Benign Breast Cancer

Question 1

What are the four most common type of benign breast disease?

Answer 1

1. Fibroadenoma
2. Cysts
3. Fibrocystic disease
4. Duct ectasia

Question 2

Fibroadenoma:

Describe, presentation, diagnosis & management

Answer 2

Benign overgrowth of one lobule of the breast.
composed of both fibrous and glandular tissue
commonest at age 30. occurs any age up to menopause

presentation: discrete, firm, non tender and highly mobile nodule within breast. some present with multiple fibroadenomas (breast mouse)

Diagnosis: USS usually conclusive, maybe FNA

Management: observation - <5% increase in size, ~25% get smaller/disappear. Or Excised.

Question 3

Cysts:

describe, Presentation, Diagnosis, Management

Answer 3

Almost always benign. Full with green-yellow fluid. often associated with fibrocystic disease.

Presentation: common in peri-menopausal women
Round, symmetrical lump(s). may be discrete, multiple, can be painful

Diagnosis: aspiration - if non-bloody and lump disappears, diagnosis confirmed. If there’s residual mass/recurrent cyst, mammography to exclude associated tumour.

Management: if not blood stained, reassure pt.
if blood stained, send fluid to cytology/assess lump with mammography & FNA cytology.

Question 4

Fibrocystic Disease:

Describe, Presentation, diagnosis, Management

Answer 4

most common cause of breast lump in females of reproductive age (35-50). Characterised by overgrowth of ducts and lobules.

Presentation:

• cyclical pain and swelling (peak during menstruation)
• lumpy breasts, mobile lumps
• multiple breast cysts

Diagnosis:
- tripple assessment - fibrocystic disease can progress to carcinoma

Management:
Exclude carcinoma.
Localised pain, relieved by excision.
Diffuse pain, hormone manipulation (bromocriptine - dopamine recept. stimulant to decrease prolatin)

Question 5

Duct Ectasia (mammary)
Describe, Presentation, Diagnosis, Management

Answer 5

Refers ti dilation, scarring and chronic inflammation of mammary ducts. associated with smoking

Presentation:
Commonly in menopause or older.
Lump - hard doughy tender lump beneath or close to areola
Nipple discharge - cheesy, may be green and blood stained

diagnosis:
mammography - dilated ducts

Management:
metronidazole and drainage of acute abscess
Surgery rarely needed.