Lecture 17 The Breast Flashcards
What type of gland is the breast?
Sweat gland
What is the epithelium of the breast made of?
Ducts and lobules arranged in terminal duct lobular units
With pain in the breast?
2% have cancer
What can palpable masses in the breast be?
Cysts, benign tumours, cancer
Involving nipple discharge, what percantages are benign or malignant?
B = 95% m = 5%
With a mammographic abnormality
2% screened asymptomatic populaition
What does breast cancer screening involve?
50-70years old. (undergoing extension). Mammography. 3 yearu.
What is a mammography?
(Mastography) is the process of using low energy x-rays to examine the breast. Squash it.
40% and 10%of incidences of breast disease are
40% = fibrocystic changes. 10% = cancer
Name the three types of benign breast diseases
Fibrocystic disease, fat necrosis and mastitis.
What is fibrocystic disease?
V. common. Lumpiness, calcification, pain/tenderness. Hormone related and cumulative >30yo
What is Fat necrosis?
Trauma to breast -> localised haemorrhage and necrosis -> hard lump
What is mastitis? Risk factor?
Inflam, red, tender, warm. Blocked ducts can lead to lactation mastitis (encourage breast feeding). Smoking
What are the benign breast tumours?
Fibroadenoma and papilloma
What is fibroadenoma?
Rubbery lumps, reproductive age, do not need removal, ^during pregnancy
What is papilloma?
Wart like growth in ducts (up to 2cm), -> bleeding/nipple discharge
What are the malignant breast cancer types?
Ductal carcinoma, lobular carcinoma and paget’s disease
What is the average age at diagnosis for breast cancer?
64 years
What gene mutation causes breast cancer?
BRCA. 5x ^ breast cancer risk, 10x^ ovarian cancer risk.
What are the risk factors for breast cancer?
Age, height, Oestrogen (menache, breast feeding), Life style (obesity (30%), alcohol, dietary fat)
Clinical presentation of breast cancer?
Lump, skin dimpling, change in skin colour or texture, change in nipple, fluid leaking from nipple
What is ductal carcinoma?
DCIS or invasive.
What is ductal carcinoma in situ?
Abnormality of milk ducts, pre-malignant condition. Low grade>high grade > invasive
What is invasive ductal carcinoma?
Most common breast cancer. Grades 1-3.
How do you treat invasive ductal carcinoma?
Lumpectomy, mastectomy, sentinel lymph node. Chemo/radio or hormone therapies (tamoxifen, herceptin).
What is lobular carcinoma?
Can be LCIS or invasive
What is paget’s disease?
Affects nipple skin, eczema type rash, itchy, poss bleeding. Invasive or non-nvasive.
