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Repro > Week 11.1 - Breast disease > Flashcards

Week 11.1 - Breast disease Flashcards

1
Q

How would pain present in breast disease?

A
  • Non-cyclical

- Focal

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2
Q

How would a malignant lump present in breast disease?

A
  • Hard
  • Craggy
  • Fixed
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3
Q

Give 3 differential diagnoses for palpable masses

A
  • Invasive carcinomas
  • Cysts
  • Fibroadenoma
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4
Q

What is the most common benign palpable mass?

A

-Fibroadenoma

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5
Q

Give 2 differential diagnoses for milky discharge

A
  • Pituitary adenoma

- OCP

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6
Q

Give 3 differential diagnoses for bloody/serous nipple discharge

A
  • Benign lesion eg papilloma
  • Duct ectasia
  • Malignancy
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7
Q

Why are mammographic abnormalities easier to detect in older people?

A

-High adipose content in breasts

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8
Q

What does calcification suggest on a mammograph?

A
  • DCIS

- benign mass

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9
Q

What is polyethelia?

A

-Additional nipple

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10
Q

What is acute mastitis?

A

-Inflammatory condition of the breast from Infection from staph. aureus during lactation due to nipple cracks as can track up the lactiferous duct

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11
Q

What is fat necrosis?

A

-Inflammatory condition of the breast which presents as a mass of skin changes as a history of trauma or surgery

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12
Q

What is fibrocystic change?

A
  • The most common breast lesion which presents as a mass or on mammograph
  • Histology shows cyst formation, fibrosis and apocrine metaplasia
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13
Q

State 3 benign epithelial lesions of the breast

A
  • Fibrocystic change
  • Stromal tumour eg fibroadenoma or phyllodes
  • Gynacomastia
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14
Q

Name 2 benign stromal tumours

A
  • Fibroadenoma

- Phyllodes

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15
Q

Describe how fibroadenoma would be on presentation

A
  • Highly mobile mass (breast mouse)
  • Well circumscribed
  • Can be multiple, bilateral and large
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16
Q

In what age group does phyllodes most oftn occur?

A

-Over 40 years

17
Q

Describe the behaviour of malignant phyllodes

A
  • Aggressive
  • Recur
  • Metastasise by blood
18
Q

What is the histiological difference between phyllodes and fibroadenoma?

A

-Phyllodes withh have more atypical stroma

19
Q

When excising phyllodes, what is the difference between that and fibroadenoma? why?

A

-Wide excision margin as can recur

20
Q

What is gynaecomastia? In who does it most often occur?

A
  • Enlargement of the male breast due to decreased androgens or increased oestrogens
  • Young or elderly
21
Q

give 3 causes of gynaecomastia

A
  • Liver disease
  • Klinefelters
  • Testicular tumour
22
Q

What is the most common type of breast malignancy?

A

-Adenocarcinoma

23
Q

Describe some riskfactors for breast malignancy

A
  • Uninteruppted menses
  • Early menarche
  • Late menapause
  • Obesity
  • OCP/HRT
24
Q

What is mean by in situ carcinoma?

A

-Neoplastic cells are limited to ducts and lobules by BM and thus cannot metastasise

25
Q

What is distinctive about DCIS histiologically?

A

-Central comedo necrosis

26
Q

What is pagets disease of the breast?

A
  • DCIS which has extended up to the nipple skin as does not have to cross BM to get here
  • Red crusting nipple
27
Q

How does DCIS most often present?

A

-Mammographihc calcification

28
Q

By the time a breast malignancy is palpable, what % have mets?

A

-50%

29
Q

Where does invasive carcinoma commonly metastasise first?

A

-Axillary LNs

30
Q

What is the cause of peau d’orange?

A

-Blockage of the lymphatics causing odematous breast -> Hair follicles are firmly attched to dermis and pull down

31
Q

What are the two types of invasive carcinoma? Which is most common?

A
  • IDC-No special type (most common)

- Invasive lobular carcinoma

32
Q

How does invasive lobular carcinoma look histologically?

A

-Discohesive single file infiltrating cells

33
Q

How does breast cancer commonly metastasise?

A
  • Using lymphatics

- (distant mets usually by bloodstream)

34
Q

Where does breast malignancy commonly metastasise?

A

-ipsilateral LNs, bone, lung, liver, brain

35
Q

Describe the triple approach to investigation and diagnosis

A
  • Clinical history and examination
  • Radiographic imaging
  • FNA
36
Q

Describe breast cancer screening

A
  • 47-73
  • 2 view mammograms every 3 years
  • Aims to detect small impalpable cancers
37
Q

When would a breast malignancy get treated with tamoxifen?

A

-If it was oestrogen receptor positive

38
Q

When would a breast malignancy get treated with herceptin?

A

-If it was HER2 receptor positive

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