Breast surgery Flashcards
What is part of the breast triple assessment?
clinical assessment
imaging
+/- biopsy
If there is a scaly nipple, what should you suspect?
Paget’s disease of the breast
How does breast eczema usually present?
affects areola and usually spares nipple
If you suspect breast cancer in a patient <40, what imaging should be done?
ultrasound +/- core biopsy
mammogram if malignant
breasts are generally denser so mammogram less good in younger patients
If you suspect breast cancer in a patient <40, what imaging should be done?
mammogram + ultrasound +/- core biopsy
What is the number system used to assess breast cancer?
1 = normal
2 = benign
3 = indeterminate, probably benign
4 = suspicious for malignancy
5 = highly suspicious for cancer
What is the gold standard biopsy type for breast cancer?
core biopsy (not fine needle aspiration)
Describe cyclical breast pain
mild breast pain
<5 days before menstrual cycle
dull, aching or burning
no association with cancer
exacerbation of sx prior to menopause, most resolves
Describe non-cyclical breast pain
shorter pain
usually unilateral
exacerbations of pain for no clear reason and difficult to treat
generally not associated with cancer (0.4% is cancer)
What are some other origins of mastalgia?
scapular bursitis
costochondritis
lateral extramammary pain syndrome
cervical radiculopathy
Breast pain management
supportive bra, day and night
weight loss
caffeine reduction
medications - SSRI, OCP, HRT
topical NSAIDs
vitamin E supplements
Clear nipple discharge cause
intraductal papilloma
Milky nipple discharge causes
physiological up to 2 years after breastfeeding
prolactinoma
Purulent nipple discharge cause
periductal mastitis - antibiotics, drainage of collection, smoking cessation
Multi-coloured nipple discharge cause
duct ectasia - normal ageing of breast/ducts
