11. Breast Lump Flashcards Preview

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Flashcards in 11. Breast Lump Deck (19)
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1

What are 4 most common diagnoses for a breast lump?

Benign cystic change
Fibroadenoma
Cyst
Carcinoma

2

What are the 5 most common diagnoses for a breast lump in women under 30?

Physiologically normal lumpy breast
Benign cystic change
Fibroadenoma
If breastfeeding: Galactocele + Abscess

3

What are the 4 most common diagnoses for a breast lump in women aged 30-45 ?

Benign cystic change
Cyst
Abscess (esp. smokers)
Carcinoma

4

What are the 3 most common diagnoses for a breast lump in women aged 45-60?

Cyst
Abscess (smokers)
Carcinoma

5

What are the most common diagnoses for a breast lump in women aged over 60?

Carcinoma

6

What 2 diagnoses would you only encounter in breast-feeding women?

Galactocele
Mastitis

7

What are the 5 main risk factors for breast cancer?

Previous breast cancer
FH of breast cancer
Previous bowel, ovarian + endometrial cancer
Irradiation to the chest wall
Increased exposure to oestrogen

8

What 7 questions should you ask in a breast lump history?

How long has the lump been there, why was it first noticed?
Breast trauma?
Has the lump got bigger, smaller or stayed the same size? Are changes related to the menses?
Is the lump painful?
Any skin/ nipple change or nipple discharge?
Otherwise fit + well?

9

What 4 key features will you look for on inspection in a breast exam?

(new) Asymmetry
Countours (disruption)
Skin changes
Nipple changes/ discharge

10

What kind of surface, borders, consistency, mobility, fixity and lymphadenopathy do cysts have?

S: Smooth
B: Distinct
C: Firm to lax
M: None
F: None
L: None

11

What kind of surface, borders, consistency, mobility, fixity and lymphadenopathy do fibroadenomas have?

S: Smooth
B: Distinct
C: Rubbery
M: Yes
F: None
L: None

12

What kind of surface, borders, consistency, mobility, fixity and lymphadenopathy do carcinomas have?

S: Irregular
B: Indistinct
C: Hard
M: None
F: Maybe
L: Maybe

13

What makes up the triple assessment for breast lumps?

1. Clinical examination
2. Radiological: <35 US, >35 two view mammogram
3. Fine needle aspiration or core biopsy

14

List 8 causes of increased oestrogen exposure

Early menarche
Late menopause
Nulliparity
Having 1st child >30y
Not breastfeeding
HRT
COCP
Obesity

15

What kind of surface, borders, consistency, mobility, fixity and lymphadenopathy do benign cystic changes have?

S: Irregular
B: Indistinct
C: Mixed
M: None
F: None
L: None

16

Where does breast carcinoma most commonly metastasise to?

Liver
Bone
Lungs
Brain

17

What are the advantages and disadvantages of fine needle aspiration?

A:
Quick
Minimally invasive
Low risk of bruising/ local complications
Can assess hormone receptor status of cell
D:
May have poor sensitivity
In situ + invasive disease can't be distinguished

18

What are the advantages and disadvantages of core biopsy?

A: In situ + invasive disease can be distinguished as local architecture preserved
D:
Higher risk of local complications + bruising
Results not immediate
Requires LA
More invasive + time consuming

19

What is meant by the letters and numbers used in the scoring system of breast lumps?

P: Physical exam
R: Radiological exam
C: Cytology (FNA)
B: Biopsy (core)
1= Normal
5= Malignant