Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Surgery - Yr 3 > Breast > Flashcards

Breast Flashcards

1
Q

What is mastitis and what Is it caused by?

A

Mastitis is inflammation of the breast tissue and caused by infection - Staph Aureus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What 2 types of mastitis are there?

A
  1. Lactational mastitis
    seen in women breastfeeding
    present during first 3 months
    Associated with cracked nipples and milk stasis
  2. Non lactational mastitis
    Risk factors –> smoking and Duct ectasia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the clinical features and management of mastitis?

A

Clinical features
- Tenderness, swelling and erythema, induration

Management

  • Abx - cephlaxin (beta lactam - cell wall inhibitor)
  • In lactational mastitis - continued milk drainage and feeding is recommended
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are breast cysts and clinical features?

A

Breast cysts are epilthelial lined, fluid filled sacs, which form lobules when distended due to blockage
occurs in perimenopausal age

clinical Features:

  • one or more lesions
  • one or both breasts
  • smooth, fluid filled masses
  • can be tender
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How do breast cysts appear on investigations

and give management?

A

Mammogram - Halo shape
Ultrasound - to confirm diagnosis
Aspiration - if persisting or symptomatic, or undeterminable
- if the fluid is free from blood or the lump disappears - cancer may be excluded

Management

  • self resolving
  • aspiration for aesthetic reasons or patient reassurance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the complications of breast cysts?

A

2-3x greater risk of developing breast cancer in the future

- Fibroadenosis (benign - fibrocystic change) - tenderness and asymmetry

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is mammary duct ectasia and what are the clinical features?

A

Duct ectasia is the shortening and dilation of the major lactiferous ducts.

It occurs in perimenopausal women

Clinical features

  • Green or yellow nipple discharge
  • Palpable mass
  • Nipple retraction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the investigations and management for duct ectasia?

A

Investigations

  • mammogram - Dilated calcified ducts without any malignant features
  • Biopsy - multiple plasma cells

Management

  • Conservative
  • Duct excision - unremitting nipple discharge
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is fat necrosis and the clinical features?

A

Acute inflammation of the breast leading to ischaemic necrosis of the fat lobules

  • associated with trauma
  • previous surgical or radiological intervention to the breast
  • usually asymptomatic
  • Lump
  • Less commonly - fluid discharge, skin dimpling, pain and nipple inversion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What investigations are used in fat necrosis and management?

A

Positive traumatic history Ultrasound - hypererchoic
Core biopsy - to rule out malignancy

Management

  • self limiting
  • analgesics and reassurance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What benign breast tumours are there?

A

Fibroadenoma
Adenoma
Papilloma
Lipoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the most common benign growth in the breast?

A

Fibroadenoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What age women get fibroadenomas?

A

Women of reproductive age more likely get fibroadenomas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is a fibroadenoma and how does it appear?

A

Fibroadenomas are prolferations of stromal and epithelial tissue of the duct lobules

  • high mobile lesions
  • well defined and rubbery, smooth
  • <5cm
  • can be multiple and bilateral
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the management of fibroadenoma?

A

There is a low malignancy potential
Can be left in situ with routine follow up appointments

  • core biopsy or fine needle aspiration
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is an adenoma?

A

Benign glandular tumour (older female population)
Nodular lesions
- Easily mimic malignancy
- Most cases with escalate for triple assessment

17
Q

What is a breast triple assessment?

A
  • History + exam
  • Imaging
  • Histology
18
Q

What is a papilloma?

A

Intraductal papillomas are benign breast lesions
- 40-50 yrs

biopsy
risk of breast cancer with multiductal papillomas

19
Q

What are the general features of benign lesions?

A
  • more mobile
  • smoother borders
  • can get multiple lumps
20
Q

What are general features of malignant lesions?

A

Craggy surfaves
Firm consistency
Fixed to tissue
Single mass

subareolar region
blood or clear nipple discharge

require biopsy die to similarity to ductal carcinomas

21
Q

What is gynaecomastia?

A

Development of breast tissue in males.

Due to the imbalance of Oestrogen and Androgens - delayed testosterone at puberty

Usually benign disease but breast cancer can develop in 1% cases

22
Q

What is the difference between physiological and pathological gynaecomastia?

