Disorders of the Breast Flashcards
disorders of the breast we need to know (4)
abscess
fibroadenoma
fibrocystic changes
mastitis
32 yo lactating f w. breast pain, swelling, f/c, and fluctuant mass in left breast - area above lesion is warm, erythematous, and ttp
breast abscess
t/f: women w. breast abscess should continue to breastfeed on affected side even in setting of I&D
t!
*she can use hand expression or breast pumping if procedure interferes w. ability to breastfeed *
a breast abscess is a pocket of infection contained w.in the breast that is often a complication of
mastitis
what differentiates mastitis from a breast abscess (2)
w. breast abscess:
localized mass
signs of infxn
mc pathogen assocaited w. breast abscess
s. aureus
tx for breast abscess
-I&D
-nafcillin/oxacillin IV OR cefazolin PLUS metro
-alt: vanco
-continue bf
27 yo f w. painless mass in r breast x 3 months - it has not changed in size - lmp 10 days ago - no fam hx breast ca - PE shows 3 cm, firm, non tender, smooth, well circumscribed, mobile mass in ULQ - no skin changes, nipple d.c, or axillary LAD
breast fibroadenoma
what is this US showing
breast fibroadenoma
mc type of noncancerous breast tumor
fibroadenoma
fibroadenomas mc affect what age group
young women
describe a fibroadenoma (7)
solitary
small
mobile
firm
painless
well circumscribed
completely round
classic description of fibroadenoma
rubbery
t/f: size of fibroadenoma may was and wane w. menstruation
t!
t/f: fibroadenomas may become painful for a few days before onset of menstruation
t!
dx for fibroadenoma
mammogram
US
fine-need aspiration
+/- bx
indication for bx of fibroadenoma
< 25 yo
tx for fibroadenoma (3)
supportive bra
combined OCP
avoid caffeine/chocolate
42 yo f w. breast masses that change in size, esp during menstrual cycles - masses are painful, pain radiates to axillae - c/o full/heavy feeling in breasts - small, occassional greenish-brown nipple d.c
fibrocystic dz
describe fibrocystic dz masses (7)
multiple
bilateral
well circumscribed
round
discrete
somewhat mobile
increase in size and pain before menses
what relieves pain of fibrocystic breast changes
onset of menses
dx of fibrocystic changes (3)
fine needle aspiration
US
+/- mammogram
fine need aspiration findings of fibrocystic changes
straw-colored fluid w. NO blood
tx for fibrocystic changes (5)
NSAIDs
heat/ice
supportive bra
avoid caffeine/chocolate/fatty foods
OCP
if women w. fibrocystic changes want to do self breast exam, when should they do it
one week after period
when cysts are smallest
t/f: fibrocystic changes mc self resolve
t!
breastfeeding f 3 weeks postpartum c/o painful area of breast that is red/warm - she feels fatigued and is febrile -
mastitis
describe mastitis pain
burning
constant vs only when breastfeeding
PE findings of mastitis (4)
unilateral erythematous breast
palpable mass
induration
ttp
what do you think when you see: primigravida pt w. bilateral, painful breast engorgement
congestive mastitis
mc pathogen associated w. breast infxns
s. aureus
regional infxn of the breast from skin flora/oral flora of breastfeeding baby -> oragnism enters erosion or cracked nipple
mastitis
mc cause of mastitis
clogged milk ducts
mastitis is mc caused by _ trauma
nipple
congestive mastitis is _ lateral
infectious mastitis is _ lateral
congestive: bilateral
infectious: unilateral
dx for mastitis
clinical
+/- US
tx for mastitis
warm compress 4x/day
analgesics
abx if infectious
continue to bf
abx for infectious mastitis (3)
dicloxacillin
cephalexin
erythromycin
