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Hospital Based Medicine And Surgery > L07: Breast Disease Signs And Symptoms > Flashcards

L07: Breast Disease Signs And Symptoms Flashcards

1
Q

What are the symptoms of breast disease

A 
Lump
Change in size
Nipple change
Nipple discharfe 
Infection
Pain (mastalgia)
Skin changes
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2
Q

What questions should be asked in the history

A

Menstrual cycle- menarche, menopause, preganncy, gynaecological procedures
Drug history: oral contraceptive pills or HRT (risk of breast cancer)
Family history: of breast cancer and ovarian cancer

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3
Q

What are the 3 categories of benign breast conditions

A

Benign lump
Hormonal breast condition
Inflammatory breast condition

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4
Q

What are the benign lumps that can occur

A

Fibroadenoma
Cyst
Traumatic fat necrosis
Phyllodes tumour

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5
Q

What is a fibroadenoma

A

Abberation of normal development where there is proliferation process in single terminal ductal unit in the breast

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6
Q

What is the diagnosis of fibroadenoma

A

Tripple assessment

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7
Q

What does a tripple assessment involve

A

Physical examination
Radiological imaging
Biopsy

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8
Q

What is the treatment of fibroadenoma

A

Monitor the breast as it can grow

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9
Q

What are cysts

A

Fluid filled lobules

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10
Q

When are cysts common

A

Around menopause

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11
Q

When are breast cysts uncommon

A

Post menopause

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12
Q

What is the presentation of cysts

A

Pain
Tenderness
Mulitple or single lump

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13
Q

What is the diagnosis of cysts

A

Tripple assessment

Ultrasound- diagnostic

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14
Q

What is the treatment for a cyst

A

Reassurance and advice

Aspiration if the patient is symptomatic

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15
Q

What is a traumatic fat necrosis

A

Lump due to iatrogenic e.g surgical or blunt trauma e.g seat belt injury or elbow injury which causes fat necrosis or breakdown of adipose tissue

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16
Q

What is the presentaiton of traumatic fat necrosis

A

Skin changes with or without bruising

Presents like breast carcinoma

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17
Q

What is the assessment of traumatic fat necrosis

A

Biopsy- to distunguish between breast carcinoma

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18
Q

What is pyhloddes tumour

A

A arare tumout that occurs aronnd menopausal age that can be benign or malignant

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19
Q

What is the presentation of phyloddes tumour

A

Firm
Mobile
Wel circumscribed
Non tender breast mass

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20
Q

What is the diagnosis of phyllodes tumour

A

Triple assessment

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21
Q

What is the management of phyloddes tumour

A

Wide excision

22
Q

What hormonal breast condition can occur

A

Gynaecomastia

23
Q

What is gynaecomastia

A

Hormonal proliferation of breast tissue in males due to increased oestrogen and androgen

24
Q

Which condition can cause gynaecomastia

A

Liver cirrhosis
Testicular tumour
Hypogonadism
Idiopathic

25
Q

What is the treatment for gynaecomastia

A

Reassurance

Liposuction/excision/cosmetic surgery

26
Q

What are the types of breast and inflammatory breast condition that can occur

A

Periductal mastitits

Acute bacterial mastitis and abscess

27
Q

What is periductal mastitis

A

Inflammatory process around the dilated milk ducts which can be secondary to duct entasia (dilation of major ducts in the subareolar region)

28
Q

What is the presentation of periductal mastitis

A

Pain
Nipple discharge
Cellullitis
Suberaolar mass

29
Q

What is the assessment of periductal mastitis by

A

Ultrasound

30
Q

What is the treatment of periductal mastitis

A

antibiotics

Surgery

31
Q

What is acute bacterial mastitis and asbcess

A

Usually associated with lactation in breastfeeding mothers

In non lactating women can be associated with women immunocompromised

32
Q

What are the presentation of bacterial mastitis and abscess

A

Signs of breast inflammation
Localised to a breast area
Systemic signs of infection

33
Q

What is the assessment of aucte bacterial mastitis

A

Ultrasound

34
Q

What is the treatment of acute bacterial mastitis

A

Antibiotics
Continue breastfeeding
Aspiration of asbcess

35
Q

What are the types of breast cancer

A 
Ductal: can be separated to intraductal and invasive ductal carcinoma
Lobular 
Tubular
Medullary 
Mucinous
36
Q

How can breast cancer spread

A

Direct extension
Lymphatic system: to axillay and internal thoracic nodes
Haematolgical: via blood to lungs, liver, bone and brain

37
Q

What are the risk factors for developing breast cancer

A 
Gener- female
Drugs: ocp and hrt (oestrogen exposure)
Family history of BRCA gene mutation
Early periods
Late menopause
Radiation
Alcohol and overweight
38
Q

What are the features of breast cancer

A

Nipple discharge
Lump
Nipple retraction or inversion
Skin changes such as tethering

39
Q

How do we diagnose breast cancer, what are the investigations

A

Triple assessment: clinicla examiantion, imaging and biopsy

Further: bloods, lfts, ue, chest xray, bone scans, liver ultrasound scan

40
Q

What are the treatment options for breast cancer

A

Wide local excsision
Mastectomy
Surgery to the axilla: by sentinel lymph nodes biopsy, axillary node sampling, axillary node clearance

41
Q

What is the difference between wide local excision and mastectomy

A

Wide local excision: removal of the lump and marging of healthy tissue
Mastectomy: removal of the whole lump

42
Q

What is sentinel lymph node biopsy

A

Taking a biopsy from the first axillay lymph node

43
Q

What is axillay lymph node sampling

A

When several lymph nodes are removed for histological examination

44
Q

What is axillay lymph node clearance

A

Removing lymph nodes that were found to be positive

45
Q

What are adjuvant therapies

A

When you give therapy after surgery to prevent reoccurance such as chemotherapy and radiotherapy

46
Q

When do we give hormonal therapy

A

To reduce ostreogen levels in an ER positive tumour only

47
Q

What are the types of hormonal therapy

A

Selective oestrogen receptor modulators: prevent oestrogen from binding to its receptors
Aromatase inhibitor: inhibit aromatas that produce oestrogen in fatty tissue
Ovarian ablation: chemotherapy, radiotherapy and lh analogue e.g goserelin

48
Q

Who is aramatase inhibitors given to

A

post menopausal women that have the oestreogen produced by the fatty tissue instead of the ovaries

49
Q

If there is a HER2 positive breast cancer what can be given

A

herceptin

50
Q

What is herceptin

A

A monoclonal antibody that binds to HER2 receptors

Hospital Based Medicine And Surgery (30 decks)

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