Breast Lumps

Question 1

What does a triple assessment involve?

Answer 1

Clinical assessment
Imaging - US or mammography
Histology - fine needle aspiration or core biopsy

Question 2

What are fibroadenomas?

Answer 2

Common benign tumours of stromal/epithelial breast duct tissue

Question 3

What age are fibroadenomas more common?

Answer 3

20-40 years
Respond to female hormones

Question 4

How do fibroadenomas appear on examination?

Answer 4

Painless
Smooth
Round
Well defined borders
Mobile
Up to 3cm in diameter

Question 5

Explain fibroadenomas association with breast cancer?

Answer 5

Not cancerous
Not associated with increased risk of developing breast cancer

Question 6

What are fibrocystic breast changes?

Answer 6

When connective tissues (stroma), ducts and lobules of the breast respond to the female sex hormones (oestrogen and progesterone), becoming fibrous (irregular and hard) and cystic (fluid-filled).

Question 7

Explain how fibrocystic breast changes can present?

Answer 7

Lumpiness
Breast pain or tenderness
Fluctuation of breast size
Symptom often occur prior to menstruation and resolve when it begins

Question 8

What is management of fibrocystic breast changes?

Answer 8

Exclude cancer first
Wear supportive bra
NSAIDs
avoid caffeine
Heat to area
Hormonal treatments

Question 9

What age do breast cysts tend to occur

Answer 9

30-50 yearsH

Question 10

How do breast cysts present?

Answer 10

Painful lump fluctuating in size over menstrual cycle

Question 11

How do breast cysts appear on examination?

Answer 11

Smooth
Well circumscribed
Mobile
Fluctuant

Question 12

What is management of breast cysts?

Answer 12

Exclude cancer
Potential aspiration or excision to help with symptoms

Question 13

What are breast cysts association with cancer ?

Answer 13

May slightly increase the risk of breast cancer

Question 14

What is fat necrosis?

Answer 14

Benign lump formed by localised degeneration and scarring of fat tissue in the breast

Question 15

What triggers fat necrosis?

Answer 15

Trauma
Radiotherapy
Surgery

Question 16

How does fat necrosis appear on examination?

Answer 16

Painless
Firm
Irregular
Fixed in local structures
Can be dimpling of skin or nipple inversion

Question 17

What investigations would you do for fat necrosis?

Answer 17

USS or mammogram to exclude breast cancer
Histology to confirm diagnosis

Question 18

How is fat necrosis treated?

Answer 18

Conservatively
May resolve spontaneously with time

Question 19

What are lipomas?

Answer 19

Benign tumours of fat tissue

Question 20

How do lipomas appear on examination?

Answer 20

Soft
Painless
Mobile
Do not cause skin changes

Question 21

How are lipomas treated/

Answer 21

Conservatively
Surgical removal

Question 22

What are galactoceles

Answer 22

Breast milk filled cysts occurring when the lactiferous duct is blocked

Question 23

Who do galactoceles affect?

Answer 23

Women who are lactatingH

Question 24

How do galactoceles present>

Answer 24

firm, mobile, painless lump, usually beneath the areola

Question 25

What is management of galactocele?

Answer 25

Usually resolve without any treatment

Question 26

What are phyllodes tumour ?

Answer 26

Rare tumours of the connective tissue (stroma)

Question 27

What age do phyllodes tumours affect?

Answer 27

40-50 years

Question 28

What percentage are malignant of phyllodes tumours?

Answer 28

25%

Question 29

What is treatment of phyllodes tumours?

Answer 29

surgical removal
Chemo