Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Y3 Oxford Cases > Breast Lump > Flashcards

Breast Lump Flashcards

1
Q

What are the four most common diagnoses for a breast lump

A

Benign cystic change/fibroadenosis
Fibroadenoma
Cyst
Carcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the most common diagnoses of a breast lump in patients <30

A 
Physiologically normal, lumpy
Benign cystic change
Fibroadenoma
Abscess (if breastfeeding)
Galactocele (If breastfeeding)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the most common diagnoses of a breast lump in patients 30-45

A

Benign cystic change
Abscess (esp. smokers)
Carcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the most common diagnoses of a breast lump in patients 45-60

A

Cyst
Abscess (esp. smokers)
Carcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the most common diagnoses of a breast lump in patients >60

A

Carcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are galactoceles and how do they present

A

Caused by obstruction of a lactiferous duct -> become sdistended with milk + epithelial cells
Present as a firm mass (often subareolar) during or shortly after cessation of breastfeeding. Very similar to a cyst on exam.
May become infected -> abscess formation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the common causes of mastitis

A

Skin commensals e.g. S. aureus or staph. epidermis in lactating women
Anaerobic in older women (periductal)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the important risk factors for breast cancer

A 
Being female and increasing age
Previous breast cancer
Family history of breast cancer
Previous ovarian, endometrial or bowel cancer
Irradiation to the chest wall
Increased exposure to oestrogens
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What may cause increased exposure to oestrogens

A 
Early menopause (<13) or Late (>51)
Nulliparity 
Having a first child after 30
Not breast-feeding
HRT
COCP use
Obesity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What questions should be asked about a breast lump

A 
How long has the lump been there, when was it noticed
Breast trauma?
Changes in size, any relating to menses
Painful lump
Any skin changes
Any discharge or nipple changes
Risk factors and general health
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What can the length of time a lump has been there tell you

A

Very quick - abscess or cyst

Longer period - fibroadenoma or carcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the association between breast trauma and any lumps

A

Trauma, accidental or iatrogenic, can predispose to fat necrosis and infective sequelae e.g. abscess

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What does the changes in size to a breast lump tell you

A

Abscesses and cysts can change size very rapidly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What can pain tell you about a breast lump

A

Benign cystic change, acute mastitis and abscesses classically cause pain and tenderness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What do skin changes on the breast tell you

A

Warm erythematous skin - mastitis or abscess or inflamed carcinoma

Peau d’orange (puckering) suggests carcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What do changes to the nipples ± discharge (blood, milk, coloured, serous) tell you

A

Recent nipple change - carcinoma

Blood - carcinoma
Milk - galactocele
green/brown/yellow - periductal mastitis from duct ectasia
Serous/seroanguinous - intraductal papilloma

17
Q

What does back pain with a breast lump suggest

A

Sign of metastases to the spine

18
Q

What should be looked for on breast exam

A 
Asymmetry 
Contours
Skin changes (erythema, ulceration, dimpling, radiotherapy tattoo)
Nipple changes or discharge
19
Q

What would a solitary cyst feel like on palpation

A

Smooth, distinct borders, firm-lax, not mobile or fixed

No lymphadenopathy

20
Q

What would a fibroadenoma feel like on palpation

A

Smooth, distinct borders, rubbery, mobile, not fixed

No lymphadenopathy

21
Q

What would a benign cystic change feel like on palpation

A

Irregular, indistinct borders, mixed consistency, NOT mobile or fixed
No lymphadenopathy

22
Q

What would a carcinoma feel like on palpation

A

Irregular, indistinct borders, hard consistency, NOT mobile, may be fixed and may have lymphadenopathy

23
Q

What is a fibroadenoma

A

Aberrations of normal breast development that contains stromal and epithelial elements
7-30% of young women will have one at some stage

24
Q

How are all solid lumps investigated in a breast clinic

A

Clinical examination
Radiological examination (USS <35yrs, mammography otherwise)
Fine needle aspiration or core biopsy

25
Q

What are the treatment options for a fibroadenoma

A

Either leave it to resolve or excision biopsy

26
Q

Where do breast carcinomas often metastasise to and which are investigated

A

Lungs
Liver
Bone
Brain

Liver and bone is always investigated, lung and brain only if they are clinically suspected

27
Q 
How are the following investigated for metastases from the breast:
Lungs
Liver
Bone 
Brain
A

Liver: CT/MRI abdomen
Bone: axial skeleton bone scintigraphy or CT/MRI AND imaging of long bones via scintigraphy or radiograph. Blood tests (Ca2+, ALP, phos)
Lungs: CT
Brain: CT

28
Q

In general, what treatments are available for a breast carcinoma

A

Surgery or radiotherapy

Chemo, hormonal therapy, monoclonal Abs e.g. herceptin

29
Q

What is the management for a breast abscess

A

Antibiotics
Refer to surgeons for drainage
Smoking cessation

30
Q

What are some causes of gynaecomastia

A

Liver disease
Drugs e.g. cimetidine, spironolactone, phenothiazines, finasteride, steroids
Primary/acquired/secondary testicular failure
Endocrine tumours e.g. pit, testicular, adrenal
Non-endocrine tumour e.g. bronchial

31
Q

What are the advantages and disadvantages of fine needle aspiration

A

Quick, minimally invasive
Low risk of bruising or local complications
Adequate to assess hormone receptor status

May have poor sensitivity. In situ and invasive disease cannot be differentiated

32
Q

What are the advantages and disadvantages of core biopsy

A

In situ and invasive disease can be differentiated

Higher risk of local complications and bruising
Results are not immediate
Requires more local anaesthesia, more invasive and time-consuming

33
Q

What methods exist for axillary staging of breast cancer

A 
Axillary clearance (remove local lymph nodes)
Axillary sampling (minimal dissection of the axilla, at least 4 nodes removed)
Sentinel lymph node biopsy (injeciton of blue dye and/or radio-isotope into the periareolar tissue)

Y3 Oxford Cases (29 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions