Breast

Question 1

how to tell the difference between Paget’s disease and eczematous changes?

Answer 1

eczema starts on the areola and may or may not affect the nipple; it is usually bilateral

Question 2

a 70 year old woman presents with a lesion on the left nipple that is itchy and has itchy bleeding. what is the diagnosis?

Answer 2

Paget’s disease

Question 3

when is Paget’s disease considered?

Answer 3

consider if a woman presents with a focal, destructive nipple lesion

Question 4

what causes Paget’s disease?

Answer 4

caused by ductal-carcinoma in situ (CDIS) or invasive cancer spread along the ducts behind the nipple, resulting in an eczematous-type change of the nipple

Question 5

what is the treatment of non-lactational mastitis?

Answer 5

oral amoxiclav x3 a day for up to 14 days

Question 6

a 55 year old woman comes to her GP complaining that she has recently noticed a change in the shape of her nipple. on exam you notice a slit-like appearance with no discharge or change in colour. what is the diagnosis?

Answer 6

duct ectasia

this is age-related where the duct shortens and dilates resulting in inversion of the nipple

Question 7

what is the mode of action of tamoxifen?

Answer 7

selective oestrogen receptor modulator