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Summary Breast Core Conditions

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A condensed summary of the breast core conditions for the Leeds MBChB year 3 syllabus

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BREAST CORE CONDITIONS SUMMARY
Condition Summary Epidemiology Pathophysiology Prognosis Aetiology Risk Factors S/S Investigations DDs Treatment Complications

Malaise; myalgia; Breast engorgement Need for cessation of
15-45y/o Milk stasis or overproduction, Breastfeeding with
Most resolve pyrexia; mastitis; USS; FNA; discharge (common post-partum); breastfeeding; fistula;
Breast Mastitis more likely coupled with infection from Bacteria colonising poor technique;
Localised infection with a without serious decreased lactation; cytology; pregnancy galactocele; fibrocystic abscess; sepsis;
during lactation; bacteria entering the breast via a the skin (often lactation; mastitis; Abx; surgery
abscess sealed collection of pus complication if firmness, swelling, test; blood cultures; breasts; breast trauma; breast hypoplasia;
abscess more likely traumatised nipple and/or the Staph. aureus) prior breast
treated promptly calor, erythema of FBC primary invasive breast scarring; necrotising
with mastitis infant’s mouth abscess the breast carcinoma; fibroadenoma fasciitis

Most common
female malignancy Malignant cells result from a Comorbidities Unknown White ethnicity; Surgery;
Breast cancer that has Nipple discharge; Mammography;
Breast cascade of genetic events exert significant high socio- chemotherapy; Drug-related
penetrated the basement >50y/o breast lump; axillary biopsy; USS/MRI; Fibrocystic changes;
involving the uncontrolled negative Genetic (BRCA in economic class; radiotherapy; osteoporosis;
carcinoma membrane of the duct or Incidence (white lymphadenopathy; hormone receptor fibroadenoma; mastitis
expression of endogenous GFs influence on 87%)/hormonal FHx; alcohol; osteoporosis lymphoedema
lobule women); mortality skin changes testing
and signalling pathways outcomes (oestrogen) factors breast disease prophylaxis
(black women)

Breast cancer confined DCIS is a
Proliferation of malignant- FHx; benign breast Nipple discharge; Mammography; core/ Surgical excision +/-
to the duct/lobule in potential Proliferation of Locally invasive breast Tamoxifen-related
Ductal which is originated, and 70-75y/o appearing epithelial cells that precursor of malignant- disease; BRCA breast lump; FNA/sentinel node cancer; atypical hyperplasia; radiotherapy; endometrial cancer;
carcinoma White women have not penetrated the gene; Klinefelter’s eczema-like rash; biopsy; hormone mastectomy +/-
does not extend beyond invasive appearing cells fibroadenoma; breast cyst invasive breast cancer
basement membrane syndrome in men ulceration receptor testing; MRI reconstruction
the basement membrane carcinoma

Surgical excision;
Benign tumour within the Spontaneous bloody Debris within a dilated duct; Post-op bleeding,
Appears to result from A/w risk factors; Contraceptive use; Physical exam; USS; vacuum-assisted
Intraductal breast duct; usually a 35-55y/o proliferative fibrocystic epithelial Local recurrence may be related to HRT; oestrogen or clear nipple mammography) fat necrosis with cystic or excision biopsy; infection, pain, fat
papilloma solitary, central lesion is very low discharge; palpable solid areas; malignant non- necrosis; cosmetic
hyperplasia ductal adenomas exposure; FHx tissue biopsy/FNA mastectomy+/-
found behind the nipple mass (occasionally) papillary tumour deformity
reconstruction

Association with menstrual cycle Late-onset
Unknown
Lumpy breasts a/w pain is the most likely explanation for menopause; later Mastalgia; diffuse Chest wall pain; Analgesia; HRT; cyst
Fibrocystic and tenderness that the cyclical nature of symptoms; age at first child symmetrical costochondritis; aspiration; referral to Progression to breast
30-50y/o Good Higher cellular Mammography; USS
disease fluctuates with the fibrocystic change reflects a birth; nulliparity; lumpiness through fibroadenoma; breast oncology; surgical carcinoma
proliferation of
menstrual cycle spectrum of conditions (not oestrogen- both breasts carcinoma excision; observation
breast epithelium
necessarily fibrocystic disease) replacement




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