Inflammatory Conditions Of The Breast

Question 1

What is the most common pathogen for acute mastitis and what is the mechanism usually by which this pathogen gains entry to the breast?

Answer 1

Staph

Breast feeding can cause tiny fissures in the nipple and allow staph to get in. Basically a little cut

Question 2

2 clinical signs of acute mastitis?

Answer 2

Red/swollen breast

Nipple charge with pus.

Question 3

What is the drug of choice for treating acute mastitis?

Answer 3

Antibiotic dicloxacillin

Question 4

How do we define periductal mastitis and what is the typical patient presenting with it and why?

Answer 4

Inflammation of the subareolar ducts.
Smokers
These ducts have a specialized epithelium and in order to maintain this epithelium, you need vitamin A. Smoking makes you vitamin a deficient.

Question 5

So, what happens when you can’t maintain the epithelium and how does that end to inflammation?

Answer 5

The epithelium turns to squamous which has keratin and it plugs the lactiferous ducts. Inflammation and infection behind the clog.

Question 6

2 clinical signs of periductal mastitis?

Answer 6

Mass with nipple retraction

Question 7

How do we define mammary duct ectasia?

Answer 7

Inflammation with dilation of the subareolar ducts

Question 8

2 clinical signs of mammary duct ectasia?

Answer 8

Mass and classic green, brown nipple discharge

Question 9

What is a typical patient presenting with mammary duct ectasia?

Answer 9

Postmenopausal women with mass.

Question 10

So lets say this postmenopausal women with a mass shows up and its mammary duct ectasia, but we are thinking cancer (as we should), so we do a biopsy. What does histo show for mammary duct ectasia?

Answer 10

Inflammation with plasma cells

Question 11

What is the most common cause of necrosis of breast fat tissue?

Answer 11

Trauma

Question 12

Why do we care about fat necrosis?

Answer 12

Because it can show up on a physical exam as a mass or calcination on mammogram.