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Finals revision > Breast medicine > Flashcards

Breast medicine Flashcards

1
Q

FIBROADENOMA

What is a fibroadenoma and describe it’s epidemiology

A

benign tumour of epithelial breast lobule tissue

Common in younger women (20-40)
Respond to oestrogen and progesterone

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2
Q

FIBROADENOMA

Describe fibroadenomas on examianiton

A

Unilateral

Painless

Smooth

Round

Well circumcised

Firm

Mobile

<5cm diameter

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3
Q

FIBROCYSTIC BREAST

Describe fibrocystic breast changes

A

Bilateral diffuse lumpiness of breasts - connective tissue, ducts and lobules of breasts respond to oestrogne and progesterone becoming fibrous (irregular and hard) and cystic

Changes fluctuate with menstrual cycle

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4
Q

FIBROCYSTIC BREAST

Describe the pattern of symtpoms

A

Occur prior to menstruation - within 10 days

resolve once menstruation begins

resolve after menopause

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5
Q

FIBROCYSTIC BREAST

How does fibrocystic breast changes present

A

lumpiness - upper outer quadrant

breast pain and tenderness

fluctuation of breast size

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6
Q

FIBROCYSTIC BREAST

What is the management

A

triple assessment - exclude cancer

manage cyclical breast pain:

wear a supportive bra

NSAIDs

Apply heat to the area

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7
Q

BREAST CYST

Describe a breast cyst

A

Benign unilateral fluid-filled lumps
Painful
Flucuate in size

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8
Q

BREAST CYST

Describe a breast cyst on examination

A

Smooth
well circumcised
mobile
fluctuant

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9
Q

BREAST CYST

What is the management of a breast cyst

A

Triple assessment to exclude cancer

aspiration or excision

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10
Q

BREAST CYST

Does having a breast cyst increase cancer risk

A

Yes - slightly

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11
Q

FAT NECROSIS

What is fat necrosis of the breast

A

Benign lump caused by localised degeneration and scarring of fat tissue in breast - triggered by localised trauma / radiotherapy / surgery

Inflammatory reaction in fibrosis and necrosis of fat tissue

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12
Q

FAT NECROSIS

Describe the presentation of fat necrosis

A

Painless
Firm
Irregular
Fixed to local structures
Skin dimpling or nipple inversion

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13
Q

FAT NECROSIS

What investigations are required in fat necrosis

A

Triple assesment
- USS shows similar appreance to cancer
- Histology required

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14
Q

FAT NECROSIS

What is the manageemnt

A

Conservative

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15
Q

LIPOMA

What is a lipoma

A

Benging tumour of adipose tissue

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16
Q

LIPOMA

How does a lipoma present on examination

A

Soft
painless
mobile
no skin changes

17
Q

GALACTOCELE

What is a galactocele

A

breast milk filled cyst that occur when lactiferous duct is blocked preventing drainage of milk

18
Q

GALACTOCELE

How does a galactocele present one examination

A

Firm
Mobile
Painless lump - beneath areola

19
Q

Describe a triple assesment

A

Examination

USS or mammogram

Fine needle aspiration (cytology) or core biopsy (histology)
Fine needle aspiration for benign, core biopsy for malignant

20
Q

What is the NICE referral criteria for breast lumps

A

> 30 with unexplained breast lump

> 50y/o with nipple changes

Unexplained lump in axilla

Skin changes suggestive of breast cancer

21
Q

DUCTAL PAPILLOMA

Describe a ductal papilloma

A

Benign tissue of breast ductal tissue

Common in women aged 40-50

22
Q

DUCTAL PAPILLOMA

How does a duct papilloma present

A

Clear / bloody discharge
Small areolar lump

23
Q

DUCTAL PAPILLOMA

How is it managed?

A

Triple assessment and complete excision

24
Q

DUCT ECTASIA

Describe ductal ectasia

A

Dilatation of lactiferous ducts

common in peri/post-menopausal women

25
Q

DUCT ECTASIA

What increases the risk of ductal ectasia and ehat is seen on mammograhy

A

smoking

microcalcification

26
Q

DUCT ECTASIA

How does it present

A

Tender lump - periareolar

nipple inversion

nipple discharge - blood stained / green or brown

Bilateral

27
Q

DUCT ECTASIA

What is the investigation

A

Tripple assesment

28
Q

BREAST CANCER

Name 5 risk factors

A

FHx
personal hx
increased oestrogen - early menarche and late menopause
obesity
smoking
more dense breast tissue
COCP
HRT

29
Q

BREAST CANCER

Describe the appearance of Paget’s disease of the nipple

A

eczeme of nipple
erythematous
crusty rash
itching
burning sensation
bloody nipple discharge
non healing ulcer
breast lump

30
Q

BREAST CANCER

what is the time frame for screening

A

Every 3 years for women aged 50 - 70

31
Q

BREAST CANCER

name 4 negatives to cancer screening

A

Anxiety and stress
Exposure to radiation, with a very small risk of causing breast cancer
Missing cancer, leading to false reassurance
Unnecessary further tests or treatment where findings would not have otherwise caused harm

32
Q

BREAST CANCER

Outline the specific referral crietria for higher risk patients

A

A first-degree relative with breast cancer under 40 years
A first-degree male relative with breast cancer
A first-degree relative with bilateral breast cancer, first diagnosed under 50 years
Two first-degree relatives with breast cancer

33
Q

BREAST CANCER

How does breast cancer present

A

irregular lump
painless
fixed in place
tethered to skin wall
skin dimpling / peau d’orange
lymphaednopathy

34
Q

BREAST CANCER

Outline the 2 week wait referral criteria

A

An unexplained breast lump in patients aged 30

Unilateral nipple changes in patients aged 50 or above (discharge, retraction or other changes)

An unexplained lump in the axilla in patients aged 30 or above

Skin changes suggestive of breast cancer

35
Q

BREAST CANCER

When are USS and mammograms used in triple assessment

A

USS - Women under 30
- distinguish solid lumps (e.g., fibroadenoma or cancer) from cystic (fluid-filled) lumps

Mammograms - older women
- better at identifying califications

36
Q

management of lymphoedema

A

massage techniques
compression bandaging
weight loss
good skin care

37
Q

outline tamoxifen

A

SERM

Blocke oestrogen receptors in breast tissue

Stimulates receptors in bones and endometrium

38
Q

Ouline letrozole

A

converts androgens to oestrogens

39
Q

Outline herceptin

A

Trastuzamab - MAB against human epidermal growth factor 2

Finals revision (17 decks)

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