Week 8 - The Breast Flashcards

1
Q

What is the clinical presentation of breast disease?

A

Pain - less than 2% have cancer

Palpable mass - cysts, benign tumours, cancer

Nipple discharge

Mammographic abnormality

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2
Q

What benign diseases of the breast can you get?

A

Fibrosistic disease

Fat necrosis

Mastisis

Tumours

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3
Q

What is fibrocystic disease?

A
  • very common
  • lumpiness on one or usually both breasts
  • pain/tenderness in breasts
  • hormone regulated changes
  • cumulative process >30 years old
  • calcification
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4
Q

What can cause fat necrosis in the breast and what are the symptoms?

A
  • trauma to breast can result in localised haemorrhage and necrosis
  • hard lump - mimics cancer clinically
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5
Q

What is mastitis?

A
  • inflammatory condition
  • red, tender, warm
  • blocked ducts - lactation mastitis
  • encourage breastfeeding
  • smoking
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6
Q

What benign tumours can arise in the breast?

A

Fibroadenoma

Papilloma

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7
Q

What malignant tumours can arise in the breast?

A

Ductal carcinoma

Lobular carcinoma

Paget’s disease (invasive or non invasive)

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8
Q

What is a papilloma in the breast?

A
  • benign
  • wart-like growth in ducts
  • bleeding/nipple discharge
  • up to 2cm
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9
Q

What is a fibroadenoma in the breast?

A
  • benign
  • rubbery lumps
  • reproductive age
  • can increase in size during pregnancy
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10
Q

What age is someone most likely to get breast cancer?

A

Incidence increases with age

Average age at diagnosis = 64 yrs

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11
Q

What are the risk factors for breast cancer?

A

-hereditary (BRCA mutation - X5 risk of breast cancer and X10 risk of ovarian cancer)

  • age, height
  • oestrogen (early menache, breast feeding)
  • lifestyle
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12
Q

How can breast cancer present?

A
  • lump
  • skin dimpling
  • change in skin colour or texture
  • change in how the nipple looks, like the pulling in of the nipple
  • clear or body fluid that leaks out of the nipple
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13
Q

What is the most common type of breast cancer?

A

Invasive ductal carcinoma

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14
Q

What is ductal carcinoma?

A

In situ:

  • abnormality of milk ducts
  • pre-malignant condition

low grade > high grade > invasive

Invasive:

  • most common type of breast cancer
  • grades 1-3
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15
Q

How is breast cancer treated?

A
  • surgery +/- lymph node dissection
  • chemo/radiotherapy
  • hormone therapy e.g. Tamoxifen, herceptin
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16
Q

What surgical procedures can be undertaken to remove breast cancer?

A
  • lumpectomy
  • wide local excision
  • mastectomy
  • sentinel lymph node
17
Q

What is Paget’s disease of the nipple?

A
  • affects skin of one nipple
  • eczema type rash, itchy, possible bleeding
  • sign of underlying breast cancer
18
Q

What is the anatomy of the breast?

A
  • stroma

- epithelium (ducts and lobules arranged in terminal duct lobular units)