Breast + Neck Lump Flashcards
A 36-year-old woman presents to the urgent care centre with a small
tender mass under her left nipple. The area is tender to touch and she’d
noticed a small amount of yellow-green discharge from the nipple. She
mentions to you that she’s smoked since her early 20s.
What is the most likely diagnosis?
A – Breast cyst B – Lobular carcinoma C – Non-lactational mastitis D – Duct ectasia E – Breast abscess
D – Duct ectasia
- yellow-green discharge is characteristic, smoking is a risk factor, tenderness is typical
A 22-year-old woman presents to the GP with a lump in her right breast.
She found the lump incidentally and has not experienced any symptoms.
On examination, the lump is located in the upper outer quadrant and is 2cm.
It feels firm, smooth and well demarcated and is mobile.
What is the most likely diagnosis?
A – Phyllodes tumour B – Fibroadenoma C – Breast cyst D – Ductal carcinoma in situ E – Mastitis
B – Fibroadenoma
- 2cm (1-5cm), firm, smooth, well demarcated, mobile, no fluctuance mentioned or discharge but firmness also rules out cyst
A 32-year-old woman comes to the GP complaining of a painful left
breast. She gave birth a few weeks ago and has been breast-feeding every
few hours. On examination, the breast is tender, there is marked erythema
and her nipple is cracked. You do not suspect there are any abscesses
present.
Given the likely diagnosis, which of the following is NOT a recommended
treatment option?
A – Stopping breast feeding B – Antibiotics if symptoms are severe C – Analgesia D – Anti-fungals if nipple candidiasis suspected E – FNA to rule out an abscess
A – stopping breast feeding
- The advice actually lists encouraging breast feeding if lactational mastitis, not mentioned here what type of mastitis is present, but the rest all make sense and stopping breast feeding is never a treatment option. I misread the answer the first time I saw this question
A 55-year-old is referred for an urgent mammogram after noticing a lump
in her right breast.
Which of these is NOT a recognised risk factor for breast cancer?
A – Increased age B – Use of the combined oral contraceptive pill C – Obesity D – Having more than 1 child E – Family history of ovarian cancer
D - Having more than 1 child
- all others are RFs for breast cancer, nulliparity is another (no children)
A 60-year-old woman presents to the GP after noticing some changes in her right nipple. On examination, the nipple is erythematous and crusty with some apparent scaliness of the skin.
What is the most likely diagnosis?
A – Eczema B – Paget’s disease of the breast C – Intraductal papilloma D – Ductal carcinoma E – Phyllodes tumour
B - Paget’s disease of the breast
- eczematous, crustiness/scaliness of the skin
A 56-year-old lady presents to the GP with a lump on her neck. She doesn’t
report any other symptoms, apart from being a bit more anxious and tired
than usual, and some infrequent diarrhoea. On examination, the lump is
2x3 cm and appears to be in the mid-line of the neck. The lump does not
move when the patient sticks out her tongue however does move when she
swallows.
What is the most likely diagnosis?
A – Thyroglossal cyst B – Goitre C – Thyroid nodule D – Lipoma E – Dermoid cyst
C – Thyroid nodule
- symptoms described indicate mild hyperthyroidism
- lump moves on swallowing = thyroid gland so the superficial cysts are ruled out
I’m guessing the reason it is a single nodule (adenoma), rather than goitre, is uneven enlargement and only mild symptoms
