Breast Lumps Flashcards
What lesion occurs in < 30 year olds, is discreet, non-tender and highly mobile?
Fibroademona (aka breast mice)
What lesion occurs in middle-aged women, causes a lumpy breast that may be cyclically painful.
Fibroadenosis
A peri-menopausal woman has a tender breast around the nipple with green discharge.
What is the diagnosis?
Mammary duct ectasia
A female patient presents with blood stained nipple discharge.
What is the diagnosis?
Duct papilloma
An obese female patient presents with a hard and irregular lump that was initially firm and round.
What is the diagnosis?
Fat necrosis
What is the most common breast cancer?
Invasive ductal carcinoma
Who is screened for breast cancer?
How often are they screened?
50-70 year olds
3 yearly
What is involved in triple assessment?
History and exam
Imaging (USS <35, mammography in >35)
Histology - core biopsy or FNA
What are risk factors for breast cancer?
More ovulations
COCP
BRCA1 and BRCA2
How do the indications for mastectomy and wide excision differ?
Mastectomy - large lesion in small breast, multifocal, central tumour. DCIS >4cm
Wide excision - small lesion in large breast, solitary and peripheral tumour. DCIS <4cm
What is the approah to lymphadenopathy prior to surgery for breast cancer?
if no palpable nodes - USS, if +ve, then sentinel node biopsy during surgery.
If palpable nodes - axillary clearance during surgery
When should radiotherapy be used in breast cancer?
Post-op
If mastectomy of T3 or 4 tumour.
Always in wide excision
Describe the approach to hormonal therapy in breast cancer.
If oestrogen receptor +ve then utilise:
if pre/peri-menopausal - tamoxifen for 5 years
If post-menopausal - aromatase inhibitor (anastrozole)
What are 3 side effects of tamoxifen?
endometrial cancer risk
VTE
menopausal-like symptoms
When can biological therapy be used in breast cancer?
What is the drug used?
If HER2 +ve (20% of cases)
Trastuzumab (Herceptin)
