Breast Medicine

Question 1

What is mastitis?

Answer 1

Inflammation of breast tissue from duct obstruction or infection (staph aureus)

Question 2

What are some symptoms of mastitis?

Answer 2

Breast pain and tenderness
Erythema of breast tissue
Local warmth and inflammation
Nipple discharge
Fever

Question 3

What is the management of mastitis from infection?

Answer 3

Flucloxacillin

Question 4

What is the management for mastitis from blocked ducts?

Answer 4

Conservative - expressing, massage, heat packs, warm showers

Question 5

What is the treatment for candida of the nipple?

Answer 5

Topical miconazole for mother and miconazole gel for baby

Question 6

What are 4 features of a benign breast cyst?

Answer 6

Smooth
Mobile
Possibly fluctuant
Well-circumscribed

Question 7

What is the most common cancer in the UK?

Answer 7

Breast

Question 8

What are some risk factors for breast cancer?

Answer 8

Earlier menarche
Later menopause
More dense breast tissue
Obesity
Smoking
First degree family history
COCP
HRT

Question 9

What is the mutation that can increase breast cancer risk?

Answer 9

BRCA1 and 2

Question 10

When is breast cancer screening performed?

Answer 10

Every 3 years for women 50-70 years old

Question 11

What are symptoms of breast cancer?

Answer 11

Hard, irregular, painless or fixed lumps
Tethered to skin or chest wall
Nipple retraction
Skin dimpling
Lymphadenopathy - axilla

Question 12

What is the triple assessment for breast cancer?

Answer 12

USS, mammogram and MRI

Question 13

What is triple negative breast cancer?

Answer 13

Cells don’t express oestrogen, progesterone or HER2 so limits treatment options

Question 14

What are the 3 types of receptor on breast cancer cells?

Answer 14

Oestrogen
Progesterone
HER2

Question 15

Where does breast cancer metastasise to?

Answer 15

2 Ls and 2 Bs
Lungs and liver
Bones and brain

Question 16

What is chronic lymphoedema?

Answer 16

Impaired lymphatic drainage making the areas more prone to infection

Question 17

What is given for oestrogen receptor positive breast cancer before and after menopause?

Answer 17

Tamoxifen before
Anastrozole after

Question 18

Name a monoclonal antibody that targets HER2 receptors

Answer 18

Trastuzumab

Question 19

What is ductal ectasis?

Answer 19

Benign condition with dilation of large breast ducts

Question 20

What is a significant risk factor of ductal ectasia?

Answer 20

Smoking

Question 21

What are some symptoms of ductal ectasia?

Answer 21

Nipple discharge
Tenderness or pain
Nipple retraction or inversion
Breast lump

Question 22

What is a fibroadenoma?

Answer 22

Common benign tumour of stromal/ epithelial breast duct tissue

Question 23

Why do fibroadenomas regress after menopause?

Answer 23

Because they respond to oestrogen and progesterone

Question 24

What are fibroadenomas composed of?

Answer 24

Glandular epithelium and interlobular stroma

Question 25

What are some features of a fibroadenoma?

Answer 25

Painless, smooth, round, well-circumscribed, firm, mobile, usually up to 3cm in diameter

Question 26

What is the 1st line investigation for fibroadenoma?

Answer 26

USS or mammogram

Question 27

What is a papilloma?

Answer 27

Warty lesion that grows within one of the breast ducts from a proliferation of epithelial cells

Question 28

What does a papilloma show on ductography?

Answer 28

Area that doesn't fill with contrast (filling defect)

Question 29

What is fibrocystic disease?

Answer 29

Multiple small breast lumps and the commonest benign breast disease

Question 30

What is the 1st line treatment for fibrocystic disease?

Answer 30

Paracetamol or ibuprofen

Question 31

What is the 1st line investigation for fibrocystic disease?

Answer 31

USS or mammogram