Breast lumps Flashcards
The most significant differential of a breast lump is…
Breast cancer
What clinical features may suggest breast cancer?
- Lumps that are hard/irregular and/or tethered to the skin or chest wall
- Nipple changes (e.g. retraction, discharge)
- Skin changes (Paget’s disease of the nipple, peau d’orange)
What is a fibroadenoma?
Benign tumour of stromal/epithelial breast duct tissue
What is the other name for a fibroadenoma?
“Breast mouse”
Describe the features of a fibroadenoma on examination
Smooth, firm and mobile
Fibroadenomas commonly affect which age group?
20-40 years old
Are fibroadenomas associated with an increased risk of developing breast cancer?
What treatment is advised for large fibroadenomas (>3cm)?
- No usually not, however…
- Complex fibroadenomas and a positive family history of breast cancer may indicate a higher risk
Excision
What is a breast cyst?
Benign, fluid-filled lump of the breast
What is the most common cause of breast lumps?
Breast cyst
Which age group do breast cysts most commonly affect?
Perimenopausal
Describe the clinical features of a breast cyst on examination
Similar to a fibroadenoma (smooth, firm, mobile)
Is there any association between breast cysts and breast cancer?
Having a breast cyst may slightly increase the risk of breast cancer
Which intervention may help to relieve pain for a patient with a breast cyst?
Aspiration
What is fat necrosis? What triggers this process?
An inflammatory process - fibrosis and necrosis of fat tissue results in formation of benign lump
This is commonly triggered by localised trauma, radiotherapy or surgery
Describe the clinical features of fat necrosis on examination
Fat necrosis may have some features which can also be present in breast cancer e.g. irregular lump, nipple changes, tethering
In fat necrosis, USS and mammogram may show…
A similar appearance to breast cancer (therefore histology may be required to confirm the diagnosis and exclude breast cancer)
Describe the management of fat necrosis
- Usually treated conservatively (may resolve spontaneously with time)
- Surgical excision may be required
What is a lipoma?
Benign tumour of fat tissue
Describe the clinical features of a lipoma
- Can occur anywhere on the body
- Typically soft, mobile and painless
Typically how is a lipoma managed?
Conservatively with reassurance
What is a galactocele? Who gets this type of breast lump?
Cyst filled with breast milk, caused by a blocked lactiferous dust
These commonly occur in women who are lactating (often after stopping breastfeeding)
Describe the clinical features of a galactocele
Firm, mobile and painless lump (usually beneath the areola)
How is a galactocele managed?
Conservatively with reassurance (usually resolve spontaneously)
