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*B32 GI and Surgery* > Breast disease > Flashcards

Breast disease Flashcards

BENIGN: Fat necrosis, mastitis, Fibroadenoma, Intraductal papilloma, phyllodes tumour MALIGNANT: DCIS, LCIS, IDC, ILC, Paget's disease of the breast, inflammatory carcinoma

1
Q

Recent breast surgery or trauma to the chest can cause a benign mass. What is this known as?

A

Fat necrosis

  • usually disappears after 2-3 months
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2
Q

Mastitis

A

Inflammation caused by milk stasis in a lactating woman

Unilateral breast discomfort, swelling

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3
Q

Treatment of mastitis

A

ABX

Continue breastfeeding

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4
Q

Acute mastitis is usually caused by which pathogen?

A

Staph aureus -> can lead to abscess

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5
Q

What is the most common benign breast condition?

A

Fibroadenoma

  • Common in women under the age of 30 years
  • THINK breast mice! Discrete, non-tender, highly mobile lumps
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6
Q

The size of fibroadenomas varies with _______ levels

A

Oestrogen

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7
Q

Staghorn cell arrangement of cells on histology seen in..

A

Fibroadenomas

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8
Q

What is the main symptom of intraductal papilloma

A

Clear/bloody nipple discharge

Local areas of epithelial proliferation in large mammary ducts

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9
Q

Phyllodes tumour

A

Rare breast tumours (most are benign but some are malignant)

More common in women with fibroadenomas

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10
Q

Dilatation of the large breast ducts =

A

Mammary duct ectasia

Common around the menopause
Tender lump and can cause green nipple discharge

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11
Q

Breast abscess is common in..

A

lactating woman

Red/hot/tender swelling
Commonly follows mastitis

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12
Q

What is the most common type of breast cancer

A

IDC Invasive ductal carcinoma

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13
Q

If there is no BM penetration (no metastases) what kind of breast cancer is it more likely to be?

A

DCIS or LCIS

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14
Q

Breast abscess treatment

A

Aspirate or incision and drain, remove dead skin and irrigation of pus

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15
Q

If you treat suspected mastitis with ABX twice and still no improvement consider that it could be something…

A

more sinister/malignancy

Inflammatory breast cancer

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16
Q

Granulomas in breast usually caused by..

A

Sarcoidosis

TB

17
Q

Galactocoele =

A

Milk filled cyst

Seen in pregnant/breast feeding women
When duct gets blocked

18
Q

When do you commonly see green/ brown nipple discharge

A

Duct ectasia

19
Q

When do you commonly see green/ brown nipple discharge

A

Duct ectasia

Common in post-menopausal women

20
Q

Which carcinoma in-situ will have calcifications

A

DCIS

21
Q

Cannonball lung lesions commonly seen with

A

IDC

22
Q

Paget’s disease of the breast =

A

Scaly/Eczema-like changes to the skin of the nipple and areola

Sign of underlying breast cancer (usually DCIS)

23
Q

How to tell the difference between eczema and Paget’s disease

A

Eczema is itchy and Paget’s is not itchy

Eczema is bilateral, Paget’s is unilateral

Eczema usually presents with history of atopy

24
Q

Triple assessment for early/rapid detection of breast cancer =

A

1) History and examination
2) Radiological imaging (Mammograph or US)
3) Histology (biopsy of suspision mass)

25
Q

Triple assessment for early/rapid detection of breast cancer =

A

1) History and examination
2) Radiological imaging (Mammograph or US)
3) Histology (biopsy of suspicious mass)

26
Q

Punch biopsy is done when..

A

there is a change to the skin of the breast or nipple

27
Q

The NHS Breast Screening Programme

A

Women aged 50-70 invited every 3 years

28
Q

Breast cancer management

A

Wide local excision or mastectomy

29
Q

Breast cancer management

A

Surgery = Wide local excision or mastectomy
Radiotherapy = Usually after surgery
Chemo = used neoadjuvantly or for node +ve cancer
Hormonal therapy = If ER positive = anostrazole or tamoxifen
Biological therapies = if HER2 receptor positive = trastuzumab/herceptin

30
Q

What does it mean if cancer is triple-negative

A

Cancer does not have receptors for either HER2 or hormones oestrogen and progesterone

31
Q

Signs of inflammatory breast cancer

A

Progressive, erythema and oedema of the breast in the absence signs of infection (such as fever, discharge or elevated WCC/CRP)

32
Q

Tumour marker in breast cancer

A

CA 15-3

33
Q

Which hormonal breast cancer therapy is used in pre-menopausal women

A

Tamoxifen

Anastrozole is used in post-menopausal women

34
Q

Why isn’t tamoxifen used in post-menopausal women with ER-positive breast Ca?

A

Increased risk of endometrial cancer

35
Q

BRCA1/BRCA2 gene mutation increase your risk of breast/ovarian cancer by __%

A

40%

36
Q

The ‘snowstorm’ sign on ultrasound of breast for someone with breast implants indicates

A

breast implant rupture

*B32 GI and Surgery* (9 decks)

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