Lecture 12 - Breast Disease (Primary Care) Flashcards

1
Q

Label breast on slide 3

A
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2
Q

What are some examples of benign breast lumps?

A

Intraduct papilloma
Adenoma

Lipoma
Fibroadenoma

Fibroadenoma
Phyllodes tumours

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3
Q

What is cyclical mastalgia?

A

Pain of breast usually in the cycle of the menstrual cycle

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4
Q

Look at case 1 slide 6

What is the most likely diagnosis?
How would it be managed?

A

Fibroadenoma

Reassure its fine

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5
Q

What is the most common type of breast lump in young women??

A

Fibroadenoma (BENIGN)

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6
Q

How do breast cysts present?

A

Palpable of discrete lumps

Non mobile

Often get referred down cancer pathway to exclude cancer

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7
Q

How does an Intra ductal papilloma present?

A

Unilateral blood stained nipple discharge
Lump is tender

Essentially when benign tumour grows in single milk duct

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8
Q

What is mammary duct ectasia?

A

Dilation of large and intermediate breast ducts

Leads to shortening and dilation of subareola ducts as they. Involute

May get breast lumps or nipple discharge

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9
Q

What is fibrocystitc change?

A

When the breast have increased amount of fibrous connective tissue and cysts

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10
Q

What is mastitis and when is it most common?

A

When milk ducts get blocked leading to breast inflammtion
Can have it with infection or without

BREAST FEEDING//PREGNANT WOMEN

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11
Q

What advice is give to someone with mastitis?

A

Continue to breast feed

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12
Q

What abx is usually given to a mastitis with infection?

A

??

Flucloxacillin or erythromycin if penicillin allergic

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13
Q

What are some importnat questions to ask in a patient Hx in. Primary care?

A

When first noticed
Change in size
Nipple changes
Discharge
Skin changes
Menstrual history
Changes through menstrual cycle
FHx
Risk factors

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14
Q

What do you examine in a breast exam?

A

Mass assessed:
-location
-size
-mobility
-lymph nodes

Assses in a clock like fashion

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15
Q

What is the NICE referral criteria for the urgent 2 week pathway from breast cancer?

A

30+ with unexplained breast lump +- pain

50+ unilateral discharge, retraction or other changes

Skin changes or 30+ with unexplained Axillary lump

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16
Q

What are the major risk factors for breast cancer?

A

-Older (50+)
-Previous breast cancer
-FHx (BRCA1 and 2)
-Dense breast tissue
-Benign breast disease
-Hormonal factors (HRT early menarch and late menopause)

-lifestyle (OBESITY, ALCOHOL and SMOKING)

17
Q

How do breast cancers often present?

A

Lump
Normally painless
Nipple symptoms

Skin changes

18
Q

What is the clinical sign on slide 21:

A

Peau D’Orange

Looks like the skin of an orange

19
Q

What is pagets disease?

A

Presentation of breast cancer that is associated with ductal carcinoma in situ or invasive carcinoma

Looks like eczema on the nipple

20
Q

What is the screening program for breast cancer?

A

Mammograms every 3 years from 50-71

Earlier screening if FHx

21
Q

How do malignant breast masses typically differ to benign breast masses?

A

Malignant:
Hard
Painless
Irregular margins
Fixed

Benign:
Firm/rubbery
Painful
Regular or smooth margins
Mobil and not fixed