Disorders of the Breast Flashcards
what is mastitis & what is the MC organism that causes it
inflam/infxn of breast in lactating women
- MC caused by Staph aureus
30 y/o F presents w/ unilateral breast pain accompanied by swelling, erythema, warmth and nipple d/c. She recently gave birth to a baby boy who she has been consistently breastfeeding.
Dx?
other than clinical Dx, what other two things help Dx this?
Dx = Mastitis
Dx = PE, fever and incr WBCs
Mastitis Tx
- What is the 1st line tx
- should mothers continue to breastfeed
- if no improvement w/ 1st line tx or IV ABX what should suspected?
Mastitis tx
- PO Dicloxacillin
- Yes, mothers should continue to breastfeed
- no improvement w/ 1st line tx or IV ABX –> suspect breast abscess
fluid filled breasts d/t exaggerated stromal response to hormones (estrogen/progesterone) and growth factors
Fibrocystic breast dz
Fibrocystic Breast Dz
- MC in what age group of women
- what age group is it rare in
Fibrocystic Breast Dz
- MC in premenopausal women
- Rare in Postmenopausal women
32 y/o F presents w/ bilateral breast pain and swelling. Pt states the pain is worse right before her period starts and her breasts feel lumpy. On PE you feel multiple, well demarcated, mobile lumps on both breasts. Pt complains of tenderness during exam.
Dx?
Dx = Fibrocystic Breast Dz
most spontaneously resolve
Dx of Fibrocystic Breast Dz
- what imaging modality is used
- what color of fluid is typical when obtaining FNA
Dx of Fibrocystic Breast Dz
- US
- FNA –> straw colored fluid
Fibrocystic Breast Dz Tx
- what dietary modifications should be made
- what other lifestyle adjustment may help
- If symptomatic what can be done for Tx
Fibrocystic Breast Dz Tx
- Diet –> avoid caffeine, tea, chocolate, EtoH, soda
- lifestyle modification –> supportive bra
- Symptomatic –> +/- fluid removal w/FNA
Breast Abscess
- how does it present?
- what is main form of Tx?
- Should mothers continue to breastfeed?
Breast Abscess
- induration w/ fluctuance
- Tx = I&D
- NO, mothers should stop breastfeeding from the affected breast
What is the MC benign breast tumor
MC benign breast tumor = fibroadenoma
benign solid tumor, made of glandular + fibrous tissue
25 y/o F presents w/ single, firm, round, well circumscribed, mobile mass on L breast. On exam it is not tender and feels rubbery. Pt states the size does not change during her menses
Dx?
Tx?
Dx = Fibroadenoma
Tx = observation + f/u
Fibrocystic Breast Dz vs Fibroadenoma
- which is usu bilateral/multiple masses
- which is not painful/tender
- which does the size not change w/menses
- which is described as lumpy masses
Fibrocystic Breast Dz vs Fibroadenoma
- Bilateral/multiple masses = Fibrocystic Breast Dz
- NOT painful/tender = Fibroadenoma
- size does NOT change w/menses = Fibroadenoma
- Lumpy masses = Fibrocystic Breast Dz
Tx of Fibroadenoma
- If pt is young (< 30), stable and has classic presentation what is the Tx?
- what is done for large/worrisome Fibroadenomas?
- what type of method is good for detecting cancer and phyllodes tumors
Tx of Fibroadenoma
- Tx for young (< 30), stable and classic presentation = observation + f/u
- Large/worrisome Fibroadenomas –> excisional Bx
- FNA = good at detecting cancer and phyllodes tumors
