Condition Flashcards
Definition for breast abscess
usually a complication of infectious mastitis which can either be puerperal mastitis (due to breast feeding) or subareolar abscess (an aseptic inflammation associated with squamous metaplasia of the lactiferous ducts)
how common is breast abscess
quite rare - 0.4-0.5% of breastfeeding mother’s develop an abscess
who is affected the most by breast abscess
mainly breastfeeding mothers who develop puerperal mastitis
RF for breast abscess
maternal age >30 (age of delivery)
past history of mastitis
gestational age> 41 weeks
improper nursing leading to incomplete emptying of the breast
symptoms for breast abscess
tender, hard breast mass
fluctuant
overlying erythema
further investigation for breast abscess
USS - see if collection of pus
management of breast abscess
improve breast feeding technique
manual extraction of milk
antibiotics - flucloxacilin or erythromycin
surgical - if overlying skins is thin or necrotic
needle aspiration every other day if severe
complication for breast abscess
sepsis
what is fibrocystic disease of the breast
noncancerous breast lumps
how common is fibrocystic disease
30-60% of women
5% of childbearing age
causes of fibrocystic disease of the breast
not fully understood but might link to hormone levels
symptoms of fibrocystic disease of breast
lumpy, cobblestone texture in the breast
smooth with defined edges
breast aching/tenderness
breast swelling
itchy breast/nipple
symptom might follow periodic trend closely related to menstrual cycle
further investigation for fibrocystic disease of breast
diagnosis mainly clinical once breast cancer excluded
USS/MRI including mammography might be used for a diagnosis
treatment or management for fibrocystic disease of breast
no treatment normally but if needed then progesterone ointments and supplements
defintion for intraductal papilloma
benign proliferation of breast lesions occurring anywhere in the ductal system which can be solitary or multiple
how common is intra-ductal papilloma
2-3% incidence rate
most common cause of bloody nipple discharge in women aged 20-40
mainly a disease of middle aged women
causes of intra-ductal papilloma
genetic but not really know
symptoms for intraductal papilloma
breast enlargement
breast pain
central or peripheral mass often too small to be palpated or felt
bloddy nipple discharge
usually asymptomatic and found incidentally on breast biopsies
further investigation for intraductal papilloma
galactogram - fine needle aspiration/breast biopsies
exam of nipple discharge
management of intraductal papilloma
surgical excision followed by biopsy to confirm that it is not cancer
prognosis of intraductal papilloma
if central and solitary the excellent
if peripheral and muiltiple then higher risk of breast cancer
Definition of breast carcinoma
malignancy of the breast tissue
can be ductal or lobular, in situ or invasive
what is Paget’s disease of the breast
a type of breast carcinoma which infiltrates - 1& of all breast cancer
how common is breast carcinoma
lifetime risk of female - 1 in 8
men can also get breast cancer but rare
RF for breast cancer
FH female old age smoking previous history Genetic - BRCA1,2,3 and TP53 mutation no children never breastfeed early menarche and late menopause radiation to chest high alcohol intake gynecomastia
symptoms of breast carcinoma
lumps (80%) - painful in 20%, hard, irregular, fixed, painless, skin dimpling
nipple discarge
skin contour changer
nipple discharge
breast pain/mastalgia alone
bloody nipple
differential for breast carcinoma
fibrocystic breast disease
Cyst
further investigation for breast carcinoma
mammography
fine needle aspiration
core biopsy
management for breast carcinoma
wide local excision or mastectomy with radio followed by reconstruction
adjuvant hormal therapy if tumour if +ve for hormonal receptors - tamoxifen
herceptin - used for HER2 gene
adjuvant chem
