Week 8 - The Breast Flashcards
What is the clinical presentation of breast disease?
Pain - less than 2% have cancer
Palpable mass - cysts, benign tumours, cancer
Nipple discharge
Mammographic abnormality
What benign diseases of the breast can you get?
Fibrosistic disease
Fat necrosis
Mastisis
Tumours
What is fibrocystic disease?
- very common
- lumpiness on one or usually both breasts
- pain/tenderness in breasts
- hormone regulated changes
- cumulative process >30 years old
- calcification
What can cause fat necrosis in the breast and what are the symptoms?
- trauma to breast can result in localised haemorrhage and necrosis
- hard lump - mimics cancer clinically
What is mastitis?
- inflammatory condition
- red, tender, warm
- blocked ducts - lactation mastitis
- encourage breastfeeding
- smoking
What benign tumours can arise in the breast?
Fibroadenoma
Papilloma
What malignant tumours can arise in the breast?
Ductal carcinoma
Lobular carcinoma
Paget’s disease (invasive or non invasive)
What is a papilloma in the breast?
- benign
- wart-like growth in ducts
- bleeding/nipple discharge
- up to 2cm
What is a fibroadenoma in the breast?
- benign
- rubbery lumps
- reproductive age
- can increase in size during pregnancy
What age is someone most likely to get breast cancer?
Incidence increases with age
Average age at diagnosis = 64 yrs
What are the risk factors for breast cancer?
-hereditary (BRCA mutation - X5 risk of breast cancer and X10 risk of ovarian cancer)
- age, height
- oestrogen (early menache, breast feeding)
- lifestyle
How can breast cancer present?
- 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
What is the most common type of breast cancer?
Invasive ductal carcinoma
What is ductal carcinoma?
In situ:
- abnormality of milk ducts
- pre-malignant condition
low grade > high grade > invasive
Invasive:
- most common type of breast cancer
- grades 1-3
How is breast cancer treated?
- surgery +/- lymph node dissection
- chemo/radiotherapy
- hormone therapy e.g. Tamoxifen, herceptin