Miss C Breast Lump

Question 1

4 commonest differentials breast lump

Answer 1

carcinoma
cyst
fibroadenoma
fibrocystic change

Question 2

other differentials for breast lump, less common

Answer 2

fat necrosis
periductal mastitis
abscess
galactocele
phyllodes tumour
sarcoma
duct papilloma
nonbreast lump e.g. lipoma

Question 3

at what age does carcinoma becomethe most likely diagnosis for a patient?

Answer 3

> 60 years old

Question 4

diagnosis only encountered in breast feeding women?

Answer 4

galactocele

Question 5

family hx suspicious for breast cancer(4)

Answer 5

− Two close blood relatives develop breast cancer before the age of 60
− One close blood relative develops breast cancer before the age of 40
− One male close blood relative develops breast cancer
− One close blood relative develops bilateral breast cancer

Question 6

What should any GP offer to a patient with a palpable breast lump?

Answer 6

referral to breast clinic: can be non urgent if no red flags

Question 7

triple breast assessment componenets

Answer 7

1. clinical exam
2. radiological examination
3. fine needle aspiration/biopsy

Question 8

different types of radiological examination

1. <35
2. > 35

Answer 8

1. ultrasound (too dense for radiography)

2. two-view mammogram

Question 9

two treatment options for fibroadenoma

Answer 9

1. most resolve - conservative stance and reassurance patient benign
2. excisional biopsy removal - indications include patient preference, increasing size or lump causing discomfort.