Benign Breast Disorders

Question 1

What is an infection of the breast

Answer 1

Mastitis

Question 2

What is the most common organism causing mastitis

Answer 2

S. aureus

Question 3

What is the main risk factor of developing mastitis

Answer 3

Breast feeding

Question 4

What are some symptoms of mastitis

Answer 4

Fever, tenderness, erythema, induration, unilateral, warmth

Question 5

What is the treatment for mastitis

Answer 5

Dicloxacillin 500mg

Question 6

Can a patient who has mastitis still breastfeed

Answer 6

Yes

Question 7

What is a complication of mastitis and what is the treatment

Answer 7

Breast abscess you will need to I&D

Question 8

What are the worrisome signs with nipple discharge

Answer 8

Serous, bloody
Spontaneously comes out
Unilateral 
Secretes from one duct
Mass present

Question 9

What is a common cause of bloody nipple discharge

Answer 9

Intraductal papilloma, invasive papillary carcinoma

Question 10

What is a common cause of galactorrhea

Answer 10

Pregnancy, pituitary adenoma, thyroid disease, meds, stress

Question 11

What is a common cause of serous nipple discharge

Answer 11

Normal menses, OCP, early pregnancy, fibrocystic changes

Question 12

What is a common cause of yellow tinged nipple discharge

Answer 12

Fibrocystic changes, galatocele

Question 13

What is a common cause of green and sticky nipple discharge

Answer 13

Duct ectasia

Question 14

What is a common cause of purulent nipple discharge

Answer 14

Breast abscess

Question 15

Name the dx.
A patient comes to you with milky nipple discharge from both breast. On exam there are no masses noted. Patient stated that she is not breastfeeding

Answer 15

Galactorrhea

Question 16

What is galactorrhea due to

Answer 16

High levels of prolactin (Hyperprolacinemia)

Question 17

What do you want to do to work up a patient with bilateral milky discharge in a non-lactating women

Answer 17

This is galactorrhea want to get the following;
TSH, prolactin level, and review meds
Consider MRI

Question 18

Is breast pain a common symptom of breast cancer

Answer 18

No

Question 19

How do you normally treat breast pain

Answer 19

Tylenol or NSAIDS

Question 20

What are some sx of a worrisome breast mass

Answer 20

Dominant mass, dense/firm, irregular, immobile, LN>1cm, firm, matted, more than one, bloody discharge

Question 21

What can an US tell you on a breast mass

Answer 21

Helps distinguish if its solid or cystic

Question 22

What type of masses and mammograms evaluate

Answer 22

Solid

Question 23

What hormone is known to commonly cause fibrocystic changes

Answer 23

Estrogen

Question 24

What type of sx does someone with fibrocystic changes of their breast have

Answer 24

Breast pain/tenderness that is cyclic
Focal or multiple areas
Worse in perimenstrual phase
May have serous nipple discharge

Question 25

What do you want to do to dx a fibrocystic changes in the breast

Answer 25

US or mammogram

Question 26

Why cant you use mammograms in a younger women

Answer 26

Not as acccuarate because younger women have more Dense breast tissue

Question 27

What is the treatment for fibrocystic changes of the breast

Answer 27

Wear a supportive bra | NSAIDS/Tylenol

Question 28

What is the most common benign breast tumor in young women

Answer 28

Fibroadenoma

Question 29

When can a fibroadenoma increase in size

Answer 29

During pregnancy or estrogen use

Question 30

How does a typical fibroadenoma feel

Answer 30

Round, well-circumsized, mobile, rubbery mass, non-tender

Question 31

How do you treat a fibroadenoma

Answer 31

After benign imaging can follow-up in 3-6 months with repeat US

Question 32

What is an uncommon fibroepitheal breast tumor

Answer 32

Phyllodes tumor

Question 33

What does a phyllodes tumor look like

Answer 33

Large mass (4-7cm) bulky, overlaying skin warm and red, grow rapidly

Question 34

What do you need to do for a phyllodes tumor

Answer 34

core needle biopsy bc of risk of malignancy

Question 35

What is the treatment of a phyllodes tumor

Answer 35

Wide local excision with 1cm margins

Question 36

What is the most common cause of bloody discharge

Answer 36

Intraductal papilloma

Question 37

What is a benign solitary lesion involving epithelial lining of lactiferous ducts

Answer 37

Intraductal papilloma

Question 38

What is the treatment of a intraductal papilloma

Answer 38

Diagnosis and treatment is excision of involved ducts

Question 39

In what age do intraductal papilloma occur in

Answer 39

Post menapausal women

Question 40

What is acute/chronic inflammation of the ductal system that causes dilation of mammary ducts

Answer 40

Mammary duct ectasia

Question 41

Name the dx. A 50 y/o women presents to you with a green sticky nipple discharge that is bilateral. She is having some tenderness and redness surrounding her nipples

Answer 41

Mammary duct ectasia

Question 42

How do you diagnose mammary duct ectasia

Answer 42

Mammo and excisional biopsy to rule out malignancy

Question 43

What is the treatment for mammary duct ectasia

Answer 43

Local excision of the inflamed area and sometimes needs duct excision

Question 44

What is a milk filled cyst from a plugged milk duct, during pregnancy, breastfeeding, or weaning

Answer 44

Galactocele

Question 45

Name the dx. A breastfeeding patient comes to you with a round mobile mass in her left breast. She has noticed a whitish, yellow discharge from that breast. There is no pain associated with her sx

Answer 45

Galactocele

Question 46

How do you diagnose a galactocele

Answer 46

US-helps to differenciate from other causes | aspiration of fluid-confirms the dx

Question 47

How do you treat a galactocele

Answer 47

Repeated aspiration or excision if bothersome

Question 48

Can you continue breastfeeding during treatment of a galactocele

Answer 48

Yes