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Disease Profiles > O+G - Breast Disease > Flashcards

O+G - Breast Disease Flashcards

1
Q

Definition - Atypical Lobular Hyperplasia

A

Pre-cancerous condition affecting lobular breast cells

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2
Q

Presentation - Atypical Lobular Hyperplasia

A

Asymptomatic - incidental finding on screening

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3
Q

Management - Atypical Lobular Hyperplasia

A

Surgical removal of abnormal cells
Follow up to monitor for cancerous changes

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4
Q

Complication - Atypical Lobular Hyperplasia

A

Increased risk of breast cancer

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5
Q

Causes - Atypical Lobular Hyperplasia

A

Untreated mastitis

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6
Q

Common Causative Organisms - Atypical Lobular Hyperplasia

A

Most common = staph aureus

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7
Q

Presentation - Atypical Lobular Hyperplasia

A

Painful, red warm breast
Fluctuant swelling
Systemic symptoms of infection

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8
Q

Diagnosis - Atypical Lobular Hyperplasia

A

USS

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9
Q

Management - Atypical Lobular Hyperplasia

A

Antibiotics
Drainage
Encourage continued breastfeeding

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10
Q

Genetic Risk Factor - Breast Cancer

A

BRCA mutations

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11
Q

Presentation - Breast Cancer

A

Asymptomatic (found at screening)
Changes in appearance and skin texture
Breast lump
Pain
Nipple discharge

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12
Q

Diagnosis - Breast Cancer

A

Triple assessment = examination, imaging + biopsy

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13
Q

Two Week Wait Referral Criteria - Breast Cancer

A

Unexplained breast/axilla lump >30
Unilateral nipple changes >50
Skin changes suggestive of breast cancer

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14
Q

Management - Breast Cancer

A

Surgery (lumpectomy or WLE)
Chemotherapy
Hormonal therapy

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15
Q

Management - Breast Cancer (HER2+)

A

Trastuzumab

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16
Q

Management - Breast Cancer (ER+)

A

Pre-menopausal = tamoxifen
Post-menopausal = aromatase inhibitors e.g. anastrozole

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17
Q

Risk Factor - Breast Cyst

A

Peri-menopausal age group

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18
Q

Presentation - Breast Cyst

A

Smooth, mobile ± fluctuant breast lump
Pain in some cases

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19
Q

Management - Breast Cyst

A

Aspiration or excision if required

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20
Q

Diagnosis - Mastalgia

A

Breast pain diary
Exclude other underlying causes

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21
Q

Management - Mastalgia

A

Supportive bra
NSAIDs
Heat

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22
Q

Definition - DCIS

A

A non-invasive tumour confined to the ducts of the breast

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23
Q

Presentation - DCIS

A

Asymptomatic (screening)
Breast lump
Nipple discharge
Skin changes

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24
Q

Diagnosis - DCIS

A

Triple assessment

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25
Q

Management - DCIS

A

Surgical excision if <4cm
Mastectomy if >4cm

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26
Q

Definition - Duct Ectasia

A

Mammary ducts under the nipple widen and become clogged
A benign condition

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27
Q

Risk Factors - Duct Ectasia

A

Increasing age
Smoking !!!!!!

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28
Q

Presentation - Duct Ectasia

A

Asymptomatic (screening)
Bloody/purulent discharge
Breast lump
Nipple retraction
Pain

