Benign Neoplasms Flashcards
(22 cards)
fibroadenoma is common in which age group?
lumps are often described as what?
<30 years
‘breast mouse’ - non-tender highly mobile lump
is there an increase in risk of malignancy in fibroadenoma?
No
Tx of fibroadenoma?
if >3cm = surgical excision
if very large = mastectomy
difference between fibrocystic change + fibroadenoma in terms of the following:
1) age range
2) lump features?
3) pathology
4) pain?
1) fibrocystic = 30-50 (rare in extremes of age)
fibroadenoma = <30
2) fibrosis = irregular, cysts = hard, smooth, painful mobile lump
fibroadenoma = hard, smooth and highly mobile
3) fibrocystic = thickening of breast tissue +/- cysts
fibroadenoma = benign tumour
Fibroadenoma = painless lump fibrocystic = painful
painless lump with eczematous changes?
Paget’s disease of the breast - intraductal carcinoma associated with a reddening and thickening (may resemble eczematous changes) of the nipple/areola
What is duct ectasia?
most common at what age?
present?
dilatation of the large breast ducts
menopausal women
tender lump around areola with green discharge
what is duct papilloma?
presents with?
age group?
Tx?
benign - epithelial proliferation in large mammory ducts
blood stained discharge + painless mass if large
young pts
microdochectomy (surgical excision of duct)
breast abscess common in whom?
infection caused by what bacteria?
Tx?
Lactating women (lactational mastitis)
Staph aureus
Abx + US guided aspiration
Overlying skin necrosis is indication for surgical debridement
Acute Bacterial Mastitis vs Periductal Mastitis
1) Pathology?
2) age range?
3) chronic painful lump w/ cellulitis w/ nipple discharge
4) acute painful lump during breastfeeding w/ no nipple discharge
1) acute bacterial: infective process (lactational or non-lactational)
periductal: inflammatory process
2) acute bacterial: 20-40
periductal: premenopausal women
3) periductal mastitis
4) acute bacterial mastitis
Tx for acute bacterial mastitis?
if left untreated?
Flucloxacillin 10-14 days
Abscess (requiring incision + drainage)
How many breastfeeding patients get mastitis?
who do you treat?
1 in 10
if systemically unwell,
if nipple fissure is present
if symptoms don’t improve after effective milk removal
in fibroadenoma when should a core biopsy be performed?
when lump measuring more than 4cm
how can you tell if a painless lump is fibroadenoma or carcinoma
fibroadenoma is mobile
A 55-year-old women presents with nipple discharge. On examination she has a slit like retraction of the nipple in the centre of this area is a small amount of cheese like material.
what is it?
duct ectasia
A 48-year-old lady presents with discomfort in the right breast. On examination she has a discrete soft fluctuant area in the upper outer quadrant of her right breast. A mammogram is performed and a ‘halo sign’ is seen by the radiologist.
what is it?
breast cyst - Lesions such as breast cysts compress the underlying fat and produce a radiolucent area (halo sign).
when should cysts be aspirated?
when they are symptomatic
A 35-year-old woman complains of ‘lumpy’ breasts. Her symptoms are worse in the premenstrual period.
what is it?
Fibroadenosis
A 72-year-old woman complains of ‘eczema’ on her left nipple. On examination the areola is erythematous and thickened
what is it?
Paget’s disease of breast
A 22 year old lady presents with lump in the right breast. She reports it has been present for around 4 months but she has grown increasingly concerned as it has not gone away. On examination there is a 2cm smooth lump in the right breast. It is mobile and not fixed to the skin. There are no nipple or skin changes. What is the most likely diagnosis?
Fibroadenoma
Fibroadenomas are the most common breast lumps in women aged 15-25. They are typically less than 3cm in size, are firm and mobile.
A 38-year-old lady who smokes heavily presents with recurrent episodes of infection in the right breast. On examination, she has an indurated area at the lateral aspect of the nipple areolar complex. Imaging shows no mass lesions. What is the most likely diagnosis?
Periductal mastitis is common in smokers and may present with recurrent infections. Treatment is with co-amoxiclav.
A 18-year-old female notices a non tender mobile breast lump. Clinically there is a smooth lump which is not tethered to the skin.
Fibroadenoma
A 21-year-old female notices a bloody discharge from the nipple. She is otherwise well. On examination there are no discrete lesions to feel and mammography shows dense breast tissue but no mass lesion.
Intraductal papilloma
