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Breast > Breast Infection / other > Flashcards

Breast Infection / other Flashcards

1
Q

What is Phyloddes tumour

A

Tumour of breast
Large and fast growing
Can be benign or malignant potential
FIbroepithlial

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2
Q

What is benign part

A

Epithelial

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3
Q

What is malignant

A

Stroma / connective tissue

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4
Q

What type of malignancy

A

Mixed adenocarcinoma

Glandular and fibrous tissue

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5
Q

How does it present

A

Pre-menopause (40-50)
Smooth firm lump
Circumscribed

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6
Q

Histologically

A

Leaf like + cyst

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7
Q

How do you investigation

A

Triple assess
Biopsy as FNA misses
Do multiple pass as don’t want to miss

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8
Q

How do you Rx

A

Surgery
Often mastectomy but can do WLE
RT after if malignancy

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9
Q

What can it be confused with

A

Fibroadenoma but usually larger and older patient

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10
Q

What is duct ectasia

A

Dilatation and shortening of breast ducts in menopause
Leads to
Stagnant secretion
Ruptured material = dilatation / inflammation / fibrosis

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11
Q

How does duct ectasisa present

A 
Nipple discharge 
Lump behind nipple if inflamed 
Nipple retraction / inversion 
Mastalgia 
Red/ swollen / warm
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12
Q

What is discharge

A

Green / yellow /red
Never blood but can be blood stained
Multiple duct
Bilateral

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13
Q

RF

A

Menopause

Smoking

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14
Q

How do you Dx

A

Triple assess

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15
Q

How do you Rx

A

Stop smoking

Duct excision if persistent

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16
Q

What are types of mastitis

A

Neonatal
Lactating
Non lactating
Skin associated

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17
Q

What are common organism

A

S.Aureus

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18
Q

What are other organisms in non-lactating

A

Enterococci

Anerobic strep

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19
Q

What causes lactating mastitis

A

Milk stasis

If too painful = express

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20
Q

What can develop with all breast infection

A 
Abscess if left unRx
Red
Hot
Tender swelling
Pus dischage
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21
Q

How does lactating mastitis present

A 
Pain
Swelling
Tender
Erythema
Hx cracked nipple
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22
Q

What is non-lactating mastitis known as

A

Periductal

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23
Q

RF for peri-ductal mastitis

A 
Smoking
Immunocompromised
DM
Obesity
Pregnant / lactating
Neonate
24
Q

What organism in neonate

A

E.coli

25
Q

How do you Dx

A

Examine
Swab of discharge / breast milk
USS guided aspiration if abscess

26
Q

How do you treat lactating

A

Continue breast feeding / express
Warm compress
Analgesia

27
Q

When do you give Ax

A

No improvement 12-24 hours

Culture +Ve

28
Q

What Ax

A

Fluclox 1st lie

Erythromycin

29
Q

How do you treat abscess

A

Aspiration USS
Repeat till no pus
Ax
Surgical incision + drainage if necrotic

30
Q

What do you do if inflammatory lesion + solid on USS or not settling with one course Ax

A

BREAST REFERRAL
Triple assessment
Inflammatory carcinoma

31
Q

How does inflammatory carcinoma present

A

Red breast
Not cured after Ax or no signs of infection - CRP / fever
Peu d’orange

32
Q

Why is it important fast referral

A

Dermal lymphatic spread
Bilateral
Advanced nodes
Block LN drainage

33
Q

How do you Rx

A

Chemo neoadjuvant = 1st line
Mastectomy + RT
Whole breast change

34
Q

What causes periductl

A

S.aureus

35
Q

How does it present

A 
Hot red breast
Tender
Discharge
Lump behind nipple
Nipple pulled in
Abscess
36
Q

Differentiate from duct ectasia

A

Younger

37
Q

How do you Dx

A

Triple asses
USS
FNA

38
Q

How do you Dx

A

Ax

Open incision and drain

39
Q

Complication

A

Mammary duct fistula

40
Q

What is gynaecomastia

A

Growth of Brest tissue in males

Benign and reversible

41
Q

What causes gynaecomastia

A 
Decreased androgen - testosterone 
or increased oestrogen
Puberty
Old age
Fat
42
Q

What are other non physiological causes

A 
Anabolic steroid
Cannabis
Spinolactone
Digoxin
Furosemide
Liver cirrhosis
Alcohol 
Prolactinoma 
Primary hypogonadism - testicular issue 
Testicular tumour 
Hyperthyroid 
Chronic renal and pulmonary disease
43
Q

How do you Dx

A

Blood
Hormonal + biochemical
MG or USS differentiate / cancer

44
Q

What do you do for breast lump in male

A

3x assessment

Biopsy

45
Q

What is 1st line gynaecomastia

A

Tamoxifen

46
Q

Other Rx

A

Danazole (AI)

Surgery

47
Q

What is galactorrhea

A

Producing milk from breast
Physiology in response to prolactin from AP
Dopamine will block prolactin

48
Q

What causes galactorrhea

A 
Lactation
Pregnant and post breast feeding - can begin in 2nd trimester 
Idiopathic hyperprolactin
Prolactinoma 
Drugs
Endocrine
Other
49
Q

What is a prolactinoma and what are the symptoms

A

Tumour of the pituitary gland

  • Galactorrhoea
  • Amenorrhoea
  • Infertiltiy
  • Gynaecomastia
  • Sexual dysfunction
  • Bitemporal hemianopia
50
Q

What types of prolactinoma can you get

A

Micro <1cm

Macro >1cm

51
Q

What can they be associated with

A

MEN1

52
Q

How do you treat

A

Dopamine agonist

Surgery if fails

53
Q

What drugs can cause hyperprolactin

A 
Contraception
SSRI
Dopamine antagonist - Anti-psychotic / anti-emetic
Methyldopa
BB
Digoxin
Spirnolactone
54
Q

What endocrine causes

A

Hypothyroid
Acromegaly
CUshing’s
PCOS

55
Q

What are other causes

A

Liver failure

CKD

Breast (6 decks)

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