Breast Conditions

Question 1

Give some examples of in-situ breast malignancies

Answer 1

Intraductal carcinoma in-situ
Lobular carcinoma in-situ
Paget’s disease

Question 2

Give some examples of invasive breast malignancies

Answer 2

Cribiform carcinoma
Inflammatory carcinoma
Lobular carcinoma
Secretory carcinoma
Tubular adenocarcinoma

Question 3

Give some clinical risk factors for breast cancer

Answer 3

Female
Age
Gene mutations
Atypical ductal/lobular hyperplasia
Lobular carcinoma in-situ
Atypical epithelial hyperplasia

Question 4

Give some epidemiological risk factors for breast cancer

Answer 4

Age >30 first birth
Early menarche
Family history
Nulliparity
Postmenopausal obesity
Late menopause

Question 5

What are the common ways for breast cancer to present?

Answer 5

Dimpled skin
Visible lump
Nipple/texture/colour change
Bloody discharge

Question 6

What is used to definitively diagnose breast cancer?

Answer 6

Image-guided tissue core-needle biopsy

Question 7

Lobular carcinoma in-situ spreads diffusely with what typical histological pattern?

Answer 7

Indian file

Question 8

What occurs in breast-conserving surgery?

Answer 8

A wide local excision removes all the cancer without removing the whole breast

Question 9

What therapy also usually takes place with breast conserving surgery?

Answer 9

Radiotherapy

Question 10

What occurs in mastectomy?

Answer 10

The entire breast and axillary lymph nodes are removed

Question 11

Women who undergo mastectomy are candidates for which surgery?

Answer 11

Breast reconstruction

Question 12

Give some indications for post-mastectomy radiation therapy

Answer 12

Involvement of >3 nodes
Positive surgical margins
Tumour >5cm

Question 13

What is the most commonly used hormonal therapy for breast cancer?

Answer 13

Tamoxifen

Question 14

Trastuzumab is a monoclonal antibody which targets what?

Answer 14

HER-2

Question 15

What is the most common benign neoplasm of the breast?

Answer 15

Fibroadenoma

Question 16

How is fibroadenoma diagnosis confirmed?

Answer 16

USS core biopsy

Question 17

How do fibroadenomas most commonly present?

Answer 17

Palpable mass that is firm, mobile and smooth

Question 18

What treatment can be done for fibroadenomas?

Answer 18

Removal via percutaneous vacuum-assisted core biopsy or BCS

Question 19

Fibroadenomas occur in older women while Phyllodes tumours occur in younger women. True/false?

Answer 19

False - fibroadenomas occur in early reproductive stage while Phyllodes occur in older women

Question 20

Phyllodes tumours tend to increase in size. True/false?

Answer 20

True

Question 21

What are the two main variants of mastalgia?

Answer 21

Cyclic and non-cyclic

Question 22

Give some characteristics of the cyclic variant of mastalgia

Answer 22

Bilateral, diffuse and most intense during the immediate premenstrual phase

Question 23

Give some characteristics of the non-cyclic variant of mastalgia

Answer 23

Localised and more persistent

Question 24

How is mastalgia treated?

Answer 24

Use of well-fitting bra
Regular exercise
Primrose oil
Tamoxifen

Question 25

When do breast cysts tend to occur?

Answer 25

Late reproductive years

Question 26

Describe how a breast cyst may present

Answer 26

Palpable, smooth, clearly defined and mobile

Question 27

What method can be used to both diagnose and treat a breast cyst?

Answer 27

Fine needle aspiration

Question 28

Bloody cyst fluid is commonly a sign of what?

Answer 28

Intracystic papilloma

Question 29

How is an intracystic papilloma diagnosed?

Answer 29

USS-guided core biopsy

Question 30

Intraductal papillomas are the most common cause of what presenting complaint?

Answer 30

Spontaneous nipple discharge

Question 31

How may Paget's disease of the nipple present?

Answer 31

Erythematous weeping lesion of nipple surface | Scaly eczematous lesion

Question 32

How is Paget's disease of the nipple diagnosed?

Answer 32

Histologic tissue biopsy

Question 33

Puerperal mastitis will usually clear with a course of antibiotics. True/false?

Answer 33

True

Question 34

Give some clinical signs of mastitis

Answer 34

``` Fever Erythema Induration Tenderness Swelling ```

Question 35

How does a breast abscess present?

Answer 35

Bulging mass in the central area of mastitis

Question 36

How is a breast abscess managed?

Answer 36

USS and drainage

Question 37

What treatment is given for periareolar fistulae?

Answer 37

Surgical excision

Question 38

Fat necrosis is most commonly secondary to what?

Answer 38

Breast trauma

Question 39

What is a galactocele?

Answer 39

A palpable milk-filled cyst

Question 40

How is galactocele diagnosed and treated?

Answer 40

FNA

Question 41

What occurs in Mondor's disease?

Answer 41

Phlebitis and clot formation in the superficial veins of the breast

Question 42

How does Mondor's disease commonly present?

Answer 42

Firm vertical cord-like structure secondary to breast trauma