Mastalgia Flashcards
__________usually presents as a heaviness or
discomfort in the breast or as a pricking or stabbing
sensation.
Mastalgia
• The typical age span for mastalgia is _______
30–50 years.
There are four common clinical presentations of mastalgi
1 diffuse, bilateral cyclical mastalgia
2 diffuse, bilateral non-cyclical mastalgia
3 unilateral diffuse non-cyclical mastalgia
4 localised breast pain
The commonest type of mastalgia is_________
cyclical mastalgia.
Less than _______ of breast cancers present with
localised pain.
10%
Mastalgia
The problems, especially types _____ and _____are
difficult to alleviate.
2 and 3,
Cyclical mastalgia is the commonest diffuse breast
pain. It occurs in the _______
latter half of the menstrual cycle, especially in the premenstrual days, and subsides with the onset of menstruation
Cause of mastalgia
It obviously has a hormonal basis, which may be an abnormality in _________
prolactin secretion.
Non-cyclical mastalgia, which is pain that does
not vary within the menstrual cycle, is also quite
common and the cause is________
poorly understood
___________ which is a rare florid form of breast cancer found in young women, often during lactation, is red and hot but not invariably painful or tender
‘Mastitis carcinomatosa’,
Mastitis is common among nursing mothers. It
should be regarded as a serious and urgent problem
because a ________ can develop quickly
breast abscess
Drugs that can cause breast discomfort include 1 2 3
oral contraceptives, HRT and
methylxanthine derivatives such as theophylline
Drugs that cause tender gynaecomastia (more applicable to men) include 1 2 3 4
digoxin, cimetidine,
spironolactone and marijuana
When is UTZ not useful?
It is not so useful for the postmenopausal
breast, which is fatty and looks similar to cancer on
ultrasound.
_______ can be useful for an area of
localised pain, especially in the presence of a possible
mass.
FNA e xcision biopsy
Breast pain is uncommon in children, including
puberty, but it may be a presenting problem in the _______
late
teens
Breast pain is rare after the menopause but is
increasing with increased use of ________, where it tends to present as the diffuse bilateral type
HRT
If the problem is
related to the introduction of HRT, the _____ dose
should be reduced or an alternative preparation used.
oestrogen
Cyclical mastalgia
• the typical age is 30–40 years (mean 35)
• discomfort and sometimes pain are present
• usually bilateral but one breast can dominate
(usually _______
upper outer quadrant)
T or F
Cyclical mastalgia is rare after the menopause.
T
effectiveness of _____, _______ and _______ and showed that all provided significant
relief, but that all have the potential for severe
adverse effects.
danazol, bromocriptine and tamoxifen
The cause is often obscure, but the
costochondral junction may become strained in
patients with a persistent cough. The pain can appear
to be in the breast with intermittent radiation round
the chest wall and is initiated or aggravated by deep
breathing and coughing
Costochondritis (Tietze syndrome)
________is basically cellulitis of the interlobular
connective tissue of the breast
Mastitis
Infecting organisms in Mastitis
Staphylococcus aureus, or more rarely, Escherichia coli and Candida albicans.
___________infection usually causes severe
breast pain—a feeling like a hot knife or hot shooting
pains, especially during and after feeding. It may
occur after a course of antibiotics.
Candida
How to treat bacterial mastitis
resolution without progression to an
abscess will usually be prevented by antibiotics
di/(flu)cloxacillin 500 mg (o) 6 hourly for 10 days
or (if hypersensitive to penicillin) cephalexin
500 mg (o) 6 hourly for 10 days
How to Tx candidia mastitis
fluconazole 200–400 mg (o) daily for 2–4 weeks
second line—nystatin 500 000 U (o) tds
If tenderness and redness persist beyond ______
and an area of tense induration develops, then a
breast abscess has formed
48 hours
Breast abscess
Surgical drainage
may be required but should be avoided if possible
because _______
fistula formation is common.
The basis of management for benign mastalgia is
_______
firm reassurance
