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Surgery M4 part 1 > Breast 2 > Flashcards

Breast 2 Flashcards

1
Q

When does fibroadenosis affect females?

A

after puberty and before menopause (in anovulatory periods)

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2
Q

Where is progesterone released from?

A

The ovaries from corpus luteam when it ruptures

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3
Q

What’s the pathology of fibrocystic disease? (fibroadenosis)

A
  • fibrosis
  • adenosis
  • cyst formation
  • papillomatosis
  • epitheliosis
  • atypical epithelial hyperplasia
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4
Q

is fibroadenosis precancerous?

A

NO
except if there is
- marked papillomatosis
- atypical epithelial hyperplasia

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5
Q

What is gynecomastia?

A

enlargement of male breast due to increase in glandular element

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6
Q

increase in fat element in male breast is called?

A

Lipomastia

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7
Q

What are the physiological causes of gynecomastia?

A
  • neonatal: high maternal estrogen
  • pubertal: hormonal imbalance
  • old age: low testicular function
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8
Q

what is the most common cause of gynecomastia?

A

idiopathic

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9
Q

What drugs could cause gynecomastia?

A

digitalis
aldactone
cimitidine

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10
Q

How to treat gynecomastia if it’s physiological or idiopathic?

A

wait for 6 months it may disappear

if the patient demands it, preform surgical interventiom

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11
Q

if a patient presents with a recent onset of gynecomastia, what is the first line of treatment?

A

search for the secondary cause and treat the underlying cause

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12
Q

a patient presents with unilateral bleeding from 1 duct, what is your diagnosis?

A

duct papilloma

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13
Q

What causes the retroareolar breast lump causing obstruction in a ductal papilloma?

A

the retention cyst

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14
Q

What is the treatment of a duct papilloma?

A

Microdochectomy

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15
Q

What is the most common cause of breast lump is young females?

A

fibroadenoma

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16
Q

the most common cause of breast PAIN in young females is?

A

fibroadenosis

17
Q

how do we treat hard fibroadenoma?

A

enucleation because it has 2 complete capsules

18
Q

how do we treat soft fibroadenoma?

A

excision with a safety margin because it has an incomplete capsule

19
Q

What is the phyllodes tumor?

A

giant type of soft intra-canalicular fibroadenoma

cystosarcoma pylloides

20
Q

What is the most common cause of lipid discharge from nipple?

A

duct ectasia

21
Q

What are the 3 most common pathologies occurring in pregnant females?

A
  • lactating adenoma
  • galactocele
  • breast infarction
22
Q

How should secondary causes be ruled out in gynecomastia?

A
  • hormonal assay
  • pelvi-abdominal CT
  • scrotal ultrasound
23
Q

What is a genetic cause of gynecomastia?

A

Klinefeter syndrome

24
Q

What are pathological hormonal causes of gynecomastia?

A

HIGH ESTROGEN

  • LCF
  • feminizing tumors

LOW TESTOSTERONE

  • orchectomy
  • testicular atrophy
25
Q

A female presents to the clinic with mastalgia that is increase premenstrual & my breast movement. She has dull aching pain. On palpation nodularity is felt. What is your diagnosis for these signs & symptoms, and what should be seen on further investigation to confirm your diagnosis?

A

Fibroadenosis

smooth filling defect should be seen on ductography

26
Q

How should fibroadenosis be treated?

A
  • reassurance
  • analgesia
  • anti-prolactin: Parlodel
  • androgenic steroid: Danazol
27
Q

What are the surgical indications for fibroadenosis?

A
  • doubtful diagnosis

- large recurrent cyst

28
Q

What are the lines of treatment for gynecomastia?

A

If SECONDARY
- treat the cause (stop offending drug or remove tumor)

If IDIOPATHIC

  • subcutaneous mastectomy
  • liposuction
  • endoscopic surgery
29
Q

What is the gross picture of fibroadenosis?

A

in major milk duct

  • pedunculated mass
  • may ulcerate and bleed
  • may cause ductal obstruction
30
Q

What are the differences between peri-canaliculaar & intra-canalicular fibroadenoma?

A

PERI-CANALICULAR INTRA-CANALICULAR

  • hard - soft
  • in 20-30 y/o - in 30-50 y/o
  • small - large
  • smooth - lobulated
  • firm to hard - soft
  • whorly - cystic degeneration
  • 2 capsules - incomplete
  • more fibrous - more glandular
  • never turns malignant - may turn into a sarcoma
31
Q

What are the signs & symptoms seen to diagnose fibroadenoma?

A
  • painless breast mass
  • freely mobile (BREAST MOUSE)
  • no axillary LN enlargement
32
Q

What is the clinical description of Phyllodes tumor?

A
  • huge soft mass in the breast
  • can cause pressure necrosis of the skin leading to ulceration (PROBE TEST for diagnosis)
  • soft fibroadenoma
  • may show malignant transformation & metastasis
33
Q

How should Phyllodes tumor be treated?

A

Wide local excision up to simple mastectomy

Surgery M4 part 1 (47 decks)

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