Breast Physiology and Benign Diseases 4

Question 1

List the major complications of breastfeeding post-partum.

Answer 1

• Mastitis
• Breast abscess

Question 2

What is mastitis and what are the risk factors, diagnosis, and treatment methods?

Answer 2

• Pain and inflammation of the breast
• —Affects 10% of all breastfeeding women
• —Risk factors:
  
  • sore/cracked nipples
  • blocked milk ducts
  • —yeast infection of the breast
  • —infant mouth abnormalities
• —Diagnosis:
  
  • clinical: unilateral breast pain and erythema, fever, malaise, body aches
  • culture only necessary of not responding to therapy
• —Treatment
  
  • ​antibiotics
  • frequent feeding/pumping

Question 3

What are breast abscesses and what is the diagnosis and treatment?

Answer 3

• —Presents similarly to mastitis
  
  • firm area in the breast with fluctuance
• —Diagnosis:
  
  • ultrasound
• —Treatment:
  
  • surgical/needle drainage
  • antibiotic therapy
  • culture is useful to help direct antibiotic therapy

Question 4

Differentiate the differences between benign and malignant nipple discharge.

Answer 4

• Benign
  
  • bilateral
  • milky or green in color
  • multiductal
• Malignant
  
  • unilateral
  • uniductal
  • spontaneous
  • clear, serous, or bloody

Question 5

What are the common characteristics of cyclic mastalgia? What are the common treatments?

Answer 5

• Breast pain and tenderness that occurs with menstrual cycle
• Treatments:
  
  • reassurance
  • well-fitted bras
  • restrict caffeine, fat and salt intake
  • evening primrose oil 2000-3000 mg/day
  • NSAIDs
  • OCPs?
  • more severe symptoms:
    
    • danazol
    • tamoxifen
    • bromocriptine

Question 6

What are some common extramammary sources of breast pain?

Answer 6

• Costchondritis (Tietze syndrome)
  
  • Rx with NSAIDs
• Mondor disease
  
  • superficial thrombophlebitis of the lateral thoracic vein
  • underlying cause may be found in about 50% with chance of underlying breast CA
  • Rx with NSAIDs