benign breast diseases
Post on 10-Aug-2015
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Common Breast Diseases
byPROF/ GOUDA ELLABBAN
SCU HOSPIAL/ EGYPT
Congenital
• Extra nipples and Breast- • polythalia, polymazia• Milk line• Unilateral hypoplasia- augmentation• Hypoplasia of pectoral muscles
Life cycle of Breast
• Development – early reproductive• Mature reproductive life• Involution• Most BBD occur in specific period –
aberrations – rather than disease• Changes in glandular tissue- areas of
fibrosis, microcysts, adenosis
<25 yrs
• Normal Development- aberration
• Stromal - juvenile hypertrophy• Lobular – Fibroadenoma
• ANDI- abberations of normal development and involution
25-40 yrs
• Cyclical activity
• cyclical mastalgia • cyclical nodularity- focal, diffuse
35-55 yrs
• Normal• Involution• Lobular – macrocysts• Stromal – sclerosing lesions• Ductal -- duct ectasia
Juvenile Hypertrophy
• Uncontrolled growth• Adolescent girls• No endocrine abnormality• Social embarrassment, pain, discomfort• Reduction mammoplasty
Fibroadenoma
• Develop from whole lobule• Mass in breast• Types – FA, Giant FA,Juvenile FA,
Phyllodes tumor• Giant - > 5cm diameter• CBE, USG,FNA• 2yrs – 10% in size, rest disappear
Pain , nodularity
• Physiological, prolonged – aberration• Focal nodularity – common- all ages• Pathological – benign breast changes
Involution
• Palpable breast cysts- perimenopausal• Smooth lump,painful• MMG,USG, FNA - blood + , cytology• Re-examine breast – MMG,USG,FNA – 1-
3% Ca, risk x2
Sclerosis
• Sclerosing adenosis,• radial scars, • complex sclerosing lesions• Excision biopsy- suspicious on MMG
Duct Ectasia
• Subareolar ducts dilate- shorten• Age 70 – 40% have duct dilation,ectasia• D/C cheesy, nipple retraction, mass• Slit like nipple,• Surgery- troublesome D/C, inverted nipple
Epithelial hyperplasia
• Terminal duct lobule unit – cellular hyperplasia
• Mild,moderate, florid• Atypia- ADH- BBD- increased risk of Br Ca• First degree relative – Br Ca
Gynecomazia
• Benign, reversible, puberty, old age• Surgery – if socially unacceptable• Senescent Gynecomazia- 50-80,males• Progressive,painless increase• MMG – fat or malignancy, FNA,hormone• Drug –anabolic steroids, - Danazol,Tmx
Benign Neoplasms
• Duct pailloma –single, multiple• Blood stained d/c, ductography• Duct excision
• Lipomas - Soft, lobulated, radioluscent• Haematomas – trauma – RTA. FNA, core
bx, open biopsy• Antocoagulant therapy• Sometimes associated with Ca• Fat necrosis – Traumatic –seat belt injury• Granuloma –multiple masses, sarcoid, TB• Breast infections, Mastalgia
Infections
• Abscess- lactational-I&D,TB, syphilis,fungal• Periareolar(NL) – AB- abscess – duct fistula• Mammary duct fistula – excision• Skin infections- hidradenitis,cellulitis,
eczema, sebaceous cysts
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