Breast Surgery Flashcards
mobile firm breast lump in 18-25 year old
fibroadenoma
management of fibroadenoma
more than 3cm then excise
often reduce in size spontaneously
middle aged woman with painful lumpy breasts that worsen prior to menstruation
fibroadenosis
(fibrocystic disease, benign mammary dysplasia)
smooth, soft and discrete breast lump with a halo sign on imaging
breast cyst
management of a breast cyst
aspirate - if blood or persistently refill then excise/biopsy
slight increased risk of malignancy
breast lump with pain and mammographic changes that mimic cancer
sclerosing adenosis
management of sclerosing adenosis
BIOPSY
varied history of a lump/lumps
epithelial hyperplasia
management of epithelial hyperplasia
atypical features - refer
no atypical features - conservative
obese woman presents with a firm and round mass increasing in size after trauma
(can progress to hard and irregular)
fat necrosis
management of fat necrosis
image and biopsy to rule out cancer as fat necrosis is rare
blood stained nipple discharge
duct papilloma
dilation of the breast ducts around menopause causing a tender lump around the nipple/areola with green nipple discharge and slit nipple retraction
mammary duct ectasia
red hot and tender swelling in lactating women
breast abscess
cause of recurrent breast infections in smokers
periductal mastitis
hard and irregular lump with nipple inversion and skin tethering
breast cancer
what is the most common breast cancer
invasive ductal carcinoma
intraductal carcinoma presenting with red eczematous nipple/areola
pagets disese of the breast
first line treatment for breast cancer
wide local excision
management of lymphadenopathy in breast cancer
axillary lymphadenopathy then node clearance
no lymphadenopathy then sentineal node biopsy
when is radiotherapy given in breast cancer
after local excision/mastectomy
when would you give hormone therapy in breast cancer
if oestrogen receptor positive
which medications are given for hormone therapy and why
pre-peri menopausal: TAMOXIFEN
post menopausal = ANASTRAZOLE
tamoxifen increased VTE and endometrial cancer risk
anastrazole increases osteoporosis
when is trautzumab given in breast cancer
if HER2 receptor positive
why is chemotherapy given as a neo-adjuvant
to reduce size allowing breast conservation surgery rather than mastectomy
BRCA1 - chances that siblings or children have the gene
50%
breast cancer screening
every 3y from the age of 50-70 years
management of a over 30 years old and breast lump
2ww
snowstorm sign
ruptured implant
