Breast Diseases Flashcards
Paget’s Disease of the Breast
- more common in older women
- eczema-like rash around nipple and areola
- has underlying mass
- commonly associated with cancer
- bloody nipple discharge
Fibroadenoma
- benign breast lump
- smooth firm and highly mobile
- painless
Fibrocystic breast disease
- lumpy breasts
- tender
- fluctuates with the menstrual cycle
- not associated with fever or breast feeding
Lactational breast abscess
- caused by infectious mastitis
- typical in breast feeding mothers
- fever, painful breast
ductal carcinoma
abnormal proliferation of the ductal cells
- large nuclei
- basement membrane is NOT BREACHED (in-situ)
- INVASIVE DUCTAL CARCINOMA - basement membrane IS BREACHED
first line of treatment for mastitis
Flucloxacillin
mastitis
- inflammation of the breast tissue due to infection
- causes breast swelling, pain, tenderness and warm
- fever and chills
can lead to pus build up in the breast - causing lactational breast abscess
Cyclical Masatalgia
- breast tenderness which fluctuates with the period cycle
- lumpiness is caused due to fibrocystic changes in the cycle
- more common in premenopausal women
phyllodes tumour
- breast cancer
- smooth, hard, mobile breast mass
- grows rapidly
- in women from 40-50
intraductal papilloma
benign papillary tumour
- bloody nipple discharge
- no palpable mass
Radial scar
- sclerosing breast lesion
- central scarring
fat necrosis
- inflammatory reaction to adipose tissue damage
- painless breast lump
- skin thickening
mammary duct ectasia
- peri-areolar breast caused by inflammation
- breast ducts get dilated
- thick, white nipple discharge
What is a breast cyst?
- an overgrowth of glandular connective tissue
- blocks the breast ducts
- lobules fill with fluid
Risks for breast cancer
- increased hormone exposure
- late menopause
- early menarche
- HRT
- BRCA gene mutations
Lobular Carcinoma
- abnormal growth in the lobules
- more likely to be bilateral
IN-SITU: BASEMENT MEMBRANE IS NOT BREACHED
INVASIVE: basement membrane IS BREACHED
Medullary Carcinoma
- BRCA1 mutation
- more popular in younger patients
Surgical Management of Breast Cancer
- Breast saving mastectomy
or full mastectomy
Tamoxifen Drug Action
AN OESTROGEN RECEPTOR ANTAGONIST
- inhibits the transcription of oestrogen
- used to manage ER POSITIVE TUMOURS
Trastuzumb Drug Action
MONOCLONAL ANTIBODY AGONIST
- used to manage HER2 POSITIVE TUMOURS
Side Effects of Tamoxifen
causes cardiac toxicity
weight gain
risk of DVT
nausea
What is the Triple Assessment for suspected breast cancer?
- Clinical Exam
- Radio exam/ mammography
- Biopsy
When is Chemo therapy given?
- for a HER2 NEGATIVE PATIENT
Biological Management of Breast Cancer?
Herceptin - for HER2 POSITIVE TUMOUR
Hormonal Treatment for Breast Cancer
given for ER POSITIVE TUMOURS
give: Aromatase inhibitor
OR Tamoxifen
what is ANASTROZOLE
Aromatase inhibitor
how long is the referral time for suspected cancer patients
urgent 2 week referral
where does breast cancer spread first
axillary and cervical lymph nodes
when is anastrozole given?
POST MENOPAUSAL
when is tamoxifen given
PERI MENOPAUSAL
biggest risk factor for breast cancer?
ALCOHOL
What screening method is used in women <40
Ultrasound
What screening method is used for women >40
Mammogram
Why is ultrasound used on women under 40
Their breast cells are less thick so not visible well on mammogram so ultrasound is used
Bleeding from nipple
Swelling
Inverted nipple
What it is
Periductal mastitis
What is a common risk of mastectomy
Lymphoedema
Disruption to the lymphatic system
Phyllo does tumour most common characteristic
Grows rapidly in size
what happens to the cells in pagets disease of the nipple
the ductal carcinoma cells migrate onto the skin over the nipple
- this can cause the eczema around the nipple
- bloody discharge
risk of tamoxifen?
increases the risk of endometrial cancer
- given to PREMENOPAUSAL WITH OESTROGEN POSITIVE BREAST CANCER
what is sentinel lymph node biopsy
radioactive substance is injected where the tumour is, and it travels to where the tumour drains into
- the path of the tumour can be seen as it lights up