benign breast lumps

Question 1

silicone breast implant banned in 2010 is…

Answer 1

PIP = poly impact prostheses

Question 2

signs of rupture

Answer 2

• change in shape of breast
• redness
• burning sensation
• axillary lymphadenopathy
• swelling in and around breast

Question 3

Concern of PIP implants?

Answer 3

much more likely to rupture than other breast implants

as were manufactured using industrial grade silicone rather than medical grade silicone

Question 4

investigation of potential ruptured implant?

Answer 4

Ultrasound scan + MRI

Question 5

normal appearance of breast implant on USS

Answer 5

black/anechoic appearance

Question 6

abnormal appearance on USS; ruptured implant

Answer 6

multiple abnormal linear areas within implant; silicone leaked out of implant shell but held in place by the bodys fibrous capsule

Question 7

when requesting an MRI; what needs to be asked about

Answer 7

• pregnancy
• claustrophobia
• metallic implants
• pacemakers

Question 8

NHS role in managing PIP implants

Answer 8

due to risk of rupture; will remove them however will not pay to replace them (except in wales)

Question 9

• mobile, firm breast lump
• 12% all breast masses
• develop from a whole lobule
• over a 2 year period up to 30% will get smaller

Answer 9

Fibroadenoma

Question 10

• smooth discrete lump (may be fluctuant)

- small increased risk of breast cancer (if younger)

Answer 10

Breast cyst

Question 11

lump that may increase in size initially and up to 40% cases usually having a traumatic aetiology

Answer 11

Fat necrosis

Question 12

lump, usually present with nipple discharge, originating from a single duct, no increased risk of malignancy

Answer 12

duct papilloma

Question 13

symptoms of FIBROADENOMA

Answer 13

• grape sized lump
• mobile
• non tender
• no overlying skin tethering
• normal axillae

Question 14

USS findings in fibroadenoma

Answer 14

solid mass
ovoid shape
well defined margin

Question 15

investigations when suspecting fibroadenoma

Answer 15

Tripple assessment

• clinical examination
• ultrasound imaging
• core biopsy

Question 16

when to excise a fibroadenoma (2)

Answer 16

• patient requests

- > 4 cm

Question 17

what happens to fibroadenomas in post menopausal women

Answer 17

they shrink + become calcified

= popcorn calcification

Question 18

what are breast cysts made up of

Answer 18

• most common cause of breast lumps
• lobules (milk producing glands)
  and
• ducts (tubules that carry milk to the nipple)

Question 19

age group breast cysts are most common in?

Answer 19

< 35 years

Question 20

how does the prevalence of breast cysts change across a womans lifetime

Answer 20

increases as coming up to the menopause and then decreases once a woman has been through the menopause

Question 21

cysts + periods

Answer 21

before a period, a cyst may become larger + more tender

Question 22

management of cysts if large/causing discomfort

Answer 22

fine needle + syringe to draw off fluid

Question 23

is cyst fluid sent off for cytology?

Answer 23

no, only if blood stained