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Breast Conditions > Breast Lumps > Flashcards

Breast Lumps Flashcards

1
Q

What are the cornerstones of triple assessment of breast lumps.

A

Clinical.
Imaging.
Pathology.

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2
Q

What should you look at clinically when presented with a breast lump. (2)

A

History.

Examination.

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3
Q

What imaging is used to assess a breast lump. (2)

A

Mammography (if >35).

Ultrasound (if

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4
Q

What is used to assess the pathology of a breast lump. (2)

A 
Fine needle aspiration cytology (for cystic lump with bloody fluid, if clear fluid, just reassure patient). 
Core biopsy (for residual mass (cystic) and solid lumps).
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5
Q

What is a fibroadenoma.

A

A benign overgrowth of collagenous mesenchyme of one breast lobule. (An aberration of normal tissue development.)

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6
Q

Where do fibroadenomas arise from.

A

From whole lobules.

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7
Q

When do fibroadenomas tend to occur.

A

They peak in the 3rd decade.

But they may occur at any age.

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8
Q

What are the symptoms of fibroadenomas. (2)

A

Lump.

Usually painless.

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9
Q

What are the physical findings of a breast lump. (5)

A 
Firm.
Smooth. 
Rubbery. 
Highly mobile lump. 
There may be multiple.
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10
Q

What is the prognosis for patients with fibroadenomas. (3)

A

1/3 regress.
1/3 stay the same.
1/3 grow.

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11
Q

What part of the lobules do fibroadenomas affect.

A

The terminal duct lobules.

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12
Q

What is the epidemiology of fibroadenomas.

A

They are the second most common cause of breast lumps in women under 35.

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13
Q

What is a breast cyst.

A

Smooth fluid-filled sacs.

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14
Q

What do breast cysts do to the breast lobules.(2)

A

They cause an enlarged involuted lobule.

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15
Q

What are the symptoms of breast cysts.

A

They are lumps which may be painful or painless.

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16
Q

What causes a painful breast cyst.

A

High pressure in the cystic sac.

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17
Q

What are the physical findings in a breast cyst. (4)

A

Soft and fluctuant lumps when the sac pressure is low.
Hard and painful lumps when the sac pressure is high.
They are not fixed to the surrounding tissue.

18
Q

Do breast cysts occur alone or in clusters.

A

Either. They may be solitary or they may occur in clusters.

19
Q

Who are breast cysts common in. (2)

A

Perimenopausal women

20
Q

Are breast cysts benign of malignant.

A

Benign.

21
Q

What is the prognosis for patients with breast cysts.

A

They commonly recur.

There is a slight increase in risk of breast cancer with cystic disease.

22
Q

How is the diagnosis for a breast cyst reached.

A

Aspiration.

23
Q

What is a fat necrotic of the breast.

A

It is fibrosis and calcification after injury to the breast tissue.

24
Q

What is the primary cause of fat necrosis of the breast.

A

Trauma.

25
Q

What is felt on physical examination of the breast in fat necrosis.

A

A firm lump.

26
Q

What other sign may be present if there is fat necrosis.

A

Associated haematoma.

27
Q

What is the difficulty in diagnosis fat necrosis.

A

It is difficult to differentiate from carcinoma on clinical exam.

28
Q

What is the prognosis for fat necrosis of the breast.

A

It usually resolves spontaneously.

29
Q

What is a lipoma.

A

A common benign neoplasm composed of adipose tissue

30
Q

What is duct ectasia. (2)

A

It is a normal change in which the ducts shorten and widen during breast involution in later life.
The ducts become blocked and secretions stagnate.

31
Q

What are the clinical signs of duct ectasia. (3)

A 
Lump. 
Nipple discharge (may be bloody, green or brown). 
Nipple retraction (usually slit-life).
32
Q

What is a phyllodes tumour.

A

It is an uncommon fibroepithelial neoplasm.

33
Q

Are phyllodes tumours malignant or benign. (2)

A

The majority are benign, but may recur after excision.

They may be malignant, but metastases is very uncommon.

34
Q

What are the clinical features of phyllodes tumours. (2)

A

Firm lump.

Size may increase rapidly.

35
Q

What is duct papilloma.

A

A common benign neoplasm that grows within the milk duct of the breast.

36
Q

Where in the breast does duct papilloma occur.

A

Often occurs in the subareolar ducts.

37
Q

What are the clinical features of duct papilloma. (2)

A

Single or multiple lumps.

There is nipple discharge which may be bloody.

38
Q

When in life does duct ectasia usually occur.

A

Typically occurs around menopause.

39
Q

Where do phyllodes tumours arise from.

A

They form from the periductal stromal cells of the breast..

40
Q

What percentage of breast neoplasms do phyllodes tumours account for.

A

Less than 1%.

41
Q

What are the clinical findings in a patient with a lipoma. (4)

A

Smooth, imprecise margins.
Slight fluctuance.
Not fixed to skin or deep structures.
Not usually painful.

Breast Conditions (4 decks)

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