Breast Lumps Flashcards
What does a triple assessment involve?
Clinical assessment
Imaging - US or mammography
Histology - fine needle aspiration or core biopsy
What are fibroadenomas?
Common benign tumours of stromal/epithelial breast duct tissue
What age are fibroadenomas more common?
20-40 years
Respond to female hormones
How do fibroadenomas appear on examination?
Painless
Smooth
Round
Well defined borders
Mobile
Up to 3cm in diameter
Explain fibroadenomas association with breast cancer?
Not cancerous
Not associated with increased risk of developing breast cancer
What are fibrocystic breast changes?
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).
Explain how fibrocystic breast changes can present?
Lumpiness
Breast pain or tenderness
Fluctuation of breast size
Symptom often occur prior to menstruation and resolve when it begins
What is management of fibrocystic breast changes?
Exclude cancer first
Wear supportive bra
NSAIDs
avoid caffeine
Heat to area
Hormonal treatments
What age do breast cysts tend to occur
30-50 yearsH
How do breast cysts present?
Painful lump fluctuating in size over menstrual cycle
How do breast cysts appear on examination?
Smooth
Well circumscribed
Mobile
Fluctuant
What is management of breast cysts?
Exclude cancer
Potential aspiration or excision to help with symptoms
What are breast cysts association with cancer ?
May slightly increase the risk of breast cancer
What is fat necrosis?
Benign lump formed by localised degeneration and scarring of fat tissue in the breast
What triggers fat necrosis?
Trauma
Radiotherapy
Surgery
How does fat necrosis appear on examination?
Painless
Firm
Irregular
Fixed in local structures
Can be dimpling of skin or nipple inversion
What investigations would you do for fat necrosis?
USS or mammogram to exclude breast cancer
Histology to confirm diagnosis
How is fat necrosis treated?
Conservatively
May resolve spontaneously with time
What are lipomas?
Benign tumours of fat tissue
How do lipomas appear on examination?
Soft
Painless
Mobile
Do not cause skin changes
How are lipomas treated/
Conservatively
Surgical removal
What are galactoceles
Breast milk filled cysts occurring when the lactiferous duct is blocked
Who do galactoceles affect?
Women who are lactatingH
How do galactoceles present>
firm, mobile, painless lump, usually beneath the areola
What is management of galactocele?
Usually resolve without any treatment
What are phyllodes tumour ?
Rare tumours of the connective tissue (stroma)
What age do phyllodes tumours affect?
40-50 years
What percentage are malignant of phyllodes tumours?
25%
What is treatment of phyllodes tumours?
surgical removal
Chemo
