Flashcards in Repro 11.2.1 Breast Disease Deck (44)
What happens to breasts before menarche?
Increase in the number of lobules in the breast and increased volume of interlobular stroma
How might breast conditions present?
What type of breast masses are most worrying?
Hard, craggy and fixed
What are potential causes of palpable masses in the breast?
When is nipple discharge most concerning?
If spontaneous and unilateral
What type of pathology does milky nipple discharge suggest?
Endocrine disorders eg. pituitary adenoma, side effect of medicine (OCP)
WHat does bloody or serous nipple discharge suggest?
Benign lesions eg. papilloma, duct ectasia, occasionally malignant lesions
Who is invited to have mammography screening and how often?
47-53 year olds every 3 years
What are worrying findings in mammography?
Densities - invasive carcinomas, fibroadenomas, cysts
Calcifications - ductal carcinoma in situ (DCIS), benign changes
What is the most common benign breast tumour?
What type of tumours does mammographic screening increase detection of?
Small invasive tumours (hard to feel)
In situ carcinomas
WHen do fibroadenomas commonly occur?
Can occur at any age
When do phyllodes tumours commonly occur?
Most present in 6th decade
When does breast cancer most commonly occur?
Rare before 25years (except for some familial cases)
Incidence increases with age
77% occur in women >50 years
Average age at diagnosis is 64 years
Name some disorders of development.
Milk line remnants
Accessory axillary breast tissue
Name some inflammatory disorders of the breast.
What is acute mastitis?
Usually a Staph aureus infection from nipple cracks and fissures
Erythemous painful breast, often pyrexia
Almost always occurs during lactation
What may be a complication of acute mastitis?
May produce breast abscesses
How is acute mastitis treated?
What is duct ectasia?
Duct dilation and inflammation of uncertain aetiology
My have periareolar mass and/or nipple discharge
Can mimic carcinoma
Often in patients in 50/60s
How does fat necrosis present?
Presents as a mass, skin changes or mammographic abnormality
Often history of trauma or surgery
Can mimic carcinoma clinically and mammographically
Name some benign lesions.
How do fibrocystic changes commonly present?
Mass or mammographic abnormality which often disappears after aspiration with a fine needle (FNA)
What is the histology of fibrocystic change?
How is epithelial hyperplasia usually detected?
Mammographic abnormality or as incidental fining in biopsies
What is epithelial hyperplasia?
Proliferation of epithelial cells which fill and distend ducts and lobules
Associated with a slight increased risk of carcinoma (even higher if atypical)
Where are large duct papillomas commonly found?
Lactiferous ducts near nipple
Where are small duct papillomas commonly found?
Often multiple and situated deeper in the breast
What type of papillomas are associated with increased risk of carcinoma?
Small duct papillomas