Disorders of the breast Flashcards
inflammation of the breast tissue that may or may not be accompanied by infection
mastitis
localized, painful inflammation of the breast associated with fever and malaise, along with a fluctuant, tender, palpable mass
breast abscess
present as soft cystic masses on physical exam, but are not tender and are not associated with systemic findings. excision is not necessary
galactocele
the most effective method of differentiating breast abscesses from mastitis
ultrasound
Most common pathogen of breast abscess
s. aureus
commonly seen in women who have had surgery and radiation for breast cancer
delayed postoperative cellulitis
What is this:
abscess
What is this:
abscess w/necrosis
Common abx choices for non MRSA abscess
dicloxicillin or cephalexin (Keflex)
Common abx choices for MRSA abscess
Trimethoprim-sulfamethoxazole (Bactrim) or clindamycin (Cleocin)
Management of breastfeeding pt with abscess
continue breastfeeding unless severe/persistant. If there is concern about spreading infection to the baby, then breast pump.
communication between a subareolar duct and the skin, usually in the periareolar area. can occur after I&D of a central breast abscess after spontaneous drainage of a periareolar inflammatory mass
mammary duct fistula
benign solid tumors containing glandular as well as fibrous tissue. present as a well-defined, mobile mass on physical examination or a well-defined solid mass on ultrasound
fibroadenomas
Age group generally affected by fibroadenomas
15-35 yrs
Managment of fibroadenomas
CNB or short-term (three to six months) follow-up with a repeat ultrasound and breast examination. Excise if increase in size, becomes symptomatic, or pt wishes removal
Disadvantages of excisional surgery of fibroadenoma
scarring at the incision site, dimpling of the breast from the removal of the tumor, damage to the breast’s duct system, and mammographic changes (eg, architectural distortion, skin thickening, increased focal density)
benign, usually solitary tumors. present as soft, nontender, well-circumscribed masses. usually excised
lipoma
benign condition that occurs due to breast trauma or surgical intervention. can be confused with a malignancy on physical examination and may mimic malignancy on radiologic studies. once diagnosed, don’t need to be excised
fat necrosis
characteristics of pathologic nipple discharge
spontaneous, persistent, or arises from a single duct. also pathologic if the discharge contains gross or occult blood
Most common form of infectious mastitis
lactational
very rare but is seen in women with diabetes and renal failure. has also been reported in some patients within the first few days of receiving large (loading) doses of warfarin
gangrene of the breast
characterized by distension of subareolar ducts with fibrosis. associated with creamy or cheesy nipple discharge and nipple inversion. duct excision resolves symptoms
duct ectasia
