Breast disorders Flashcards
What is a fibroadenoma?
Common under 30
Described as breast mice- discrete, non-tender, highly mobile lumps
if >3cm surgical excision
What is fibroadenosis (fibrocystic disease, benign mammary dysplasia)?
Most common in middle-aged women
‘Lumpy’ breasts which may be painful. Symptoms may worsen prior to menstruation
What is breast cancer?
Characteristically a hard, irregular lump. There may be associated nipple inversion or skin tethering
Paget’s disease of the breast - intraductal carcinoma associated with a reddening and thickening (may resemble eczematous changes) of the nipple/areola
What is mammary duct ectasia?
Dilatation of the large breast ducts
Most common around the menopause
May present with a tender lump around the areola +/- a green nipple discharge
If ruptures may cause local inflammation, sometimes referred to as ‘plasma cell mastitis’
What is duct papilloma?
Local areas of epithelial proliferation in large mammary ducts
Hyperplastic lesions rather than malignant or premalignant
May present with blood stained discharge
What is fat necrosis?
More common in obese women with large breasts
May follow trivial or unnoticed trauma
Initial inflammatory response, the lesion is typical firm and round but may develop into a hard, irregular breast lump
Rare and may mimic breast cancer so further investigation is always warranted
What is breast abscess?
Lactational mastitis is common
Infection is usually with Staphylococcus aureus
On examination there is usually a tender fluctuant mass
Treatment is with antibiotics and ultrasound guided aspiration
Overlying skin necrosis is an indication for surgical debridement, which may be complicated by the development of a subsequent mammary duct fistula.
What is periductal mastitis?
Present at younger age than duct ectasia
May present with features of inflammation, abscess or mammary duct fistula
Stongly associated with smoking
Usually treated with antibiotics, abscess will require drainage
Most common type of breast cancer?
Invasive ductal carcinomas
Check Nottingham score
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Mentioned in the powerpoint
Benign breast change
Fibroadenoma
Cyst
Sebaceous cyst
Papilloma
Fat necrosis/haematoma
Mastitis/abscess
Cancer
Sarcoma, lymphoma, metastases
Fibrodenoma
Cyst
Benign breast change
Implant problems
Mastitis
Abscess
Duct ectasia
Papilloma
