Breast surgery: mastalgia + mastitis Flashcards
What is mastalgia?
Breast pain
What is cyclical mastalgia vs non- cyclical mastalgia
Cyclical mastalgia is associated with the menstural cycle. It usually comes on a few days beforehand and subsides when the period finishes
Non cyclical mastalgia is not associated with the menstrual cycle and often caused by medications such as anti-depressants, anti- psychotics and oral contraception
What is the management for cyclical mastalgia?
Reassurance, analgesia and wearing a soft bra
What is second line management of mastalgia?
Referral to specialists, usually prescribed Danazol- an anti-gonadatrophin, usually not well tolerated due to side effects
What is triple assessment?
One stop shop for 2 ww. Involves: History and examination Imaging Histology- core needle biopsy as fine needle is cytology only and core needle can differentiate between invasive and in situ carcinoma.
What is mastitis?
Inflammation of breast tissue usually due to S. Aureus. Can be divided into lactational and non lactational.
What is the prevalence of lactational mastitis?
Occurs in 1/3 of breastfeeding women
What are the clinical features of lactational mastitis?
Tenderness, swollen, erythema, nipple cracking and milk stasis
What is the epidemiology of non- lactational mastitis?
Can occur in any women, less common than lactational. More likely in women with duct ectasia or peri-ductal mastitis.
What is the main risk factor for non- lactational mastitis?
Smoking as it damages the sub alveolar duct walls
How would you treat mastitis?
Antibiotic therapy and analgesia. Lactational mastitis , encourage women to continue breast feeding. If there are multiple infections- cabergoline (D2 agonist to stop breast feeding)
What is a complication of mastitis?
Breast abscess which is collection of pus in the breast, lined with granulation tissue.
