Inflammatory Breast Disease Flashcards
(33 cards)
What is mastitis?
Inflammation of the breast tissue
What aetiologies can cause mastitis?
- Infection (by far the most common)
- Granulomatous disease
Which organism typically causes mastitis?
Staphylococcus aureus
What are the classes of mastitis?
- Lactational mastitis
- Non-lactational mastitis
What is lactational mastitis?
- Mastitis usually seen within the first three months of breastfeeding or during weaning
- Associated with cracked nipples and milk stasis (due to poor feeding technique)
- Most common prima gravida
What is non-lactational mastitis?
- Mastitis in women who are not breastfeeding
- More common with other conditions such as duct ectasia
- Tobacco smoking is an important risk factor- causes damage to sub-areolar duct walls, predisposes to infection
How does mastitis present?
Breast tenderness, swelling, tissue hardening (induration) and erythema.
What is it important to exclude?
Abscess formation
How is mastitis managed?
Systemic antibiotics (broad-spectrum) and simple analgesia
What advice should you give in lactational mastitis?
Keep breastfeeding
What can you do in lactational mastitis with persistent infection?
Cease breastfeeding with dopamine agonist e.g. cabergoline
What are breast cysts?
- Epithelial lined fluid-filled cavities
Why do breast cysts form?
Lobules become distended when blocked
When are breast cysts most common?
Peri-menopausal (45-55)
How does a breast cyst present?
- Singular or multiple lumps
- One or both breasts
- Distinct smooth masses
- Tenderness
How would you investigate a suspected breast cyst?
USS (definitive)
- Fluid-filled sac
Aspiration
- If fluid is free of blood, or the lump disappears, cancer may be excluded
What treatment is required for breast cysts?
- Self resolves, normally not treated
- Analgesia
- Can be aspirated for symptomatic relief
Do breast cysts carry any risk of breast cancer?
- Yes, 2-3x greater risk of developing cancer in the future
- 2% of cases have carcinoma on presentation, although usually incidental/unrelated
What is mammary duct ectasia?
Dilatation and shortening of lactiferous ducts
Who is at most risk of mammary duct ectasia?
Peri-menopausal women
What percentage of women will have mammary duct ectasia by 70yo?
40%
What are the symptoms of mammary duct ectasia?
- Green/yellow discharge
- Palpable mass
- Retracted nipple
What imaging is used for mammary duct ectasia?
Mammogram- dilated and calcified ducts
What will biopsy of mammary duct ectasia show?
Plasma cells- ‘plasma cell mastitis’
