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Breast surgery > Pathology/conditions > Flashcards

Pathology/conditions Flashcards

(45 cards)

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1
Q

Galactocele

A

Galactocele - tumour of milk ducts that become blocked just after breast feeding - firm, mobile and painless (Under areola)

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2
Q

What causes galactorrhea

A
  • Breast milk production outside of breast feeding
  • Hyperprolactinaemia**

Cx - idiopathic, prolactinomas, endocrine disorders (hypothyroid and polycystic ovarian syndrome), dopamine antagonists

Mx - dopamine agonists (bromocryptine)
- removal of pituitary tumour

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3
Q

Symptoms of gallactorhea

A

Sx - menstral irregularities, reduced libido, erectile dysfunction and gynae
*Prolactin suppresses GnRH, reducing LH and FSH

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4
Q

Mx of galactorrhea

A

Mx - dopamine agonists 1st (bromocryptine)
- removal of pituitary tumour

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5
Q

What is Mammary duct ectasia

A
  • Benign dilation of ducts in the breast that become inflamed

*most common just before menopause
* smoking huge risk factor

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6
Q

Sx of mammary duct ectasia

A

Sx - nipple discharge, tenderness or pain, retraction or inversion, possible lump
- green, grey or white discharge

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7
Q

Ix for mammary duct ectasia

A

Ix - Mammogram, us, MRI - micro calcifications

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8
Q

Mx of mammary duct ectasia

A

mx - conservative

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9
Q

RF for mammary duct ectasia

A

*most common just before menopause

smoking huge risk factor

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10
Q

What is an Intraductal papilloma

A
  • Benign warty lesion that grows within one of the ducts in the breast - proliferation of epithelial cells
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11
Q

Sx of Intraductal papilloma

A

Px - clear or blood stained discharge
- can be tender or have a lump
- often no symptoms

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12
Q

Ix of intra ductal papilloma

A

Ix - us, mammogram, biopsy
- ductography using die

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13
Q

Mx of intraductal papilloma

A

Mx - surgical excision

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14
Q

What is/what causes Lactational mastitis

A

*inflammation of breast ducts during breast feeding
* Very common infection with smokers

Cx - Blockage of milk during breast feeding
- infection via staph aureus

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15
Q

Sx of lactational mastitis

A

Sx - unilateral tenderness, erythema in 1 area, local warmth, nipple discharge, fever

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16
Q

Mx off lactational mastitis

A

Mx - conservative - keep breast feeding
- Flucloxacillin 10 days - if not working

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17
Q

Complications of lactational mastitis

A

Complications - candida of nipple - occurs after antibiotics, skin breaks causing recurrent mastitis

Associated with oral thrush and nappy rash

Mother and child need treatment - topical mioconazole

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18
Q

What is Pagets disease of the nipple

A
  • Rash over the nipple that spread to the areolar region, thickening of skin
  • Strongly suggestive of breast cancer
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19
Q

Sx of paget’s disease

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A

Sx - itchy rash on nipple
- starts from nipple and moves to areolar

20
Q

Ix of pagets disease

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A

Ix - punch biopsy, US, mammogram

21
Q

Mx of pagets disease

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A

Surgery
Radiotherapy

22
Q

Premature ovarian failure indicates

Study These Flashcards
A

Post menopause

23
Q

Implant rupture

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A
  • Snow storm sign of axillary lymph nodes on ultrasound indicates implant rupture
  • SIlicon spills into breast tissue and lymph nodes
24
Q

Cyclical mastalgia

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A
  • Supportive bra and analgesia
25
What is fibrocystic change
* Fibrocystic changes - normal benign lumpy changes within the breast tissue - response to female hormones and noticed just before the menstrual period
26
Breast cysts
* Cysts - benign fluid filled cysts - most common lumps between 30-50 - smooth, mobile, can be painful, change with hormones (halo sign)
27
What is Fat necrosis
* Fat necrosis (Lumpy breast pre menopausal)- local degeneration and scarring of fat tissue, cx trauma, surgery, radiotherapy, - firm, irregular, painless, dimpling or inversion - scan can show signs of cancer so FNA or biopsy is needed
28
Lipoma
* Lipoma - soft, mobile, painless,
29
Most common type of breast cancer & RF for Breast cancer
* Most common form of cancer in UK RF - increased oestrogen exposure (early periods), more glandular tissue... - combined oral contraceptive pill, HRT increases risk * BRACA 1 and 2 * 90% DUCTAL
30
Sx of breast cancer
Px - firm, irregular, fixed lump, tethered to skin or chest, nipple retraction, skin dimpling or oedema, lymphadenopathy (axilla)
31
Ix for breast cancer
US and mammogram, core biopsy - breast US nodes, sentinel lymph node biopsy - axilla * Women with breast cancer but no lymphadenopathy should have a axillary us before surgery
32
Mx of breast cancer
Medical If ER + - Tamoxifen or anastrozole If HER2 + - Herceptin (...ab) Surgical wide local excision - radiotherapy offered mastectomy * If palpable lymph nodes - node clear clearance is indicated * If not palpable - biopsy indicated
33
Areas of mets for breast cancer
LLBB Lung, liver, bone, brain
34
Breast lump <30 referral
*Woman <30 with breast lump can be non urgent referral
35
Complications of axillary node clearance
arm lymphedema and functional impairment
36
Screening for breast cancer
Screening - mammogram every 3 years women aged 50-70
37
BRACA 1 gene
* BRACA 1 - chromosome 17 - increased risk of ovarian cancer (50%) - increased risk of bowel and prostate cancer *** more severe Dominant inheritance
38
BRACA 2 gene
* BRACA 2 - chromsone 13 - increased risk of ovarian cancer (20% Dominant inheritance
39
Px of a fibroadenoma
common benign tumours that are small and mobile and smooth- respond to female hormones
40
Ix for fibroadenoma
- <30 non urgent US >30 urgent US
41
Mx of fibroadenoma
>3cm - surgical excision
42
Medications cx gynaecomastia
Imbalance between oestrogen and progesterone - Spironolactone, CCB (rare), amiodarone, GnRH, finasteride
43
Gynaecomastia cx
Testicular cancer, liver and kidney disease, genetic conditions (kallmans)...
44
Dopamine interaction with prolactin
dopamine inhibits prolactin (dopamine antagonists - anti psychotics increase levels)
45
Px of inflammatory breast cancer
Progressive erythema and swelling with the absence of infection

Breast surgery (2 decks)

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