Breast disorders, history, exam

Question 1

8 causes of benign breast lumps

Answer 1

1. Fibrocystic disease
2. Fibroadenoma
3. Breast cyst
4. Breast abscess
5. Fat necrosis
6. Atypical ductal hyperplasia
7. Mastitis
8. Lipoma

Question 2

Which is the most common benign breast disease

Answer 2

Fibrocystic disease

Question 3

4 types of breast cancer

Answer 3

1. DCIS
2. Invasive ductal carcinoma
3. Invasive lobular carcinoma
4. Metastatic breast cancer

Question 4

What does triple assessment in breast investigation entail

Answer 4

1. Clinical exam
2. Imaging: USS/mammogram
3. Biopsy: core/ fine needle aspirate

Question 5

Which age group of patients are screened with a mammogram every 3 years

Answer 5

Age 50-70

Question 6

How to describe a breast lump (4S 3C 3T)

Answer 6

• Site
• Size
• Shape
• Surface (Smooth, irregular)
• Contour
• Colour
• Consistency
• Tethering
• Transillumination
• Tenderness

Question 7

Breast lumpiness which fluctuates with the menstrual cycle is likely to be:

Answer 7

Fibrocystic disease

Question 8

What causes fibroadenoma

What age group does it normally present in

Fibroadenoma lump characteristics

Answer 8

Benign overgrowth of terminal duct lobules

Present in women <30yo

Firm, non-tender, smooth, highly mobile

Question 9

What sort of lump characteristics suggest a breast abscess

Answer 9

• pus collection within breast
• painful
• inflammation of overlying skin
• common in breast feeding mothers

Question 10

What causes fat necrosis in breast

Answer 10

Trauma to breast tissue –> fibrosis and calcification of breast tissue –> firm lump

Question 11

What benign breast disease increases risk of developing breast cancer

Answer 11

atypical ductal hyperplasia

Question 12

Symptoms of mastitis

Answer 12

• red swollen hot area on breast
• painful
• breast lump
• nipple discharge (white/bloody)

risk of mastitis increased when breastfeeding

Question 13

Symptoms of breast cancer

Answer 13

• Painful breast lump
• nipple discharge
• skin changes

Question 14

Pregnancy before WHAT AGE is protective against breast cancer,
after WHAT AGE increases risk of breast cancer

Answer 14

<35: protective

> 35: increases risk

Question 15

Non-modifiable risk factors of breast cancer

Answer 15

• Race
• Older age
• Previous breast cancer
• Atypical ductal hyperplasia in previous breast biopsy
• Family hx
• Genetics: brca
• Long interval between menarche and menopause

Question 16

Modifiable risk factors of breast cancer

Answer 16

• Oral contraceptive pill
• Obesity
• Not enough exercise
• Breast feeding
• Alcohol
• HRT
• Older age at first full term pregnancy

Question 17

Is invasive ductal or invasive lobular carcinoma more common

Answer 17

More common: invasive ductal

Question 18

4 positions to inspect breast in during breast exam

Answer 18

1. arms relaxed on thighs
2. arms above head
3. arms pressing on hips
4. arms pressing on hips and leaning forwards

Question 19

What are fibroadenomas made of

Answer 19

Develop from lobules (milk producing glands)

Made of glandular and stromal connective tissue