8. Benign tumours of the female breast

Question 1

Benign tumours of the female breast

Answer 1

• Duct papilloma

* Fibroadenoma

Question 2

Duct papilloma In Benign tumours of the female breast

Answer 2

• Etiology
• Pathology
• Clinical Picture
• Investigations
• Treatment

Question 3

Etiology of Duct papilloma In Benign tumours of the female breast

Answer 3

1. Benign tumour arising from the columnar epithelium of the ducts
2. Excessive localization of epitheliosis of ANDI

Question 4

Pathology of Duct papilloma In Benign tumours of the female breast

Answer 4

• Cell of origin
• Composition
• Ulceration
• Blocking the duct

Question 5

Cell of origin in Pathology of Duct papilloma In Benign tumours of the female breast

Answer 5

arises in one of the main ducts near the nipple in a Young woman

Question 6

Composition in Pathology of Duct papilloma In Benign tumours of the female breast

Answer 6

composed of vascular C.T Core Covered by hyperplastic columnar epithelium

Question 7

Ulceration in Pathology of Duct papilloma In Benign tumours of the female breast

Answer 7

• Before it becomes big enough to form a palpable lump, it usually ulcerates
• Causes bleeding per nipple

Question 8

Blocking the duct in Pathology of Duct papilloma In Benign tumours of the female breast

Answer 8

causes a retention cyst.

Question 9

Clinical Picture of Duct papilloma In Benign tumours of the female breast

Answer 9

1. Bleeding per nipple

2. Retroareolar retention cyst may be felt

Question 10

Pathogenesis of Retroareolar retention cyst in Clinical Picture of Duct papilloma In Benign tumours of the female breast

Answer 10

due to obstruction of the duct

Question 11

Investigations of Duct papilloma In Benign tumours of the female breast

Answer 11

1. Differential pressure
2. Ductography
3. Cytology For the discharge
4. Mammography & complementary breast U/S :

Question 12

Benefits of Differential pressure in Investigations of Duct papilloma In Benign tumours of the female breast

Answer 12

To localize the papilloma

Question 13

Finding of Ductography in Investigations of Duct papilloma In Benign tumours of the female breast

Answer 13

Shows the lesion as a filling defect

Question 14

Benefits of Mammography & complementary breast U/S in Investigations of Duct papilloma In Benign tumours of the female breast

Answer 14

to detect non palpable lump.

Question 15

Treatment of Duct papilloma In Benign tumours of the female breast

Answer 15

Microdochectomy

Question 16

Microdochectomy in Treatment of Duct papilloma In Benign tumours of the female breast

Answer 16

• Excision of the affected duct in duct papilloma

* The duct is identified at operation by passing a blunt tipped needle through the discharging nipple opening

Question 17

Fibroadenoma In Benign tumours of the female breast

Answer 17

• Incidence
• Etiology
• Pathology
• Clinical picture
• Differential Diagnosis
• Investigations
• Treatment

Question 18

Incidence of Fibroadenoma In Benign tumours of the female breast

Answer 18

The commonest benign breast mass of females

Question 19

Etiology of Fibroadenoma In Benign tumours of the female breast

Answer 19

1. Benign tumour arising from both fibrous & glandular elements.
2. Excessive localization of fibrosis & adenosis of ANDI

Question 20

Pathology of Fibroadenoma In Benign tumours of the female breast

Answer 20

There are two types:

1. Pericanalicular fibroadenoma
2. Intracanalicular fibroadenoma

Question 21

Pericanalicular fibroadenoma in Pathology of Fibroadenoma In Benign tumours of the female breast

Answer 21

• Alternative name

* Composition

Question 22

Alternative names for Pericanalicular fibroadenoma in Pathology of Fibroadenoma In Benign tumours of the female breast

Answer 22

Hard fibroadenoma

breast mouse because it’s mobile all over

Question 23

Composition of Pericanalicular fibroadenoma in Pathology of Fibroadenoma In Benign tumours of the female breast

Answer 23

• These tumours are formed mainly of fibrous tissue & Iess glandular element
• They tend to be small.

Question 24

Intracanalicular fibroadenoma in Pathology of Fibroadenoma In Benign tumours of the female breast

Answer 24

• Alternative name

* Composition

Question 25

Alternative name for Intracanalicular fibroadenoma in Pathology of Fibroadenoma In Benign tumours of the female breast

Answer 25

Soft fibroadenoma

Question 26

Composition of Intracanalicular fibroadenoma in Pathology of Fibroadenoma In Benign tumours of the female breast

Answer 26

Contains more glandular element than fibrous tissue . The markedly dilated acini They are usually larger and softer than the pericanalicular type.

Question 27

The markedly dilated acini in Composition of Intracanalicular fibroadenoma in Pathology of Fibroadenoma In Benign tumours of the female breast

Answer 27

showing projections inside The fibrous tissue is loosely arranged around them (hence the false name intracanalicular).

Question 28

Clinical Picture of Fibroadenoma In Benign tumours of the female breast

Answer 28

* Symptoms * Examination * Other clinical variants for soft fibroadenoma

Question 29

Symptoms in Clinical Picture of Fibroadenoma In Benign tumours of the female breast

Answer 29

* Accidentally discovered painless lump * Age of presentation in Hard fibroadenoma * Age of presentation in soft fibroadenoma

Question 30

Age of presentation in Hard fibroadenoma in Clinical Picture of Fibroadenoma In Benign tumours of the female breast

Answer 30

commonly in young women 20-30 years of age

Question 31

Age of presentation in soft fibroadenoma in Clinical Picture of Fibroadenoma In Benign tumours of the female breast

Answer 31

between the ages of 30-50 years.

