Surgery - Breast Flashcards
When in the life course is duct ectasia of the breast most common?
Menopause
How should duct ectasia be managed?
Conservatively
If troublesome can be managed surgically
What are the signs and symptoms of duct ectasia?
Tender lump around areola and green nipple discharge
How should fat necrosis be investigated?
Imaging
Core biopsy
How does fat necrosis of the breast appear?
Firm, round lump –> hard, irregular lump
Which pathogen most commonly causes acute mastitis?
Staphylococcus aureus
Recall 2 risk factors for acute mastitis
Smoking
Nipple injury
How should lactational mastitis be managed?
Simple analgesia
Warm compresses
Continue breastfeeding
How should non-lactational mastitis be managed?
1st line: flucloxacillin
2nd line: co-amoxiclav
If MRSA –> trimethoprim
How can breast abscess best be imaged?
USS
How should breast abscess be managed?
1st - ultrasound-guided aspiration with abx and reassess in 48 hours
(admit for IV abx if acutely unwell)
2nd - Incision and drainage and culture of fluid - usually ONLY if overlying skin necrosis
How big does a fibroadenoma have to be to warrant excision?
> 3cm
What is intraductal papilloma of the breast?
Local areas of epithelial proliferation in large mammary ducts
What are the symptoms of fibroadenosis of the breast?
Lumpy breasts (BL) which may be painful, symptoms may be worse prior to menstruation
What are the symptoms of intraductal papilloma?
Clear/blood-stained discharge
How should intraductal papilloma be managed?
Microdochectomy
What sort of tumour might arise from a pre-existing fibroadenoma?
Phyllodes tumour
Are phyllodes tumours benign or malignant?
Usually benign but occasionally behave aggressively