Disorders of the breast

Question 1

inflammation of the breast tissue that may or may not be accompanied by infection

Answer 1

mastitis

Question 2

localized, painful inflammation of the breast associated with fever and malaise, along with a fluctuant, tender, palpable mass

Answer 2

breast abscess

Question 3

present as soft cystic masses on physical exam, but are not tender and are not associated with systemic findings. excision is not necessary

Answer 3

galactocele

Question 4

the most effective method of differentiating breast abscesses from mastitis

Answer 4

ultrasound

Question 5

Most common pathogen of breast abscess

Answer 5

s. aureus

Question 6

commonly seen in women who have had surgery and radiation for breast cancer

Answer 6

delayed postoperative cellulitis

Question 7

What is this:

Answer 7

abscess

Question 8

What is this:

Answer 8

abscess w/necrosis

Question 9

Common abx choices for non MRSA abscess

Answer 9

dicloxicillin or cephalexin (Keflex)

Question 10

Common abx choices for MRSA abscess

Answer 10

Trimethoprim-sulfamethoxazole (Bactrim) or clindamycin (Cleocin)

Question 11

Management of breastfeeding pt with abscess

Answer 11

continue breastfeeding unless severe/persistant. If there is concern about spreading infection to the baby, then breast pump.

Question 12

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

Answer 12

mammary duct fistula

Question 13

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

Answer 13

fibroadenomas

Question 14

Age group generally affected by fibroadenomas

Answer 14

15-35 yrs

Question 15

Managment of fibroadenomas

Answer 15

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

Question 16

Disadvantages of excisional surgery of fibroadenoma

Answer 16

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)

Question 17

benign, usually solitary tumors. present as soft, nontender, well-circumscribed masses. usually excised

Answer 17

lipoma

Question 18

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

Answer 18

fat necrosis

Question 19

characteristics of pathologic nipple discharge

Answer 19

spontaneous, persistent, or arises from a single duct. also pathologic if the discharge contains gross or occult blood

Question 20

Most common form of infectious mastitis

Answer 20

lactational

Question 21

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

Answer 21

gangrene of the breast

Question 22

characterized by distension of subareolar ducts with fibrosis. associated with creamy or cheesy nipple discharge and nipple inversion. duct excision resolves symptoms

Answer 22

duct ectasia