Painful Breast Flashcards
Breast pain
Especially important to clarify whether there is a relationship to the menstrual cycle - more common during luteal phase
Rarely a sign of breast cancer if only symptom / sign
Types
Cyclical - linked to changing hormonal levels. Described as heaviness may radiate into the axilla or down the arms
Non-cyclical - cause often unclear but settles on its own in around 50% of cases
Do a bilateral screening mammography to investigate (fat - dark, fibroglandular tissue - white)
Breast density
RF for breast cancer
Also more difficult to detect breast cancers - obscured by the breast tissue
Mastitis
Can be infectious or non-infectious
Lactational mastitis common in breast feeding women - due to milk stasis caused by overproduction or insufficient removal of milk
Development of focal lump and systemic symptoms - abscess? Predisposing factors - baby not attaching well to breast, use of dummy / bottle, tight bra
Non lactational abscesses - smokers, diabetics, immunocompromised
Management of abscess
Ultrasound guided drainage in breast unit under local anaesthetic
Flucloxacillin - only trace found in breast milk
Support and advise re attachment (breastfeeding counseller)
Encouraged to keep expressing milk to avoid stasis
Inflammatory Breast Cancer
Rare - grows along the lymph vessels
Symptoms - redness, swelling, pain, hot, orange peel skin, nipple pain / discharge
Can spread quicker than other types of cancer. Urgent tx - chemo, radio, surgery, targeted therapy, hormonal therapy