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Flashcards in Breast disease Deck (23)
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1

What r some presenting feautures of breast disease?

2

How is breast disease divided? & explain their future risk of cancer?

Non-proliferative disorders - no increased risk. 

Proliferative disorders without atypia - mild to moderate increase in risk. 

Atypical hyperplasias - substantial increase in risk (relative risk in the order of 4.1-5.3). 

3

Causes for physiological swelling and tenderness 

Puberty

• Breast enlargement, sometimes initially unilateral, is the first obvious sign of puberty in girls. Breast buds may initially be unilateral. Pubertal breast development is known as thelarche

4

What is the most common benign breast disorder

how does it present?

when r the symptoms at its greatest? When do the decrease?

examination?

treatment?

 

 

 

Fibrocystic change

• This usually affects women aged 20-50 and appears to be hormonal in aetiology.

Most often presents with pain and nodularity

The symptoms are greatest about one week BEFORE menstruation and decrease when it starts

Examination may reveal an area of nodularity or thickening, poorly differentiated from the surrounding tissue and often in the upper outer quadrant of the breast. 

 

 

5

If the changes are bilaterally or unilateral symmetrical, they are rarely pathological. 

 

Choose one

Bikateral

6

Cyclical mastalgia 

The breasts are active organs that change throughout the menstrual cycle and some degree of tenderness and nodularity in the premenstrual phase is so common that it may be considered as normal, affecting up to two thirds of all menstruating women. It rapidly resolves as menstruation starts. 

7

Most benign lumps will be either _____or_______

cysts or fibroadenomas

8

Describe how a benign mass feels?

Smooth, hard,mobile, regualr borders, solid or cystic in consistency 

9

Breasts cysts

commin in ages?

treatment

common ages of 35 & 50.

milk glands can fill up with fluid

palpable lumps and may be recurrent. (sometimes painful)

They cannot be reliably distinguished from solid tumours on clinical examination 

aspirate it and the patient says its gone

10

Name 2 stromal tumors

type of patient, presentation, treatment

stromal (are connective tissue cells of any organ,)

WLE >> wide local excision

11

Most common breast lesion?

age?

where do they arise from? Composed of?

presentation?

what increases the incident?

Fibroadenomas 

  • benign tumours that are common in young women, peak at 20-24 years of age. 
  • They are the most common type of breast lesion. 
  • Fibroadenomas arise in breast lobules and are composed of fibrous and epithelial tissue.
  • They present as firm, non-tender, highly mobile palpable lumps.
  • Hormones seem to be involved in aetiology, & (HRT) increases the incidence. 

12

Wsh tha?

Fibroadenoma

13

In terms of nipple discharge,

 is unilateral or bilatera discharge likely to be breast cancer?

 

Unilateral

14

What is intraductal papilloma?

how does it cause nipple discharge?

wart-like lump that develops in one or more of the milk ducts in the breast

Benign growth causes imflammation>> reach end of nipple>> discharge

15

Mammary duct ectasia

near menopuase > major ducts behind nipple DILATE + SHORTEN & fill w/ creamy secretion w/ periductal inflammation.

 

COMMON IN SMOKERS!

Symptoms 

  • may be asymptomatic
  • nipple dishcarge (bloody, creamy white or yellow, serous)
  • retracted nipple (bc duct shortened)
  • recurrent chronic inflammation w/ abscess formation

treatment>> surgical excison of the major duct, and correct nipple retraction.

16

What is this?

treatemnt

presentation

caused by?

 

Mastitis

17

Gynaecomastia

  Occurs in 30% of boys at puberty

  Hormone secreting tumours: e.g. sex-cord testicular

  Chronic liver disease: hypogonadism + ↓E2

metabolism, kleinfelters 

  Drugs: spironolactone, digoxin, cimetidine

18

Amastia

complete absence of breast and nipple

19

Accessory nipples

Can occur anywhere along the milk line

20

Mastalgia

types? age common? releived by? treated?

Cyclical

 ~35yrs
 Pre-menstrual pain
 Relieved by menstruation
 Commonly in UOQ bilaterally

 

Non-cyclical

  ~45yrs

  Severe lancing (sharp) breast pain (often left)

  May be assoc. ̄c back pain

 

Rx

check other breast disease

  Reassurance + good bra for most

  1st line: EPO (eveing primrose oil)  (contains gamma-linoleic acid)

  OCP

  Topical NSAIDs (e.g. ibuprofen)

  Bromocriptine ( inhibits  prolactin release)

  Danazol (an androgen similar to testosterone)

  Tamoxifen

21

Inflammatory breast conditions?

type of patient, presentation, treatment

PAD Fat

fat necorosis> damage to the fatty tissue (following breast surgery, biospy, radiotherapy, trauma) 

22

Benign Epithelial Lesions

type of patient, presentation, treatment

23

Malignant Conditions

type of patient, presentation, treatment