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29
Q

Diagnosis - Duct Ectasia

A

Triple assessment

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30
Q

Management - Duct Ectasia

A

Analgesia
Smoking cessation
Excision of involved ducts in some cases

31
Q

Risk of Cancer - Duct Ectasia

A

None

32
Q

Definition - Fat Necrosis

A

Benign lump of dead/damaged breast tissue

33
Q

Causes - Fat Necrosis

A

Local trauma
Warfarin therapy
Surgery
Radiation

34
Q

Risk Factors - Fat Necrosis

A

Increasing age
Larger breast size
Obesity

35
Q

Presentation - Fat Necrosis

A

Breast lump
Painless

36
Q

Diagnosis - Fat Necrosis

A

Imaging (mammogram/USS)
Needle biopsy

37
Q

Management - Fat Necrosis

A

NSAIDs, warm compress
Some cases need surgery

38
Q

Definition - Fibroadenoma

A

Benign tumour of stromal/epithelial breast tissue

39
Q

Presentation - Fibroadenoma

A

Asymptomatic (screening)
Firm, discrete, painless and highly mobile mass

40
Q

Diagnosis - Fibroadenoma

A

Triple assessment

41
Q

Management - Fibroadenoma

A

Reassurance
>3cm = excise

42
Q

Definition - Fibrocystic Change

A

Lumpy breasts that fluctuate throughout the menstrual cycle

43
Q

Presentation - Fibrocystic Change

A

Asymptomatic (screening)
Pain - acute or cyclical
Smooth, discrete lumpiness

44
Q

Symptom Timing - Fibrocystic Change

A

Prior to menstruation, resolving when it starts

45
Q

Diagnosis - Fibrocystic Change

A

Imaging (mammography/USS)

46
Q

Management - Fibrocystic Change

A

Reassure
NSAIDs

47
Q

Definition - Gynaecomastia

A

Enlargement of glandular breast tissue in males

48
Q

Cause - Gynaecomastia

A

Increased oestrogen to androgen ratio

49
Q

Management Outline - Gynaecomastia

A
  1. Observation and reassurance
  2. Treat cause
  3. Tamoxifen
  4. Danazol
  5. Refer for surgery
50
Q

Complications - Gynaecomastia

A

Psychological impacts

51
Q

Definition - Paget’s disease of the Nipple

A

High grade DCIS that has extended along ducts to reach the epidermis

52
Q

Underlying Process - Paget’s disease of the Nipple

A

Breast cancer

53
Q

Presentation - Paget’s disease of the Nipple

A

Eczema of the nipple
Itch

54
Q

Diagnosis - Paget’s disease of the Nipple

A

Triple assessment

55
Q

Management - Paget’s disease of the Nipple

A

Mastectomy
Chemo/radiotherapy
Hormone therapy

56
Q

Presentation - Mastitis

A

Hot, swollen tender area
Usually unilateral

57
Q

Diagnosis - Mastitis

A

Clinical
Consider USS and culture

58
Q

Management - Mastitis

A

Analgesia
CONTINUE BREASTFEEDING
Antibiotics if indicated

59
Q

Antibiotics - Mastitis

A

Flucloxacillin 1g QDS

Clinindamycin 450mg TDS if pen allergic

60
Q

Complications - Mastitis

A

Recurrence
Breast abscess

61
Q

Presentation - Intraductal Papilloma

A

Asymptomatic (screening)
Lump
Bloody discharge
Pain

62
Q

Diagnosis - Intraductal Papilloma

A

Triple assessment

63
Q

Management - Intraductal Papilloma

A

Excision

64
Q

Definition - Galactocele

A

Cysts filled with breast milk

65
Q

Presentation - Galactocele

A

Firm, mobile and painless breast lump

66
Q

Definition - LCIS

A

Neoplastic proliferation of cells in a breast lobule

67
Q

Presentation - LCIS

A

Asymptomatic (screening)
Lump
Nipple discharge
Skin changes

68
Q

Diagnosis - LCIS

A

Triple assessment

69
Q

Management - LCIS

A

Observation
Mastectomy inn some cases

70
Q

Definition - Phyllodes Tumour

A

Slow growing, unilateral tumour of the storm of the breast
Can be benign or malignant

71
Q

Presentation - Phyllodes Tumour

A

Lump - smooth, slow growing, unilateral
Pain
Red warm skin

72
Q

Diagnosis - Phyllodes Tumour

A

Triple assessment

73
Q

Management - Phyllodes Tumour

A

WLE
Radio/chemotherapy if needed

Disease Profiles (15 decks)

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