FN: Breast:Other Breast disease - Inflammatory and benign epithelial lesions

Question 1

Acute mastitis

Patient

Answer 1

Usually lactating

Question 2

Acute mastitis presentation

Answer 2

Painful, red breast

May - abcess (lump near nipple)

Question 3

Acute mastitis Treatment

Answer 3

Fluclox alone in early stage

sluclox and I&D if flucutaunt abscess

Question 4

Fat Necrosis presentation

Answer 4

Associated with previous trauma
Painless, palpable, non-mobile mass
May calcify simulating Ca

Question 5

Fat Necrosis treatment

Answer 5

Analgesia

No f/up neccessary

Question 6

Duct ectasia

(duct dilatation) patient

Answer 6

Post-menopausal

50-60 yrs

Question 7

Duct ectasia presentation

Answer 7

Slit-like mipple
Often bilateral ± pri-areolar mass
Thick white/green discharge
May be calcified on mammography

Question 8

Duct ectasia treatment

Answer 8

Need to distinguish from Ca
Surgical duct excision if mass present or discharge troublesome
Close f/up

Question 9

Periductal mastitis patient type

Answer 9

Smokers

30 yrs

Question 10

Periductal mastitis

presentation

Answer 10

Painful, erythematous sub-areolar mass
Assoc. with inverted nipple ± purulent discharge
May - abscess or discharging fistula

Question 11

Periductal mastitis Rx

Answer 11

Broad-spectrum ABx

Question 12

Benign mammary dysplasia patient epi

Answer 12

30-50 yrs

Question 13

Benign mammary dysplasia presentation

Answer 13

Pre-mestrual breast nodularity and pain
Often in upper outer quadrant
Tender “lumpy” breasts

aberration of normal development and Involution (ANDI)

1. fibroadenosis
2. Cyst formation
3. Epitheliosis (hyperplasia)
4. Papillomatosis

Question 14

Benign mammary dysplasia Treatrment

Answer 14

1. Tripple assessment
2. Reassurance
3. Analgesia
4. Good bra ± evening primrose oil
5. Danazol may occasionally be used

Question 15

Cystic disease epi

Answer 15

Peri-menopausal >40

Question 16

Cystic disease presentation

Answer 16

Distinct, fluctuant round mass

Often painful

Question 17

Cystic disease Treatment

Answer 17

Aspiration: green-brown fluid

Persistence or blood - triple assessment

Question 18

Duct papilloma epi

Answer 18

40-50 yrs

Question 19

duct papilloma presentation

Answer 19

common cause of bloody discharge

Not usually palpable

Question 20

Duct papilloma Rx

Answer 20

tripple assessment

Excise due to increased risk of CA