Breast Conditions and Disorders Quiz

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Questions and Answers

What is the characteristic of galactorrhea discharge?

It is bilateral with a milky character. (correct)

It is localized and associated with breast cancer.

It is usually unilateral and serous.

It has a purulent nature coming from multiple ducts.

Which of the following conditions is characterized by congenital absence of one or both breasts?

Polymastia

Polythelia

Amastia (correct)

Athelia

What type of pain is typically maximal premenstrually and relieved with the onset of menses?

Noncyclic pain

Chronic pain

Cyclic pain (correct)

Acute pain

Which microorganism is most commonly associated with puerperal mastitis?

Staphylococcus aureus Signup and view all the answers

What is the primary characteristic of pathological nipple discharge?

It is unilateral and localized to a single duct. Signup and view all the answers

In the context of mastitis, what typically does not occur in non-puerperal mastitis?

Purulent discharge from the nipple Signup and view all the answers

Which benign condition commonly causes nipple discharge and can be associated with malignancy detection?

All of the above Signup and view all the answers

How is the pain associated with breast cancer commonly characterized?

Benign in nature in 90% of cases Signup and view all the answers

What characterizes a galactocele?

It is a cystic swelling containing creamy fluid that may become infected. Signup and view all the answers

Which statement is true regarding traumatic fat necrosis?

It occurs due to injury in the fatty tissue and is infiltrated by foamy macrophages. Signup and view all the answers

What can be a distinguishing feature of mammary duct ectasia?

Chronic dilatation of ducts with potential nipple discharge. Signup and view all the answers

Fibrocystic changes are most commonly found in which age group?

Women between the age of 35 and 50 years. Signup and view all the answers

What is a common characteristic of the lesions associated with fibrocystic changes?

Cysts contain either yellowish serous or brown haemorrhagic fluid. Signup and view all the answers

Which characteristic is associated with mastitis that can sometimes mimic cancer?

Significant fibrosis following acute inflammation. Signup and view all the answers

What is a prominent histological feature of traumatic fat necrosis?

Foamy macrophages and lipid crystals. Signup and view all the answers

Which feature is NOT typically associated with mammary duct ectasia?

Significant drainage of serous fluid. Signup and view all the answers

Study Notes

Pathology of the Female Breast I

Congenital Anomalies:
- Amastia: Congenital absence of one or both breasts
- Polymastia: Abnormal number of breasts
- Athelia: Absence of the nipple
- Polythelia: More than two nipples

Anatomical Structures & Lesions

Anatomical Structures:
- Ductules (or acini)
- Lobule
- Terminal duct
- Adipose tissue
- Segmental duct
- Lactiferous duct
- Lactiferous sinus
- Nipple
Lesions:
- Nipple adenoma
- Paget's disease
- Papillomas
- Traumatic fat necrosis
- Hyperplasia
- Fibroadenoma
- Most carcinomas
- Cysts

Normal Breast Tissue

Images of normal breast tissue are presented

Main Clinical Presentations

Breast Pain:
- Most breast pain is benign, but up to 10% of cases associated with cancer.
- Breast pain can be cyclic (peaking pre-menstrually and easing with menses) or non-cyclic.
- Cyclic pain can be unilaterally or bilaterally.
- Non-cyclic pain has diverse causes (hormonal changes, fibroadenomas, etc.)

Nipple Discharge

Nipple discharge is a common presenting complaint, categorized into three main types:
- Physiological discharge: Usually bilateral, serous, and not associated with an underlying disease.
- Galactorrhea discharge: Bilateral, milky discharge. Related to oral contraceptives, certain drugs and endocrine diseases like prolactinoma.
- Pathologic discharge: Unilateral discharge localized to a single duct. Frequently caused by benign breast conditions, although uncommonly cancerous (only 5%). If there is a palpable mass or mammographic abnormality, biopsy is necessary.

Mastitis: Acute Mastitis

Puerperal mastitis: An acute breast cellulitis in lactating mothers.
- Affected breast tissue is red, warm, and tender.
- Often no purulent nipple discharge. Infection typically surrounds the duct system.
- Common organism: Staphylococcus aureus
- Untreated, may progress to abscess formation.
Non-puerperal mastitis: Typically appears as an abscess, often sub-areolar, with tenderness and erythema. Usually no widespread systemic symptoms.

Chronic Mastitis

Less common than acute mastitis. May be specific (e.g., tuberculosis) or non-specific (following acute mastitis). Marked fibrosis can make it difficult to distinguish from cancer.

Tumor-like Lesions

Breast Cysts:
- Common in pre- and post-menopausal women.
- Often indistinguishable from solid masses on physical exam, requiring imaging (ultrasound) and potentially aspiration.

Galactocele

A special cystic swelling, usually of a lactiferous duct, that develops during lactation.
- Caused by duct obstruction.
- Contains creamy (milky) fluid that may turn watery.
- May lead to infection or granulomatous inflammatory reaction.
- Images of large galactocele are shown

Traumatic Fat Necrosis

A lesion caused by injury to fatty breast tissue, often in the sub-areolar region, and more common in obese individuals.
- Heavily infiltrated by foamy macrophages
- Lipid crystals are frequently deposited stimulating a granuloma.
- May contain calcification and manifest as a firm, ill-defined, painless breast mass which can enlarge over time.

Mammary Duct Ectasia

Characterized by progressive dilatation of large or intermediate-sized ducts, with an associated chronic granulomatous inflammation (often marked by plasma cells and polymorphs), from an unknown cause.
- Dilated ducts may contain cheese-like fatty material.
- May be associated with nipple retraction.
- Clinically similar to cancer and may require differential diagnosis.

Fibrocystic Changes (Fibroadenosis)

A common breast lesion, typically found in women aged 35-50, but occasionally younger.
- Often bilateral and multifocal.
- Macroscopically, characterized by a firm, ill-defined, grayish-white fibrous tissue with cysts of varying sizes. Cysts contain yellowish serous or brown hemorrhagic fluid.
- Microscopically, characterized by epithelial hyperplasia (including adenosis), epithelial changes (apocrine metaplasia).
- Fibrosis.

Fibrocystic Disease of the Breast

Images of fibrocystic disease are presented

Etiology of Fibrocystic Change

The exact cause of fibrocystic changes is unknown, but it is assumed to be caused by hormonal imbalances, particularly oestrogen (increased) and progesterone (decreased) causing breast tissue hyperplasia, which sometimes may be atypical (precancerous).

Breast with Epitheliosis & Atypical Epithelial Hyperplasia

Images of an example of breast with epithelial hyperplasia are presented.

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Description

Test your knowledge of various breast conditions and disorders in this quiz. You'll cover topics ranging from galactorrhea to mastitis, and learn about common characteristics and associated microorganisms. Perfect for students and healthcare professionals alike!