Breast year 5

Question 1

A 55-year-old women presents with nipple discharge. On examination she has a slit like retraction of the nipple in the centre of this area is a small amount of cheese like material. No discrete mass lesion is palpable in the underlying breast.

Answer 1

Duct ectasia is a common alteration in the breast that occurs with ageing. As the ducts shorten and dilate a degree of symmetrical slit like retraction occurs. A small amount of cheese like discharge may occur.

Question 2

halo sign on breast

Answer 2

breast cyst (more common) - or fibroadenoma

Question 3

when do you excise fibroadenomas

Answer 3

if over 3cm

Question 4

woman post wide excision what tx should follow

Answer 4

arrange radiotherapy

Question 5

complications of axillary node clearance

Answer 5

lymphedema and functional arm impairment

Question 6

A weeping, crusty lesion such as this is most likely to represent

Answer 6

pagets

Question 7

if breast tumour less than 4cm what excision

Answer 7

wide local excision is preffered to conserve breast

Question 8

Paget’s is associated with what ca

Answer 8

DCIS or invasive carcinoma

Question 9

dx for pagets

Answer 9

punch biopsy

Question 10

A 35-year-old woman complains of ‘lumpy’ breasts. Her symptoms are worse in the premenstrual period.

Answer 10

fibroadenosis

Question 11

A 53-year-old lady presents with a creamy nipple discharge. On examination she has discharge originating from multiple ducts and associated nipple inversion.

Answer 11

Duct ectasia is common during the period of breast involution that occurs during the menopausal period. As the ducts shorten they may contain insipiated material. The discharge will often discharge from several ducts.

Question 12

Intraductal papilloma69%

Intraductal papilloma usually cause single duct discharge. The fluid is often clear, although it may be blood stained. If the fluid is tested with a labstix

Answer 12

small amounts of blood will be detected