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Summary Breast Disease Lecture Notes

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Notes on breast disease relevant for medical school finals

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  • November 20, 2023
  • 14
  • 2022/2023
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HOPB – BREAST DISEASES

BENIGN BREAST DISEASE

Glandular component – produces milk, connected to the nipple by ducts

Fat

Suspensory ligaments – suspend the breast tissue on the chest wall

The breast lies on the pectoral muscle, and beneath this lie the ribs and intercostal muscles.




CLINIC PRESENTATIONS

 Breast lump
 Pain
 Nipple discharge
 Skin changes (including nipple)
 Breast contour changes
 Axillary lump
 Infection
 Other

Breast diseases by age

 Fibroadenomas are benign breast lumps seen in patients in their 20s and 30s
 Cysts become more common as women reach their late 30s and 40s, but then
reduces again following menopause
 Breast cancer is relatively rare in young women, and incidence increases with age
 ‘Localised benign’ refers to benign nodularity (or lumpy breasts) more commonly
seen in younger women

, ASSESSMENT

Gold standard = triple assessment

1. History and clinical examination
2. Imaging (US mammography)
3. Pathology
a. Fine needle aspiration
b. Core biopsy – more standard approach due to greater amount of information
yielded, but samples take time to process and interpret and results are not
available on the same day.


HISTORY

 HPC
o Duration of symptoms
o Associated skin changes
 New lump + associated skin dimpling is worrying for cancer
 Lump which gets bigger pre-period and then shrinks is more likely to be
benign
o Nipple discharge
 Spontaneous and blood-stained discharge is more likely to be related
to underlying pathology than white, green, or yellow ‘physiological’
discharge
o Axillary lumps
 Can be benign or malignant, but if associated with sweats, weight loss,
fatigue should raise suspicion of non-breast malignancy such as
lymphoma
o Pain – breast pain is actually often chest wall in origin and may be related to
job/hobbies
 Risk factors




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