Week 7 Flashcards
(24 cards)
What is the minimum age of patient we’ll do a mammography on?
40
What imaging modality are mammograms?
x-ray
When is MRI used in breast cancer?
used in screening of young women with a FHx of breast cancer, or mutations e.g. BRCA1
What are the 3 components of breast tissue?
- Glandular tissue
- Fibrous tissue
- Interlobular fatty tissue
What muscles are below the mammary bed?
Pectoralis major muscle (mainly)
Serratus anterior
External abdominal oblique muscle
Where is the nipple located in nulliparous females?
4th intercostal space
What are the tubercles of montgomery?
The sebaceous glands, specifically during pregnancy because they become enlarged
How does the breast change during the menstrual cycle?
During the luteal phase (after ovulation) the epithelial cells increase in height, the lumina of the ducts becomes enlarged and small amounts of secretions appear in the ducts
How does the proportion of the components of the breast change when pregnant?
There is increased proliferation of secretory tissue (due to more oestrogen and progesterone)
There is a decrease in the amount of connective tissue and adipose tissue
What are the 2 types of milk secretion?
- Apocrine secretion: lipid portion
- Merocrine secretion: protein portion
Which nodes drain most of the lymph from the breast?
axillary lymph nodes
What is the age range of Fibrocystic change?
Majority between 40-50
between 20 and 50
MUST BE PREMENOPAUSAL since likely hormone mediated
How does fibrocystic change present?
Smooth discrete lumps, sudden cyclical pain
How does hamartoma present?
Usually assymptomatic on screening
How does fibroadenoma usually present?
One (solitary) painless, firm, discrete mobile mass
What are some mechanisms of fat necrosis?
Local trauma e.g. seat belt injuries, falls
Which bacteria usually causes mastitis?
Staph aureus
How do you manage mastitis?
Continue to breastfeed
Give flucloxacillin (clindamycin if penicillin allergic) if not improving within 24hrs
NSAIDs and warm compress for symptom relief
Define mammary duct ectasua
Subareolar periductal inflammatoo with dilated mammary ducts
A patient presents with green-brown nipple discharge and periareolar mass, what is the top differential?
Mammary duct ectasia
Can you see inverted nipple in mammary duct ectasia
Yes
What is the typical age of presentation of mammary duct ectasia?
50, sometimes post-menopausal (since associated with aging)
What is the most common benign breast pathology?
Fibrocystic change
How does intraductal papilloma usually present?
Bloody nipple discharge + fibrovascular projections lined by epithelial cells
