Pathology/conditions Flashcards
Fibroadenoma
- Fibroadenoma - common benign tumours that are small and mobile (breast mouse) - respond to female hormones - common when younger (surgical excision If >3cm)
What causes Gynaecomastia
- Imbalance between oestrogen and testosterone
Cx - medications - spironolactone and anabolic steroids, idiopathic…
Exam - reduced testosterone, thyroid, testicles, bilateral changes?, medications, liver signs,
Axs for gynae
Axs - leading tescticular cancer, liver failure, hyperthyroidism, small cell lung cancer
Mx of gynae
- conservative
- tamoxifen to reduce oestrogen
prolactin and dopamine effects on gynae
dopamine inhibits prolactin (dopamine antagonists - anti psychotics increase levels)
Galactocele
Galactocele - tumour of milk ducts that become blocked just after breast feeding - firm, mobile and painless (Under areola)
What causes galactorrhea
- Breast milk production outside of breast feeding
- Hyperprolactinaemia**
Cx - idiopathic, prolactinomas, endocrine disorders (hypothyroid and polycystic ovarian syndrome), dopamine antagonists
Mx - dopamine agonists (bromocryptine)
- removal of pituitary tumour
Symptoms of gallactorhea
Sx - menstral irregularities, reduced libido, erectile dysfunction and gynae
*Prolactin suppresses GnRH, reducing LH and FSH
Mx of galactorrhea
Mx - dopamine agonists 1st (bromocryptine)
- removal of pituitary tumour
What is Mammary duct ectasia
- Benign dilation of ducts in the breast that become inflamed
*most common just before menopause
* smoking huge risk factor
Sx of mammary duct ectasia
Sx - nipple discharge, tenderness or pain, retraction or inversion, possible lump
- green, grey or white discharge
Ix for mammary duct ectasia
Ix - Mammogram, us, MRI - micro calcifications
Mx of mammary duct ectasia
mx - conservative
RF for mammary duct ectasia
*most common just before menopause
smoking huge risk factor
What is an Intraductal papilloma
- Benign warty lesion that grows within one of the ducts in the breast - proliferation of epithelial cells
Px - clear or blood stained discharge
- can be tender or have a lump
- often no symptoms
Ix - us, mammogram, biopsy
- ductography using die
Mx - surgical excision
Sx of Intraductal papilloma
Px - clear or blood stained discharge
- can be tender or have a lump
- often no symptoms
Ix of intra ductal papilloma
Ix - us, mammogram, biopsy
- ductography using die
Mx of intraductal papilloma
Mx - surgical excision
What is/what causes Lactational mastitis
*inflammation of breast ducts during breast feeding
* Very common infection with smokers
Cx - Blockage of milk during breast feeding
- infection via staph aureus
Sx of lactational mastitis
Sx - unilateral tenderness, erythema in 1 area, local warmth, nipple discharge, fever
Mx off lactational mastitis
Mx - conservative - keep breast feeding
- Flucloxacillin 10 days - if not working
Complications of lactational mastitis
Complications - candida of nipple - occurs after antibiotics, skin breaks causing recurrent mastitis
Associated with oral thrush and nappy rash
Mother and child need treatment - topical mioconazole
What is Pagets disease of the nipple
- Rash over the nipple that spread to the areolar region, thickening of skin
- Strongly suggestive of breast cancer
Sx of paget’s disease
Sx - itchy rash on nipple
- starts from nipple and moves to areolar
