Breast surgery: cysts and abscesses Flashcards
How does a breast abscess present?
Usually secondary to mastitis, fluctuant, tender mass with overlying erythema.
What are breast cysts composed of?
Fluid filled cavities due to the lobules becoming distended and blocked
How do breast cysts present?
Usually in perimenopausal women.
Multiple lumps or smooth masses
Can be unilateral or bilateral
What do breast cysts look like on mammogram?
They have a typical, halo like appearance
How do you diagnose breast cysts?
Ultrasound is for a definitive diagnosis
When would you use ultrasound guided aspiration for breast cysts?
Persisting lump or symptomatic. Cancer is excluded if aspiration is free of blood or cyst disappears on aspiration. If needed, the fluid can be sent for cytology
What is the management for breast cysts?
Usually self resolves, but the chance of recurrence increases. Larger ones can be aspirated
What are the complications of breast cysts?
Increase risk the of breast cancer later.
Fibrocystic changes, fibrotic area and cysts which leads to associated with tenderness and asymmetry, this can masks malignancy
You have examined a woman and think she has fibrocystic change. How would she have presented to get to this differential?
Nodularity (uni or bilateral). Lumps are smooth. Woman is perimenopausal. May have pain which is worse before period.
What investigations would you like to do for fibrocystic changes?
Mammography - see halo like appearance.
USS for definitive diagnosis. If cysts are recurrent or symptomatic - can aspirate the cysts.
How are fibro cysts managed?
Usually self resolve. If large - can be aspirated.
What is the link between fibrocystic changes and breast cancer?
increases likelihood of breast cancer by 2-3x.
