Breast disorders

Question 1

Fibroadenoma

Answer 1

Common in under 30s, discrete non tender highly mobile lump. If > 3cm surgical excison.

Question 2

Fibroadenosis

Answer 2

In middle aged women, lumpy painful breasts, worse prior to menstruation.

Question 3

Breast cancer

Answer 3

Hard irregular lump. Nipple changes. Skin tethering.

Most commonly upper outer quadrant.

Question 4

Paget’s disease of the breast

Answer 4

Intraductal carcinoma. Reddening thickening of the nipple. Itchy erythematous scaly rash on nipple and areola area.

Question 5

Mammary duct ectasia

Answer 5

Dilation of breast ducts. Seen in menopause. Tender lunch around the nipple. Green nipple discharge.
Rupture can cause plasma cell mastitis

Question 6

Duct papilloma

Answer 6

Epithelial proliferation in ducts. Blood stained nipple discharge.

Question 7

Fat necrosis

Answer 7

Due to blunt force trauma, in obese people

Question 8

Breast abscess

Answer 8

Seen in lactating women. Red hot tender swelling. Typically staph aureus from the baby’s mouth.
USS + drainage + antibiotics (erythromycin or clarithromycin)

Question 9

Mastitis

Answer 9

1 in 10 breastfeeding women.
Continue breastfeeding for 24-48 hours. If no improvement or signs of infection developing -> flucloxacillin for 10-14 days.