Breast

Question 1

Define fibroadenoma

Answer 1

Benign neoplasm of a lobule: arising from stroma (fibro) and glandular (adenoma) epithelium

Question 2

Define breast cysts

Answer 2

Fluid filled sacs in the breast

Question 3

Define duct ectasia

Answer 3

Dilatation of milk ducts due to blockage

Question 4

Age of fibroadenoma

Answer 4

20-30s

Question 5

Age of breast cysts

Answer 5

Peri-menopausal women (40–50s)

Question 6

When do breast cysts hurt

Answer 6

Pain associated with the menstrual cycle

Question 7

Age of duct ectasia

Answer 7

Peri/post menopausal women

Question 8

RF of duct ectasia

Answer 8

Smoking

Question 9

Size of a fibroadenoma

Answer 9

1-5cm

Question 10

Uni or bilateral breast cysts?

Answer 10

Can be both

Question 11

One or multiple lumps in a fibroadenoma

Answer 11

Single

Question 12

One or multiple lumps in breast cysts

Answer 12

Single or multiple

Question 13

What benign condition is a sub areolar mass usually (2)

Answer 13

Duct ectasia

Intraductal papilloma

Question 14

What can cause nipple inversion apart from cancer

Answer 14

Duct ectasia

Question 15

Is duct ectasia painful or painless

Answer 15

Painless

Question 16

Is fibroadenoma painful or painless

Answer 16

Painless

Question 17

Are breast cysts painful or painless

Answer 17

Painless but can be painful

Question 18

What gives thick yellow-green nipple discharge

Answer 18

Duct ectasia

Question 19

Is fibroadenoma mobile or fixed

Answer 19

Mobile

Question 20

Is breast cyst mobile or fixed

Answer 20

Mobile

Question 21

Is duct ectasia mobile or fixed

Answer 21

Fixed

Question 22

Ix for fibroadenoma (3)

Answer 22

USS/mammography

Core biopsy

Question 23

Ix for breast cyst (3)

Answer 23

USS/mammography

Fine needle aspiration (FNA)

Question 24

Ix for duct ectasia (2)

Answer 24

USS/mammography

Question 25

What colour fluid in breast cyst when drained

Answer 25

Straw

Question 26

When does fat necrosis occur

Answer 26

Normally occurs secondary to trauma | Women of any age

Question 27

Describe lump in fat necrosis (3)

Answer 27

Painful, irregular hard lump with overlying bruising/redness of the skin

Question 28

Does fat necrosis hurt

Answer 28

YEs

Question 29

Define intraductal papilloma

Answer 29

Benign neoplasm growing within ducts of the breast

Question 30

Age of intraductal papilloma

Answer 30

Peri-post menopausal women

Question 31

What kind of discharge from an intraductal papilloma

Answer 31

Bloody or clear nipple discharge

Question 32

Causes of mastitis

Answer 32

inflammation of the breast Milk stasis/over-production Can be lactational or non-lactational

Question 33

What causes breast abscess

Answer 33

Untreated mastitis, can rarely lead to: | Breast abscess = collection of pus in the breast tissue due to infection

Question 34

Age of mastitis

Answer 34

15-45 y/o | Especially those who are breast-feeding

Question 35

RF of mastitis

Answer 35

Smoking

Question 36

Most common pathogen in mastitis

Answer 36

Staph aureus

Question 37

What does a cracked nipple suggest

Answer 37

Mastitis

Question 38

What systemic symptoms can mastitis cause (3)

Answer 38

Flu like symptoms: fever, aches, | chills, generally unwell

Question 39

Mastitis Mx

Answer 39

If lactational: ENCOURAGE BREAST FEEDING Analgesia Abx sometimes required

Question 40

Breast abscess Mx

Answer 40

``` IV or oral Abx US guided FNA Therapeutic + diagnostic uses FBC + blood cultures (if systemic infection) Surgical incision + drainage ```

Question 41

A 60-year-old woman presents to the GP after noticing some changes in her right nipple. On examination, the nipple is erythematous and crusty with some apparent scaliness of the skin.

Answer 41

Pagets disease of the breast

Question 42

Most common type of breast cancer?

Answer 42

Invasive ductal carcinoma

Question 43

3 infiltrative breast cancers

Answer 43

infiltrative ductal carcinoma (75%), infiltrative lobular carcinoma, Paget’s disease of the breast

Question 44

Non-invasive breast cancer?

Answer 44

DCIS

Question 45

Which grading system is commonly used in breast cancer

Answer 45

Nottingham

Question 46

RF of breast cancer (9)

Answer 46

``` Age FHx – 1st degree relative Obesity ↑ Oestrogen exposure Early menarche (<11) Late menopause (>55) HRT/OCP EtOH consumption Fatty diet Previous radiation to the chest Nulliparity (not having any children) Familial breast cancer – 5% of cases BRCA1/2: harmful BRCA mutation 60-80% lifetime risk of developing Breast Ca Associations with Ovarian and Pancreatic Ca ```

Question 47

Ways you can have increased oestrogen exposure (3)

Answer 47

``` Early menarche (<11) Late menopause (>55) HRT/OCP ```

Question 48

What other cancers is breast cancer associated with (2)

Answer 48

Ovarian and pancreatic

Question 49

Who gets a mammogram and who gets an USS

Answer 49

>35yrs: mammogram | <35yrs: USS

Question 50

Where do breast cancers commonly metastasise (3)

Answer 50

to liver, lungs and bones

Question 51

What are deep neck lumps likely to be

Answer 51

Thyroid

Question 52

What are superficial neck lumps likely to be (4)

Answer 52

lipoma, epidermal cyst, dermoid cyst, abscess

Question 53

What are neck lumps that move on swallowing likely to be

Answer 53

Thyroid gland

Question 54

What are neck lumps that move on tongue protrusion likely to be

Answer 54

Thyroglossal cyst