BREAST MASS

Question 1

Fibrocystic condition

(1) General Considerations

Answer 1

(a) Painful breast masses
1) Often multiple and bilateral
(b) Pain often worsens during premenstrual phase of cycle
(c) Rapid fluctuation in mass size is normal
1) Estrogen is considered a causative factor
2) Increased risk in women who drink alcohol
(d) Most frequent lesion of the breast
(e) Most common age is 30-50
(f) Generally considered to increase the risk of subsequent breast cancer

Question 2

Pertinent Anatomy of a patient with a Fibrocystic Breast Mass.

Answer 2

(a) Breast
1) Mammary glands
a) Lobes
b) Alveoli
c) Tubules

Question 3

Signs and symptoms of a Fibrocystic Breast Mass.

Answer 3

(a) Breast pain or tenderness
1) May be asymptomatic and found on accident
(b) Discomfort often worsens during premenstrual phase of cycle as cysts are enlarging
(c) Fluctuation in size of masses
(d) Multiple or bilateral
(e) Absence of enlarged or tender lymphadenopathy

Question 4

Differential diagnosis of a Fibrocystic Breast Mass.

Answer 4

(a) Fibroadenoma

(b) Breast carcinoma

Question 5

Laboratory findings

of a Fibrocystic Breast Mass.

Answer 5

None

Question 6

Imaging of a Fibrocystic Breast Mass.

Answer 6

(a) Mammography
(b) Ultrasound
1) Used alone when patient is under 30 years old

Question 7

Diagnostic testing of a Fibrocystic Breast Mass

Answer 7

(a) Core needle biopsy

1) All suspicious lesions should be biopsied by a General Surgeon

Question 8

Treatment of a Fibrocystic Breast Mass

Answer 8

1) NSAIDS

More severe pain should be referred to primary care for further evaluation.

Question 9

Patient education of a Fibrocystic Breast Mass

Answer 9

1) Avoiding trauma
2) Wear supportive brassiere night and day
3) Decreasing dietary fat intake
4) Consider eliminating caffeine
5) Vitamin E, 400IU daily
6) Monthly self-breast exam just after menstruation
a) Risk of developing breast cancer is generally higher