A

Physiological

  • Occurs in adolescence
  • Delayed testosterone surge relative to oestrogen at puberty

Pathological

  • results from changes in the oestrogen:androgen ratio due to:
  • Lack of testosterone - Klinedelte’s syndrome, renal disease
  • Inc oestrogen levels - hyperthyroidism, obesity
  • Medication - anabolic steroids, metronidazole, spironolactone
23
Q

What are the clinical features of gynaecomastia?

A

Insidious onset (gradual and subtle )

  • Rubbery or firm mass > 2cm
  • Starts from underneath the nipple and spreads outwards over the breast region
24
Q

What are the investigations and management of Gynaecomastia?

A

Investigations
- ask about associated symptoms and co morbidities
- if cause is unknown
do LFT’s, U&E’s, Hormone profile

Management

  • If reversible cause - treatment of cause should allow for resolution of gynaecomastia
  • Tamoxifen - helps alleviate tenderness
25
Q

What is a Carcinoma and give examples?

A

Malignant breast tumour = cancer
- 1 in 8

Ductal carcinoma in situ
Lobular carcinoma in Situ

Invasive Ductal carcinoma
Invasive Lobular carcinoma

26
Q

Describe a ductal carcinoma in Situ

- investigations and management

A

Most common non invasive malignant breast tumour.

It is a malignancy of the ductal tissue of the breast contained within the basement membrane

Inv

  • Asymtomatic
  • Detected on Mammogram - microcalcifications
  • Local or wide spread
  • Confirmed on biopsy

Management

  • Localised - complete wide excision (all margins to ensure no residual disease)
  • Widespread - complete mastectomy
27
Q

Describe a Lobular Carcinoma in situ

  • Investigations
  • Management
A

Malignancy of secretory lobules of the breast tissue contained within the basement membrane
- greater risk of invasive breast cancer

Investigations

  • asymptomatic
  • Diagnosed on incidental finding during biopsy of breast

Management

  • low grade - monitoring
  • Invasive - Bilateral prophylactic mastectomy (BRCA1/2+)
28
Q

What is the most common Invasive breast cancer?

A

Invasice ductal carcinoma is the most common (75-85%)
- tubular, cribiform, papillary, mucinous

Invasive lobular carcinoma makes up 10% of cases

  • older women
  • Diffuse

Others

  • medullary carcinoma
  • colloid carcinoma
29
Q

What are the risk factors of Invasive carcinomas?

A
  • female
  • Age (double every 10 yrs until menopause)
  • FH
  • BRCA1/2
  • Previous benign disease
  • Obesity + high alcohol intake
  • Unopposed oestrogen
  • Early menarche
  • late menopause
  • Nulliparous women (no pregnancies)
  • HRT use
  • first pregnancy after 30 yrs old
30
Q

What are the features of malignant breast tumours?

A
  • Breast lump (hard and craggy)
  • Asymmetry
  • Swelling
  • abnormal nipple discharge
  • Nipple retraction
  • Skin changes
  • Mastalgia
  • Palpable lump in axilla
31
Q

Differentials for breast lump

A

Malignant tumour
Benign tumour
Breast cyst
Infective causes

32
Q

When is mammogram vs USS used?

A

Mammogram

  • women > 40 yrs
  • more fatty tissue = easier to see densities

characteristics

  • ill defined, spiculated mass
  • parenchymal distortion
  • Overlying skin thickening
  • malignant calcifications
  • enlarged axillary lymph nodes

USS

  • women < 40 yrs
  • firm and dense glandular tissue
  • ill defined and hyperechoic mass
  • distal acoustic shadowing
  • Surrounding halo caused by oedema and tumour infiltration
  • abnormal axillary nodes
33
Q

What age are the breast screening programmes?

A

50 - 70 yrs +/- 3 yrs

34
Q

What are the different hormone treatments?

A

Tamoxifen
- premenopausal

Aromatase inhibitor
- post menopausal

Immunotherapy
- Express specific growth factor receptors

35
Q

Describe Tamoxifen

A

Used for pre menopausal women

  • Blocks oestrogen ER receptors
  • Prophylaxis against breast cancer

Dis

  • Risk of VTE - during and after surgery or periods of immobility
  • Inc risk of uterine carcinoma (pre
36
Q

Describe Aromatase inhibitors

A

Post menopausal women

  • Blocks ER receptors and inhibits further malignant growth
  • Prevents further oestrogen production
  • Blocks conversation of androgens to oestrogen in peripheral tissues
  • anastrozole
  • Letrozole

Dis
- joint and muscle aches

Surgery - Yr 3 (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions