Breast Medicine Flashcards
What is mastitis?
Inflammation of breast tissue from duct obstruction or infection (staph aureus)
What are some symptoms of mastitis?
Breast pain and tenderness
Erythema of breast tissue
Local warmth and inflammation
Nipple discharge
Fever
What is the management of mastitis from infection?
Flucloxacillin
What is the management for mastitis from blocked ducts?
Conservative - expressing, massage, heat packs, warm showers
What is the treatment for candida of the nipple?
Topical miconazole for mother and miconazole gel for baby
What are 4 features of a benign breast cyst?
Smooth
Mobile
Possibly fluctuant
Well-circumscribed
What is the most common cancer in the UK?
Breast
What are some risk factors for breast cancer?
Earlier menarche
Later menopause
More dense breast tissue
Obesity
Smoking
First degree family history
COCP
HRT
What is the mutation that can increase breast cancer risk?
BRCA1 and 2
When is breast cancer screening performed?
Every 3 years for women 50-70 years old
What are symptoms of breast cancer?
Hard, irregular, painless or fixed lumps
Tethered to skin or chest wall
Nipple retraction
Skin dimpling
Lymphadenopathy - axilla
What is the triple assessment for breast cancer?
USS, mammogram and MRI
What is triple negative breast cancer?
Cells don’t express oestrogen, progesterone or HER2 so limits treatment options
What are the 3 types of receptor on breast cancer cells?
Oestrogen
Progesterone
HER2
Where does breast cancer metastasise to?
2 Ls and 2 Bs
Lungs and liver
Bones and brain
What is chronic lymphoedema?
Impaired lymphatic drainage making the areas more prone to infection
What is given for oestrogen receptor positive breast cancer before and after menopause?
Tamoxifen before
Anastrozole after
Name a monoclonal antibody that targets HER2 receptors
Trastuzumab
What is ductal ectasis?
Benign condition with dilation of large breast ducts
What is a significant risk factor of ductal ectasia?
Smoking
What are some symptoms of ductal ectasia?
Nipple discharge
Tenderness or pain
Nipple retraction or inversion
Breast lump
What is a fibroadenoma?
Common benign tumour of stromal/ epithelial breast duct tissue
Why do fibroadenomas regress after menopause?
Because they respond to oestrogen and progesterone
What are fibroadenomas composed of?
Glandular epithelium and interlobular stroma
What are some features of a fibroadenoma?
Painless, smooth, round, well-circumscribed, firm, mobile, usually up to 3cm in diameter
What is the 1st line investigation for fibroadenoma?
USS or mammogram
What is a papilloma?
Warty lesion that grows within one of the breast ducts from a proliferation of epithelial cells
What does a papilloma show on ductography?
Area that doesn’t fill with contrast (filling defect)
What is fibrocystic disease?
Multiple small breast lumps and the commonest benign breast disease
What is the 1st line treatment for fibrocystic disease?
Paracetamol or ibuprofen
What is the 1st line investigation for fibrocystic disease?
USS or mammogram