Question 32

Examination in Clinical Picture of Fibroadenoma In Benign tumours of the female breast

Answer 32

a. Breast : | b. Axillary L.N.:

Question 33

Breast Examination in Clinical Picture of Fibroadenoma In Benign tumours of the female breast

Answer 33

Mass with the following criteria : 1. Size 2. Shape 3. Surface 4. Mobility 5. Edge 6. Consistency

Question 34

Size of the breast Mass in Breast Examination in Clinical Picture of Fibroadenoma In Benign tumours of the female breast

Answer 34

* Small in hard fibroadenoma | * large in soft fibroadenoma.

Question 35

Shape of the breast Mass in Breast Examination in Clinical Picture of Fibroadenoma In Benign tumours of the female breast

Answer 35

Spherical

Question 36

Surface of the breast Mass in Breast Examination in Clinical Picture of Fibroadenoma In Benign tumours of the female breast

Answer 36

Smooth in hard fibroadenoma lobulated in soft fibroadenoma.

Question 37

Mobility of the breast Mass in Breast Examination in Clinical Picture of Fibroadenoma In Benign tumours of the female breast

Answer 37

Mobile all over ( hard fibroadenoma is called breast mouse).

Question 38

Edge of the breast Mass in Breast Examination in Clinical Picture of Fibroadenoma In Benign tumours of the female breast

Answer 38

Well circumscribed.

Question 39

Consistency of the breast Mass in Breast Examination in Clinical Picture of Fibroadenoma In Benign tumours of the female breast

Answer 39

* Firm in pericanalicular ( hard ) fibroadenoma | * soft in intracanalicular ( soft ) fibroadenoma.

Question 40

Axillary L.N Examination in Clinical Picture of Fibroadenoma In Benign tumours of the female breast

Answer 40

Not enlarged

Question 41

Other clinical variants for soft fibroadenoma in Clinical Picture of Fibroadenoma In Benign tumours of the female breast

Answer 41

1. Giant fibroadenoma | 2. Cystosarcoma phylloides "serocystic disease of Brodie".

Question 42

Age of presentation of Giant fibroadenoma in Other clinical variants for soft fibroadenoma in Clinical Picture of Fibroadenoma In Benign tumours of the female breast

Answer 42

Occur during puberty

Question 43

Cystosarcoma phylloides in Other clinical variants for soft fibroadenoma in Clinical Picture of Fibroadenoma In Benign tumours of the female breast

Answer 43

* Alternative name * The reason why it's called so * Pathology * Differential diagnosis

Question 44

Alternative name for Cystosarcoma phylloides in Other clinical variants for soft fibroadenoma in Clinical Picture of Fibroadenoma In Benign tumours of the female breast

Answer 44

serocystic disease of Brodie

Question 45

The reason why it's called Cystosarcoma phylloides "serocystic disease of Brodie" in Other clinical variants for soft fibroadenoma in Clinical Picture of Fibroadenoma In Benign tumours of the female breast

Answer 45

lt was so named by Brodie who used the term phylloides because the cut surface resembles a leaf of fern. the term cystosarcoma is misnomer as many are not cystic and it's not malignant

Question 46

Pathology of Cystosarcoma phylloides in Other clinical variants for soft fibroadenoma in Clinical Picture of Fibroadenoma In Benign tumours of the female breast

Answer 46

* This is highly cellular type of fibroadenoma that grows rapidly * The tumour tends to enlarge and to reach a large size, 20-30 cm in diameter * causing pressure necrosis of the overlying skin without infiltrating it & the tumour fungates from it.

Question 47

Differential diagnosis of Cystosarcoma phylloides in Other clinical variants for soft fibroadenoma in Clinical Picture of Fibroadenoma In Benign tumours of the female breast

Answer 47

Fungating carcinoma

Question 48

to differentiate between cystosarcoma phylloides and fungating carcinoma do :

Answer 48

Probe test positive in cystosarcoma phylloides

Question 49

Differential diagnosis of Soft Fibroadenoma In Benign tumours of the female breast

Answer 49

medullary breast carcinoma

Question 50

Investigations of Fibroadenoma In Benign tumours of the female breast

Answer 50

1. The clinical features are usually enough for diagnosis of hard fibroadenoma. 2. however triple assessment is done in both types.

Question 51

Treatment of Fibroadenoma In Benign tumours of the female breast

Answer 51

Treatment of : Hard fibroadenoma Soft fibroadenoma Giant fibroadenoma cystosarcoma phylloides

Question 52

Treatment of hard fibroadenoma in Treatment of Fibroadenoma In Benign tumours of the female breast

Answer 52

* Excision via a circumareolar incision. | * sent for histopathology

Question 53

Treatment of soft fibroadenoma in Treatment of Fibroadenoma In Benign tumours of the female breast

Answer 53

* Excision | * sent for histopathology

Question 54

treatment of Giant fibroadenoma in Treatment of Fibroadenoma In Benign tumours of the female breast

Answer 54

* Gillard thomas incision | * sent for histopathology.

Question 55

Gillard thomas incision in treatment of Giant fibroadenoma in Treatment of Fibroadenoma In Benign tumours of the female breast

Answer 55

Wide local excision via a submammary incision to treat Giant fibroadenoma

Question 56

Treatment of cystosarcoma phylloides in Treatment of Fibroadenoma In Benign tumours of the female breast

Answer 56

a. If not huge: Wide local excision and sent for histopathology. b. If very huge or fungating: Simple mastectomy.

Question 57

Mondor's disease

Answer 57

It is thrombophlebitis of the superficial veins of the breast and anterior chest wall of unknown cause.