Presentation of breast disease Flashcards
How does breast disease present?
- Pain
- Palpable tumour/Non-palpable tumour
- Nipple discharge
- Nipple or skin changes
- Axillary or supraclavicular nodes
- Change in size or shape of breast
What is the approach to patient with breast disease
- Observe
- History
- Clinical examination
- Special investigations
What do you look for during observation?
- Acutely ill
- Chronically ill
- Healthy
- Young / Old
- Distressed
What is important to do during the history
Let the patient tell you what is wrong
Ask additional questions
Risk factors
Additional information about other diseases
What are the important risk factors for breast cancer
Male/Female
Age
Family history - BRCA gene
What do you do during the clinical examination of the breast
Breast and Axillary tail
Axilla
Supraclavicular area
General systemic examination
What are the special investigations for breast examination
Ultrasound/mammogram
MRI
Cytology
Histology
List the different types of benign tumours
- Fibroadenosis
- Fibroadenoma
- Cysts
- Galactocoele
- Duct ectasia
- Phylloides tumor
List the malignant tumours
Carcinoma in situ
1. Lobular carcinomain situ
2. Ductal carcinoma in situ
Infiltrating cancer
1. Lobular carcinoma
2. Ductal carcinoma
Malignant phylloides tumor
Metastatic tumors
What are the steps in the case of a breast lump
Triple assessment
1. Clinical examination
2. Imaging
3. Tissue diagnosis - Fine needle or Core biopsy
Which conditions could lead to breast pain
Fibroadenosis
Mastitis or breast abscess
Constro-chondral junction syndrome
How can breast discharge present
Watery
Milk
Blood
Single or both nipples
Multiple or single ducts
