Inflammatory Disease Flashcards
What is mastitis?
Inflammation of breast tissue
Can be acute or chronic
What are the causes of mastitis?
Mostly infection
- Staphylococcus Aureus
Occasionally granulomatous
What are the types of mastitis?
Lactational
- presents during first 3 months of breastfeeding or during weaning
- associated with cracked nipples + milk stasis
- more common
- seen in 1/3 of breast feeding women
Non-lactational
- occurs in women with other conditions
- smoking is a risk factor
Clinical features of mastitis
Redness of breasts
Tenderness
Swelling
Ensure there is no abscess forming
Management of mastitis
Antibiotic therapy
- Flucloxacillin 10-14 days
- erythromycin if allergic
Analgesia
Continue milk drainage if lactational
What is a breast abscess?
Collection of pus in the breast lined with granulation tissue
Most commonly develops from acute mastitis
Complication = fistula formation
Clinical features of a breast abscess
Tender, fluid, red mass
- puncutum may be present
Fever
Lethargy
Invesitagation for a suspected breast abscess
Ultrasound
Management of a breast abscess
Empirical antibiotics
Drainage
What are breast cysts?
Epithelial lined fluid filled cavities
Formed when lobules become distended
Common in perimenopausal age group
Make up 15% of palpable breast masses
Clinical features of breast cysts
Singular or multiple breast lumps
Cysts = distinct smooth masses
Investigations for suspected breast cysts
Mammography
- halo shape
Ultrasounds
Management of breast cysts
Most self resolve
Can be aspirated
What is duct ectasia?
Dilation and shortening of major lactiferous ducts
Common presentation in peri-menopausal women
Clinical features of duct ectasia
Coloured nipple discharge
Nipple retraction
Risk factor for duct ectasia
Smoking
Is nipple discharge normal?
Nipples secrete small amount of discharge daily to clean out ducts
However should never be a noticable amount or have a change in colour
Investigations for suspected duct ectasia
Mammography
- dilated calcified ducts
Biopsy
- contain multiple plasma cells
What is fat necrosis?
Ischaemic necrosis of fat lobules
Caused by an acute inflammatory response - associated with trauma
Clinical features of fat necrosis
Usually asymptomatic
Lump
- solid/irregular
- chronic fibrotic change
Investigations for suspected fat necrosis
Positive traumatic history
Ultrasound
- hyperechoic mass
Core biopsy - rule out malignancy
Management of fat necrosis
Self - limiting condition
Analgesia
