Breast Diseases Flashcards
What are some risk factors for developing breast cancer?
Family history Age Uninterrupted oestrogen exposure Nulliparity HRT Obesity Not breastfeeding BRCA genes
What are the different types of breast cancer?
Non-invasive ductal carcinoma in situ Non-invasive lobular carcinoma in situ Invasive ductal carcinoma - most common Invasive lobular Medullary Colloid/mucoid
What are the symptoms of breast cancer?
Lump in the breast Breast pain Nipple change Nipple discharge Skin contour changes
What is a sign of breast cancer?
Skin change - peau d’orange
What tests are used to diagnose breast cancer?
All lumps should undergo triple assessment:
- Clinical examination
- Histology/cytology
- Mammography/ultrasound
CT or MRI scan to assess extent and mets
What is the treatment for breast cancer?
Surgery: wide local excision, mastectomy, sentinel node biopsy +/- sentinel node clearance
Radiotherapy
Chemotherapy: vinorelbine, docetaxel
Endocrine agents: tamoxifen, herceptin, aromatase inhibitors e.g. anastrozole
What is Paget’s Disease of the Nipple?
A rare type of cancer of the nipple-areolar complex presenting as an eczematous lesion of the nipple and it’s often associated with an underlying in-situ or invasive carcinoma of the breast
What is the pathophysiology of Paget’s Disease of the Nipple?
Usually unilateral, some cases may occur after a mastectomy despite there being no breast tissue present. It usually involves the nipple but can extend to involve other areolar skin.
How does Paget’s Disease of the Nipple present?
Chronic eczematous changes of the nipple with itching, erythema, scale formation, erosions, nipple discharge including bleeding. There is often an underlying breast lump.
What is the differential diagnosis for Paget’s Disease of the Nipple?
Skin disorders e.g. eczema
Melanoma of the nipple
Nipple adenoma
What investigations should you perform for Paget’s Disease of the Nipple?
Biopsy with immunohistochemistry
Investigation of a breast lump if palpable
Investigations looking for an underlying malignancy if there is no lump palpable
What are the associations with Paget’s Disease of the Nipple?
Higher histological grade
Oestrogen receptor-negative breast cancer
Progesterone receptor-negative breast cancer
What is the management of Paget’s Disease of the Nipple?
Chemotherapy
Radiotherapy
Surgery
