Please enable JavaScript.
Coggle requires JavaScript to display documents.
Benign breast disease (Fibroadenomas (Epidemiology
Commonest benign…
Benign breast disease
Fibroadenomas
-
Pathophysiology
Abnormal proliferation of stromal and epithelial tissue
in the duct lobules
Low malignant potential
-
Clinical presentation
Smooth, rubbery, mobile, well defined
Usually <5cm diameter
May have multiple
Management
Conservative: triple assessment, monitoring over 2 years
Surgical: excision if >3cm or pt preference
-
Diagnosis Triple Assessment
History: smooth lump(s), no nipple change
Examination: smooth, mobile, well defined lump
Investigations: USS/mammography, biopsy
Papilloma
-
-
-
Diagnosis
History: lump
Examination: well defined lump
Investigations: mammography (microcalcifications like DCIS),
biopsy shows papilloma
-
-
-
Breast cyst
Clinical presentation
Round, smooth lump
May be painful
Diagosis
History: lump
Examination: round, well defined lump, may be tender
Investigations: USS/mammography (halo shape), FNA
Epidemiology
Common
35y, peri-menopausal
-
Definition
Epithelial lined, fluid filled cavity
Pathophysiology
Lobules become blocked and distend
Cyst can turn into fibroadenosis (fibrocystic change)
from multiple small cysts and fibrosis of the area
Prognosis
Can self resolve, may recur
Increased risk of developing BC (but not from the cyst itself)
Mastitis/
breast abscess
Pathophysiology
Lactational: infection of mammary duct (S aureus)
due to cracked/sore nipples and milk stasis
Non-lactational: underlying breast disease e.g. ectasia, smoking acts as precipitant by damaging the duct wall structures, both predispose to infection
Abscess: collection of pus surrounded by granulation tissue
Epidemiology
Lactational: commonest, breastfeeding women
Non-lactational: less common
-
Clinical presentation
Mastitis:ainful, hot, erythematous, swollen area
Abscess: tender, erythematous smooth lump with punctum
Diagnosis
History: tender, red lump, fever
Examination: tender erythematous, smooth, well defined
Investigations: bloods (if pyrexial), mammo/USS, biopsy
Management
Conservative: continue milk feeding
Medical: analgesia (ibuprofen), abx
Surgical: aspiration, I+D
Complication
Mammary duct fistula: post-abscess,
communication between breast duct and skin
Adenoma
-
-
-
Diagnosis Triple Assessment
History: irregular lump
Examination: nodular/irregular lump
Investigations: mammography, biopsy
Management
Conservative: triple assessment, monitoring
Surgical: excision if large or pt preference
Pathophysiology
Benign tumour of the breast glands,
no invasive potential
Phyllodes tumour
-
Diagnosis
History: fast growing lump
Examination: mobile, rubbery lump
Investigations: USS/mammography, biopsy
-
-
Definition
Benign fibroepithelial tumours
Phyllodes=greek for leaf, shape on microscopy
-
Duct ectasia
-
-
-
-
Diagnosis
History: nipple signs, lump
Examination:, lump, nipple retraction, discharge
Investigations: mammography (dilated calcified ducts), biopsy
-
Lipoma
Clinical presentation
Soft, mobile, superficial lump
-
-
Diagnosis
History: soft mobile lump, prev trauma
Examination: soft, mobile, superficial lump
Investigations: USS/mammography, biopsy
-
Fat necrosis
-
-
Pathophysiology
Trauma to breast tissue with acute inflammation
Fibrosis and calcification of adipose tissue
Diagnosis
History: lump
Examination: firm lump, may be irregular
Investigations: USS (hyperechoic mass),
mammography (may be calcified) biopsy
-