Other breast problems

Question 1

What are fibroadenomas?

Answer 1

Hyperplasia of a single terminal duct unit

Question 2

Treatment of fibroadenoma

Answer 2

If proven on US and FNA cytology, do not need excision

Question 3

How are breast cysts investigated?

Answer 3

Aspirate after US confirmation

Question 4

Symptoms of duct papilloma (2)

Answer 4

Lump

Discharge +/- blood

Question 5

Treatment of duct papilloma

Answer 5

Excision (microdochectomy or total duct excision)

Question 6

Classification of breast pain (2)

Answer 6

Cyclical (relationship to menstrual cycle)

Non-cyclical

Question 7

Which areas of the breast tend to be affected by cyclical mastalgia?

Answer 7

Outer half of each breast although it may be unilateral

Question 8

How is cyclical mastalgia described by patients? (3)

Answer 8

Heightened awareness, fullness, heaviness

Question 9

Indications for imaging in mastalgia (2)

Answer 9

Unilateral

Breast lump present

Question 10

Possible extramammary causes of mastalgia (4)

Answer 10

Chest wall
Gall stones
Costochondritis
Lung disease

Question 11

1st line treatment of mastalgia (4)

Answer 11

Reassurance; bra fitting; simple analgesia; topical NSAIDs may help

Question 12

Second line options for mastalgia (4)

Answer 12

Gamolenic acid
Danazol
Tamoxifen
Bromocriptine

Question 13

Mechanism of a) danazol b) bromocriptine

Answer 13

a) anti-gonadotrophin b) dopamine agonist

Question 14

which test should be carried out in the case of a milky bilateral nipple discharge (when not breastfeeding)

Answer 14

PRL levels ?pituitary adenoma

Question 15

Symptomatic relief of gynaecomastia (2)

Answer 15

Danazol or tamoxifen

Question 16

Usual causative agent of breast abscess in breastfeeding woman

Answer 16

Staph aureus

Question 17

Treatment for breast abscess

Answer 17

Flucloxacillin + drainage (aspiration or incision)

Question 18

Periductal mastitis is more common in… and can present with….

Answer 18

Young smokers

Pus discharge from nipple