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Hospital Based Medicine And Surgery > L24: Benign And Malignant Breast Disease > Flashcards

L24: Benign And Malignant Breast Disease Flashcards

1
Q

What are the common symptoms of breast disease

A 
Lump
Change in skin
Nipple change 
Nipple discharge 
Pain
Infection
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2
Q

In the drug history what should you specifically ask for

A

HRT

OCP

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3
Q

In the family history what should you ask for

A

Ovarian and breast cancer

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4
Q

What is a triple assessment

A

Physical examination
Radiological imaging
Biopsy

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5
Q

What are the benign lumps in the breast

A

Fibroadenoma
Cyst
Traumatic fat necrosis
Phyllodes tumour

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6
Q

What hormonal changes can occur in the breast

A

Gynaecomastia

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7
Q

What infection can occur in the breast

A

Periductal mastitis
Acute bacterial mastitis
Abscess

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8
Q

What is a fibroadenoma

A

Commonest breast lump in women

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9
Q

What are the features of fibroadenoma

A 
Rubbery 
Firm
Painless
Oval and smooth defined border
Mobile i.e not attached to the skin
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10
Q

What is the diagnosis of fibroadenoma by

A

Tripple assessment

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11
Q

What is the treatment of fibroadenoma

A

Reassurance
Monitor
Excision

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12
Q

What are cysts

A

Fluid filled lobules

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13
Q

In which group of females are cyst common in

A

Perimenopausal

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14
Q

What is the diagnosis of cysts by

A

Triple assessment

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15
Q

What is the presentation of cysts

A

Single of multiple smooth lumps
Short history
Pain and tenderness
Can become big or painful before menstruation

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16
Q

What is the treatment of cysts

A

Reassurance

Aspiration

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17
Q

What is traumatic fat necrosis

A

Traumatic necrosis

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18
Q

What is traumatic fat necrosis due to

A

seat belt injury

Elbow injury

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19
Q

What happens in traumatic fat necrosis

A

Adipose tissue (fat) breaks downs

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20
Q

What are the presentation of traumatic fat necrosis

A

Painless, irregular and firm lump
Skin changes
With or without bruising

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21
Q

What is the assessment of traumatic fat necrosis

A

Triple assessment

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22
Q

Why is the biopsy in traumatic fat necrosis important

A

Because it can rememble cancer

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23
Q

What is the management of traumatic fat necrosis

A

Should resolve on its own

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24
Q

What is phyllodes tumour

A

A rare tumour that occurs in women around menopause

25
Q

Which cells does phyllodes tumour arise from

A

Stromal cells

26
Q

What is the presentation of phyllodes tumour

A 
Firm 
Mobile 
Well circumscribed
Non tender 
Similar to fibroadenoma
27
Q

What is the diagnosis of phyllodes tumour by

A

Triple assessment

28
Q

What is the management of phyllodes tumour

A

Triple assessment

29
Q

What is the management of phyllodes tumour

A

Wide excision

Follow up with imaging

30
Q

What is gynacomastia and who does it occur in

A

Proliferation of breast tissue in males

31
Q

What are the causes of gynacomastia

A 
Liver cirrhosis 
Testicular tumour 
Hypogonadism 
Idiopathic 
Drugs; osteogen and androgen
32
Q

What is the treatment of gynaecomastia

A

Reassurance
Manage the cause
Liposuction or cosmetic surgery

33
Q

What is periductal mastitis

A

Inflammation around the dilated milk ducts

34
Q

What is the presentation of periductal mastitis

A

Pain
Nipple discharge
Cellulitis
Subareolar mass

35
Q

What is the diagnosis of periductal mastitis by

A

Ultrasound

36
Q

What is the treatment of periductal mastitis

A

Antibiotics

Surgery- if recurrent

37
Q

What is acute bacterial mastitis usually associated with

A

Breast feeding

38
Q

Which organism is likely to cause acute bacterial mastitis

A

Staphylococcus Auerus

39
Q

What is the presentation of acute bacterial mastitis

A

Breast inflammation: redness, swelling, tenderness and warmth
Localised to small area
Fluctuant mass
Systemic signs of inflammation

40
Q

What is the diagnosis of acute bacterial mastitis by

A

Ultrasound

41
Q

What is the treatment of acute bacterial mastitis

A

Antibiotics
Continue breastfeeding
Aspirate the abscess

42
Q

What are the types of breast carcinoma dependent on

A

The location

43
Q

What are the types of breast carcinoma

A 
Ductal
Lobular
Tubular
Medulla 
Mucinous
44
Q

What are the subtypes of ductal breast carcinoma

A

Ductal carcinoma in situ

Invasive ductal carcinoma

45
Q

Where can spread of breast carcinoma to

A

Local: skin, muscle and chest wall
Lymphatic: axillary and internal thoracic nodes
Haematological: lungs, liver, bone and brain

46
Q

What are the risk factors for breast cancer

A 
Age
Family history 
BRCA gene mutations 
Oestrogen exposure: early menarache, late menopause, OCP, HRT 
Chest radiation
Alcohol 
Overweight
47
Q

What are the protective factors against breast cancer

A

Breastfeeding
Having children
Physical activity

48
Q

What are the features of breast cancer

A 
Lumps: firm and irregular 
Nipple retraction and inversion
Blood stained nipple discharge 
Skin tethering 
Peau de orange appearance
Change in breast shape
Palpable axillary lymph nodes
49
Q

What is the diagnosis of breast cancer by

A

Triple assessment: examination, imaging and biopsy

50
Q

What are the treatment options in breast cancer

A

Surgery:

  • wide local excision: removal of the lump and some healthy margin
  • mastectomy: removal of the whole breast
  • surgery to the axilla: also used as prognosis

Adjuvant therapy
Hormonal therapy
Biological therapy

51
Q

What is adjuvant therapy

A

Therapy given before or after the surgery

52
Q

Name examples of adjuvant therapy

A

Chemotherapy

Radiotherapy

53
Q

When is hormonal therapy used

A

If the tumour is postive for oestrogen receptors (ER)

54
Q

What can hormonal therapy be

A

Selective oestrogen receptor modulator e.g tamoxifen
Aromatase inhibitors e.g anastrozole
Ovarian ablation

55
Q

Who uses Aromatase inhibitors

A

Post menopausal women who make oestrogen from fatty tissue and do not have oestrogen production from the ovary

56
Q

Who has ovarian ablation

A

Pre-menopausal women

57
Q

If there is a HER2 over expressing tumour what biological therapy can be used

A

Herceptin

58
Q

What is herceptin

A

Monoclonal antibody for HER2 receptor

Hospital Based Medicine And Surgery (30 decks)

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