benign breast conditions Flashcards

1
Q

what is fibrocystic change

A

the stroma ducts and lobules of the breast respond to oestrogen and progesterone and become fibrous and cystic

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2
Q

why do the symptoms of fibrocystic change fluctuate

A

because the changes are in response to oestrogen and progesterone which fluctuate with the menstrual cycle

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3
Q

how does fibrocystic change present

A

lumpiness
mastalgia
fluctuation of breast size

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4
Q

how do you manage fibrocystic change

A
wear supportive bra 
NSAIDs
avoid caffiene 
apply heat 
danazol (GnRH inhibitor)
tamoxifen (anti-oestrogen)
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5
Q

what is a fibroadenoma

A

benign tumour of stromal/epithelial cells of breast

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6
Q

what age group are fibroadenomas common in

A

adolescents

young adults

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7
Q

why do fibroadenomas regress in menopause

A

they respond to oestrogen and progesterone which decline in menopause

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8
Q

how does fibroadenoma present

A
small mobile lump 
painless 
well circumscribed 
firm 
up to 3cm
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9
Q

what is an intraduct papilloma

A

benign tumour of milk duct

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10
Q

how does an intraduct papilloma present

A

lump
discharge
pain

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11
Q

what age group is usually effected by intraduct papillomas

A

middle aged

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12
Q

what investigations could you do in intraduct papilloma

A

FNA - epithelial hyperplasia

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13
Q

how do you manage intraduct papilloma

A

excision

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14
Q

what is fat necrosis of the breast

A

localised degeneration and scarring of fat tissue creates a benign lump
can be associated with an oil cyst
can cause fibrosis and necrosis

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15
Q

what causes fat necrosis

A

triggered by trauma

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16
Q

how does fat necrosis present

A

painless, firm, irregular lump
fixed
skin dimpling
nipple retraction

17
Q

what investigations could you do in fat necrosis

A

FNA - foamy cytoplasm

18
Q

how do you manage fat necrosis

A

conservative management

surgical removal if needed

19
Q

what is duct ectasia

A

dilation of large ducts in breasts
inflammation leads to discharge
and spooning leads to forking

20
Q

what are symptoms of duct ectasia

A
discharge 
tenderness 
pain 
nipple retraction 
lump
21
Q

how could you manage duct ectasia

A
exclude breast cancer 
reassure 
supportive bra 
warm compress 
antibiotics if needed 
surgical excision if needed
22
Q

what is phyllodes tumour

A

tumour of stroma cells in breast

large and fast growing

23
Q

what age group is phyllodes tumour common in

24
Q

what are complications of phyllodes tumour

A

can metastasise - this requires chemo +/- surgical removal

25
what are symptoms of phyllodes tumour
firm painless fast growing lump
26
what is gynaecomastia
enlargement of glandular breast tissue in males
27
what causes gynaecomastia
imbalance between oestrogen and androgens
28
what are conditions that cause gynaecomastia by increasing oestrogen levels
``` obesity (oestrogen stored in fat cells) testicular cancer - leydig cell tumours liver cirrhosis/failure hyperthyroidism hCG secreting tumour ```
29
what are conditions that cause gynaecomastia by decreasing testosterone
``` testosterone deficiency in old age hypothalamus or pituitary conditions that decrease FSH and LH klinefelter syndrome orchitis testicular damage ```
30
what are drugs that cause gynaecomastia
``` dopamine agonists anabolic steroids digoxin spironolactone GnRH analogues opiates marijuana alcohol ```
31
how do you differentiate between gynaecomastia and fat on examination
gynaecomastia has firm tissue behind the areolas | fat is softer
32
how do you manage gynaecomastia
bloods and imaging to find and treat underlying cause tamoxifen and surgery in problematic cases