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Y3 Breast > Benign Breast Conditions > Flashcards

Benign Breast Conditions Flashcards

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?

A

inflammation of the breast tissue

25
Q

what are the causes of mastitis?

A

usually infection - S.aureus

or glanulomatosis )less common)

26
Q

what are the types of mastitis?

A

lactational and non-lactational

27
Q

how common is lactational mastitis?

A

very

seen in up to 1/3rd of breastfeeding mothers

28
Q

when is lactational mastitis usually seen?

A

within first 3 months of breastfeeding or during weaning

29
Q

what is the pathophysiology of lactational mastitis?

A

milk stasis in lactiferous ducts

cracked nipples, allowing infection in

30
Q

what predisposes to non-lactational mastitis?

A

other breast conditions such as duct ectasia and peri-ductal mastitis
tobacco is a significant risk factor (damages sub-areolar duct walls)

31
Q

what is duct ectasia?

A

dilatation and shortening of lactiferous ducts

32
Q

what is peri-ductal mastitis?

A

inflammation and infection of lactiferous ducts

33
Q

what are the clinical features of mastitis?

A
  • tenderness
  • swelling or induration (raised, hardened area)
  • erythema
34
Q

what is the management for mastitis?

A
  • systemic antibiotics
  • simple analgesics
  • continued milk drainage or breastfeeding
  • can cease breastfeeding with dopamine agonists if persistent or multi-focal infection
35
Q

what is a breast abscess?

A

collection of pus within the breast tissue, lined with granulation tissue

36
Q

when does a breast abscess usually occur?

A

following on from acute mastitis

37
Q

what is the clinical presentation of a breast abscess?

A
  • erythematous, tender fluctuant mass
  • potentially has a punctum
  • fever
  • lethargy
38
Q

which investigation can be performed to diagnosis breast abscess?

A

ultrasound, if there is doubt about the diagnosis

39
Q

what is the management of breast abscess?

A
  • empirical antibiotics
  • US-guided needle therapeutic aspiration
  • more advanced abscesses may need incision and drainage under local anaesthetic
40
Q

what is a mammary duct fistula?

A

communication between skin and subareolar breast duct

41
Q

what can cause a mammary duct fistula?

A

drainage of a non-lactational abscess

42
Q

what are breast cysts?

A

epithelial lined fluid-filled cavities

43
Q

what causes breast cysts to form?

A

lobules become distended due to blockage

44
Q

which age group is usually affected by breast cysts?

A

peri-menopausal age group

45
Q

what are the clinical features of breast cysts?

A
  • can bee single or multiple, affecting one or both breasts
  • distinct smooth masses
  • may be tender
46
Q

what are the investigations done when suspecting a breast cyst?

A

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
Q

what is the management for breast cysts?

A
  • no further management needed once diagnosed
  • self-resolve
  • larger cysts can be aspirated
48
Q

what are the possible complications of breast cysts?

A
  • 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
Q

what is mammary duct ectasia?

A

dilatation and shortening of major lactiferous ducts

50
Q

which population is most commonly affected by mammary duct ectasia?

A

peri-menopausal women

51
Q

what are the clinical features of mammary duct ectasia?

A
  • coloured green/yellow nipple discharge
  • palpable mass
  • nipple retraction
52
Q

how should blood-stained nipple discharge be examined?

A

by triple assessment

53
Q

what investigations are done when suspecting mammary duct ectasia?

A

mammogram - shows dilated calcified ducts without other features of malignancy

54
Q

what is the management of mammary duct ectasia

A
  • managed conservatively unless cannot definitely exclude malignancy
  • unremitting nipple discharge can be treated with duct excision
55
Q

what is fat necrosis in the breast?

A

acute inflammatory response in the breast that leads to ischaemic necrosis of fat lobules

56
Q

what are the causes of breast fat necrosis?

A
  • blunt force trauma to the breast

- previous surgical or radiological intervention

57
Q

what are the clinical features of breast fat necrosis?

A

usually asymptomatic
or presents as a lump (solid and irregular)
rarely, fluid discharge, skin dimpling, pain, nipple inversion

58
Q

what investigations are done when suspecting breast fat necrosis?

A
  • ultrasound
  • mammogram -> necrosis can mimic malignancy
  • biopsy - to rule out malignancy
59
Q

what is the management of breast fat necrosis?

A
  • usually self-limiting

- analgesia and reassurance

Y3 Breast (2 decks)

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