Obstetrics / Gynecology Flashcards
Inflammation of the breast
Mastitis
Seen mostly in lactating women secondary to nipple trauma
Infectious mastitis
Most common bacterial etiologies of infective mastitis
Staph aureus
Strep
+/- Candida
Signs/Symptoms of infective mastitis
Unilateral breast pain Tenderness Warmth Swelling Nipple discharge
Signs/Symptoms of congestive mastitis
Bilateral breast pain and swelling
Low grade fever
Axillary lymphadenopathy
Management of infective mastitis
Supportive measures (warm compresses, breast pump)
Anti-staphylococcal abx: Dicloxacillin, nafcillin, cephalosporin
Fluconazole if fungal
Mothers may continue to nurse/breast pump
Management of congestive mastitis
If women does not want to breastfeed: ice packs, tight fitting bras, analgesics, avoid breast stimulation
If women wants to breastfeed: manually empty breast after baby is done, local heat, analgesics
Management of breast abscess
I&D
Discontinue breastfeeding from affected breast
Most common breast disorder
Fibrocystic breast disorder
Signs/symptoms of fibrocystic breast disorder
Multiple, mobile, well demarcated lumps in breast tissue
Often tender and bilateral
May increase/decrease in size with menstrual hormonal changes
Diagnosis of fibrocystic breast disorder
- Ultrasound
2. FNA - straw colored fluid
Management of fibrocystic breast disorder
Most will resolve spontaneously
+/- FNA removal of fluid if symptomatic
2nd most common breast disorder
Fibroadenoma of the breast
Composed of glandular and fibrous tissue (collagen arranged in “swirls”)
Fibroadenoma of the breast
Signs/symptoms of fibroadenomas
Smooth, well-circumscribed, nontender, freely mobile, rubbery lump in breast
Gradually grows over time
Does not usually wax and wane with menstruation
Management of fibroadenomas
Observation
Most small tumors resorb with time
Excision if painful
Most common forms of breast cancer
Ductal (milk ducts) or lobular (lobules that produce milk)
Most common non-skin malignancy in women
Breast Cancer
2nd most common cause of cancer death in women
Breast Cancer
Risk factors for breast cancer
BRCA 1 & BRCA 2 1st degree relative with breast CA Age > 65 y/o Hormonal (increased number of menstrual cycles) Increased estrogen
75% have no risk factors
Most common type of breast cancer
- Infiltrative ductal carcinoma
2. Upper outer quadrant
Signs/symptoms of breast cancer
Breast mass - usually painless, hard, fixed
Pain is rare
+/- axillary lymphadenopathy
Unilateral nipple discharge
Most common locations of breast cancer METS
Lung
Liver
Bone
Brain
Chronic eczematous itchy, scaling rash on the nipples and areolas.
Paget’s Disease of the Nipple
Indicative of breast CA
