dishcarge (bloody, creamy white or yellow, serous)
  • retracted nipple (bc duct shortened)
  • recurrent chronic inflammation w/ abscess formation

treatment>> surgical excison of the major duct, and correct nipple retraction.

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16
Q

What is this?

treatemnt

presentation

caused by?

A

Mastitis

17
Q

Gynaecomastia

A

 Occurs in 30% of boys at puberty

 Hormone secreting tumours: e.g. sex-cord testicular

 Chronic liver disease: hypogonadism + ↓E2

metabolism, kleinfelters

 Drugs: spironolactone, digoxin, cimetidine

18
Q

Amastia

A

complete absence of breast and nipple

19
Q

Accessory nipples

A

Can occur anywhere along the milk line

20
Q

Mastalgia

types? age common? releived by? treated?

A

Cyclical

 ~35yrs
 Pre-menstrual pain
 Relieved by menstruation
 Commonly in UOQ bilaterally

Non-cyclical

 ~45yrs

 Severe lancing (sharp) breast pain (often left)

 May be assoc. ̄c back pain

Rx

check other breast disease

 Reassurance + good bra for most

 1st line: EPO (eveing primrose oil) (contains gamma-linoleic acid)

 OCP

 Topical NSAIDs (e.g. ibuprofen)

 Bromocriptine ( inhibits prolactin release)

 Danazol (an androgen similar to testosterone)

 Tamoxifen

21
Q

Inflammatory breast conditions?

type of patient, presentation, treatment

A

PAD Fat

fat necorosis> damage to the fatty tissue (following breast surgery, biospy, radiotherapy, trauma)

22
Q

Benign Epithelial Lesions

type of patient, presentation, treatment

A
23
Q

Malignant Conditions

type of patient, presentation, treatment

A