Breast Conditions

Question 1

Management for mastitis?

Answer 1

First line: continue breast feeding
Analgesia + warm compress
Abx-> flucloxacillin 10-14 days

Question 2

Most common organism causing infective mastitis?

Answer 2

S. aureus

Question 3

Management for breast abscess?

Answer 3

Incision and drainage +/- USS guidance

Question 4

Risk factors for breast cancer?

Answer 4

Increased hormone exposure
Early menarche or late menopause
Nulliparity or late first pregnancy
COCP
HRT
BRCA1/ BRCA2 mutations
Obesity
Alcohol
Smoking
Hx of breast cancer
Previous radiotherapy exposure

Question 5

Name the type of breast cancer, characterises and prognosis?
IDC
ILC
DCIS
LCIS
Paget’s disease of the breast

Answer 5

Invasive ductal carcinoma (IDC):
Most common- accounts for 80% of breast cancer
Starts in a milk duct, breaks through the wall of the duct, and invades the fatty tissue of the breast.

Invasive lobular carcinoma (ILC):
Begins in the milk-producing glands and can spread to other parts of the body.

Ductal carcinoma in situ (DCIS):
This is a non-invasive or pre-invasive cancer where the cells are confined to the ducts in the breast and have not spread into the surrounding breast tissue.

Lobular carcinoma in situ (LCIS):
This is not a cancer but an area of abnormal cell growth that increases a person’s risk of developing invasive breast cancer later.

Paget’s disease of breast:
Infiltrating carcinoma of nipple epithelium.

Question 6

Cyclical mastalgia management?

Answer 6

Lifestyle- exercise, diet, limit caffeine and salt
Drugs- paracetamol, NSAIDs, COCP, danazol
FUP and surveillance

Question 7

Management for receptor cancers?
HER2+
HER2-
Triple negative breast cancer
BRCA+ and HER2-

Answer 7

HER2+ : Herceptin (Trastubzumab)
HER2- : Abermaciclib
Triple negative breast cancer: Pembrolizumab
BRCA+ and HER2- : Olaparib

Question 8

Hormonal Therapy for oestrogen-positive breast cancer?

Answer 8

Anastrozole- for postmenopausal women
Tamoxifen- for premenopausal women

Question 9

Which type of biopsy provides histological information rather than cytological?

Answer 9

Core needle biopsy- histological
FNA- cytological

Question 10

Which type of tumour is fast-growing, smooth, hard and mobile?

Answer 10

Phyllodes tumour

Question 11

MOA of Tamoxifen?

Answer 11

Oestrogen antagonist

Question 12

Side effects of Herceptin?

Answer 12

Cardiotoxicity resulting in heart failure:
shortness of breath on exertion, peripheral oedema, ascites and paroxysmal nocturnal dyspnoea

Question 13

Side effect of aromatase inhibitors (anastrozole)?

Answer 13

Osteoporosis

Question 14

What is the most common type of breast cancer?

Answer 14

Invasive ductal carcinoma

Question 15

Treatment following a wide-local excision?

Answer 15

Whole breast radiotherapy to reduce risk of recurrence