Mastalgia

Question 1

__________usually presents as a heaviness or
discomfort in the breast or as a pricking or stabbing
sensation.

Answer 1

Mastalgia

Question 2

• The typical age span for mastalgia is _______

Answer 2

30–50 years.

Question 3

There are four common clinical presentations of mastalgi

Answer 3

1 diffuse, bilateral cyclical mastalgia
2 diffuse, bilateral non-cyclical mastalgia
3 unilateral diffuse non-cyclical mastalgia
4 localised breast pain

Question 4

The commonest type of mastalgia is_________

Answer 4

cyclical mastalgia.

Question 5

Less than _______ of breast cancers present with

localised pain.

Answer 5

10%

Question 6

Mastalgia

The problems, especially types _____ and _____are
difficult to alleviate.

Answer 6

2 and 3,

Question 7

Cyclical mastalgia is the commonest diffuse breast

pain. It occurs in the _______

Answer 7

latter half of the menstrual cycle, especially in the premenstrual days, and subsides with the onset of menstruation

Question 8

Cause of mastalgia

It obviously has a hormonal basis, which may be an abnormality in _________

Answer 8

prolactin secretion.

Question 9

Non-cyclical mastalgia, which is pain that does
not vary within the menstrual cycle, is also quite
common and the cause is________

Answer 9

poorly understood

Question 10

___________ which is a rare florid form of breast cancer found in young women, often during lactation, is red and hot but not invariably painful or tender

Answer 10

‘Mastitis carcinomatosa’,

Question 11

Mastitis is common among nursing mothers. It
should be regarded as a serious and urgent problem
because a ________ can develop quickly

Answer 11

breast abscess

Question 12

Drugs that can cause breast
discomfort include 
1
2
3

Answer 12

oral contraceptives, HRT and

methylxanthine derivatives such as theophylline

Question 13

Drugs that cause tender gynaecomastia (more
applicable to men) include 
1
2
3
4

Answer 13

digoxin, cimetidine,

spironolactone and marijuana

Question 14

When is UTZ not useful?

Answer 14

It is not so useful for the postmenopausal
breast, which is fatty and looks similar to cancer on
ultrasound.

Question 15

_______ can be useful for an area of
localised pain, especially in the presence of a possible
mass.

Answer 15

FNA e xcision biopsy

Question 16

Breast pain is uncommon in children, including

puberty, but it may be a presenting problem in the _______

Answer 16

late

teens

Question 17

Breast pain is rare after the menopause but is

increasing with increased use of ________, where it tends to present as the diffuse bilateral type

Answer 17

HRT

Question 18

If the problem is
related to the introduction of HRT, the _____ dose
should be reduced or an alternative preparation used.

Answer 18

oestrogen

Question 19

Cyclical mastalgia

• the typical age is 30–40 years (mean 35)
• discomfort and sometimes pain are present
• usually bilateral but one breast can dominate
(usually _______

Answer 19

upper outer quadrant)

Question 20

T or F

Cyclical mastalgia is rare after the menopause.

Answer 20

T

Question 21

effectiveness of _____, _______ and _______ and showed that all provided significant
relief, but that all have the potential for severe
adverse effects.

Answer 21

danazol, bromocriptine and tamoxifen

Question 22

The cause is often obscure, but the
costochondral junction may become strained in
patients with a persistent cough. The pain can appear
to be in the breast with intermittent radiation round
the chest wall and is initiated or aggravated by deep
breathing and coughing

Answer 22

Costochondritis (Tietze syndrome)

Question 23

________is basically cellulitis of the interlobular

connective tissue of the breast

Answer 23

Mastitis

Question 24

Infecting organisms in Mastitis

Answer 24

Staphylococcus aureus, or more rarely, Escherichia coli and Candida albicans.

Question 25

___________infection usually causes severe
breast pain—a feeling like a hot knife or hot shooting
pains, especially during and after feeding. It may
occur after a course of antibiotics.

Answer 25

Candida

Question 26

How to treat bacterial mastitis

Answer 26

resolution without progression to an
abscess will usually be prevented by antibiotics
di/(flu)cloxacillin 500 mg (o) 6 hourly for 10 days
or (if hypersensitive to penicillin) cephalexin
500 mg (o) 6 hourly for 10 days

Question 27

How to Tx candidia mastitis

Answer 27

fluconazole 200–400 mg (o) daily for 2–4 weeks

second line—nystatin 500 000 U (o) tds

Question 28

If tenderness and redness persist beyond ______
and an area of tense induration develops, then a
breast abscess has formed

Answer 28

48 hours

Question 29

Breast abscess

Surgical drainage
may be required but should be avoided if possible
because _______

Answer 29

fistula formation is common.

Question 30

The basis of management for benign mastalgia is

_______

Answer 30

firm reassurance