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Benign Breast Conditions Flashcards

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1
Q

name 3 benign breast conditions

A

benign breast tumours
inflammatory breast disease
gynaecomastia

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2
Q

what is the most common type of benign breast tumour?

A

fibroadenoma

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3
Q

what are fibroadenomas?

A

proliferations of stromal and epithelial tissue of the duct lobules

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4
Q

in what age group do fibroadenomas usually occur?

A

women of reproductive age

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5
Q

what are the clinical features of fibroadenomas?

A
  • highly mobile lesions
  • well-defined
  • rubbery
  • most are less than 5 cm in diameter
  • they can be multiple and bilateral
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6
Q

what is the management of fibroadenomas?

A

left in-situ with routine follow-ups (very low malignant potential)
- potential decision if >3cm in diameter of patient preference

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7
Q

what are breast adenomas?

A

benign glandular tumours

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8
Q

in which age group do breast adenomas typically occur?

A

older females

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9
Q

what are the clinical features of breast adenoma?

A

nodular - can easily mimic malignancy

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10
Q

what is a rest papilloma?

A

benign, warty lesion that occurs in the subareolar region

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11
Q

what are the clinical features of a breast papilloma?

A
  • small mass behind the areola

- bloody or clear nipple discharge

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12
Q

what is the management of breast papilloma?

A
  • triple assessment in a breast clinic - examination, imaging and biopsy
  • some are excised to ensure there are no atypical cells present
  • multi-ductal papillomas are treated with micodochectomy (excision of lactiferous duct)
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13
Q

what is a breast lipoma?

A

benign adipose tumour

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14
Q

what are the clinical features of a breast lipoma?

A

soft and mobile

otherwise asymptomatic

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15
Q

how are breast lipomas managed?

A

only removed if significantly enlarging or causing symptomatic compressive or aesthetic issues

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16
Q

what are phyllodes tumours?

A

rare fibroepithelial tumours

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17
Q

what are the clinical features of phyllodes tumours?

A
  • large tumours
  • rapidly-growing
    usually affect older women (40s)
  • difficult to differentiate from fibroadenomas
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18
Q

what is the management of phyllodes tumours?

A
  • wide excision of the tumour (1/3rd will become malignant)
  • mastectomy if tumours are large
  • follow-up
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19
Q

what are the general investigations for breast lumps?

A

examination
imaging (US <40, mammogram >40)
biopsy (histology)

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20
Q

what is the general management for confirmed benign breast lumps?

A
  • usually, reassurance and routine check up appointments

- if can’t babe confirmed to be benign or has malignant potential or id causing discomfort, excision

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21
Q

what is atypical hyperplasia?

A

benign hyperplasia that can occur in the ducts or the lobes

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22
Q

what is the worry with atypical hyperplasia?

A

increased risk of malignancy

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23
Q

what is the management of atypical hyperplasia?

A

observation and follow-up

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24
Q

what is mastitis?

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A

inflammation of the breast tissue

25
what are the causes of mastitis?
usually infection - S.aureus | or glanulomatosis )less common)
26
what are the types of mastitis?
lactational and non-lactational
27
how common is lactational mastitis?
very | seen in up to 1/3rd of breastfeeding mothers
28
when is lactational mastitis usually seen?
within first 3 months of breastfeeding or during weaning
29
what is the pathophysiology of lactational mastitis?
milk stasis in lactiferous ducts | cracked nipples, allowing infection in
30
what predisposes to non-lactational mastitis?
other breast conditions such as duct ectasia and peri-ductal mastitis tobacco is a significant risk factor (damages sub-areolar duct walls)
31
what is duct ectasia?
dilatation and shortening of lactiferous ducts
32
what is peri-ductal mastitis?
inflammation and infection of lactiferous ducts
33
what are the clinical features of mastitis?
- tenderness - swelling or induration (raised, hardened area) - erythema
34
what is the management for mastitis?
- systemic antibiotics - simple analgesics - continued milk drainage or breastfeeding - can cease breastfeeding with dopamine agonists if persistent or multi-focal infection
35
what is a breast abscess?
collection of pus within the breast tissue, lined with granulation tissue
36
when does a breast abscess usually occur?
following on from acute mastitis
37
what is the clinical presentation of a breast abscess?
- erythematous, tender fluctuant mass - potentially has a punctum - fever - lethargy
38
which investigation can be performed to diagnosis breast abscess?
ultrasound, if there is doubt about the diagnosis
39
what is the management of breast abscess?
- empirical antibiotics - US-guided needle therapeutic aspiration - more advanced abscesses may need incision and drainage under local anaesthetic
40
what is a mammary duct fistula?
communication between skin and subareolar breast duct
41
what can cause a mammary duct fistula?
drainage of a non-lactational abscess
42
what are breast cysts?
epithelial lined fluid-filled cavities
43
what causes breast cysts to form?
lobules become distended due to blockage
44
which age group is usually affected by breast cysts?
peri-menopausal age group
45
what are the clinical features of breast cysts?
- can bee single or multiple, affecting one or both breasts - distinct smooth masses - may be tender
46
what are the investigations done when suspecting a breast cyst?
mammography - halo shape ultrasound - definitive diagnosis aspirate cystic fluid and send for cytology. absence of blood in aspirate of if cyst disappears excludes cancer.
47
what is the management for breast cysts?
- no further management needed once diagnosed - self-resolve - larger cysts can be aspirated
48
what are the possible complications of breast cysts?
- 2% of women with cysts also have carcinoma at presentation - 2-3x increased risk of breast cancer in the future - can cause formation of fibroadenoids which are benign but cause tenderness and asymmetry
49
what is mammary duct ectasia?
dilatation and shortening of major lactiferous ducts
50
which population is most commonly affected by mammary duct ectasia?
peri-menopausal women
51
what are the clinical features of mammary duct ectasia?
- coloured green/yellow nipple discharge - palpable mass - nipple retraction
52
how should blood-stained nipple discharge be examined?
by triple assessment
53
what investigations are done when suspecting mammary duct ectasia?
mammogram - shows dilated calcified ducts without other features of malignancy
54
what is the management of mammary duct ectasia
- managed conservatively unless cannot definitely exclude malignancy - unremitting nipple discharge can be treated with duct excision
55
what is fat necrosis in the breast?
acute inflammatory response in the breast that leads to ischaemic necrosis of fat lobules
56
what are the causes of breast fat necrosis?
- blunt force trauma to the breast | - previous surgical or radiological intervention
57
what are the clinical features of breast fat necrosis?
usually asymptomatic or presents as a lump (solid and irregular) rarely, fluid discharge, skin dimpling, pain, nipple inversion
58
what investigations are done when suspecting breast fat necrosis?
- ultrasound - mammogram -> necrosis can mimic malignancy - biopsy - to rule out malignancy
59
what is the management of breast fat necrosis?
- usually self-limiting | - analgesia and reassurance

Y3 Breast (2 decks)

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