Surgery Benign Breast Condition

Front 1

Smooth, discrete, circular, mobile mass.
late teens to early 30s
increased tenderness during pregnancy

Back 1

Fibroadenoma:
Fibrous stroma surrounds ductlike epithelium and forms a benign tumor that is grossly smooth, white, and well circumscribed.

Hint 1

Diagnosis: FNA.
patient<30=observe
patient>30,symptom=excision

Front 2

Acute pain in axilla or superior aspect of lateral breast.
Physical exam: Tender cord palpated.

Back 2

Mondor’s Disease:
Superfi cial thrombophlebitis of lateral thoracic or thoracoepigastric
vein.

Hint 2

Diagnosis: Confirm with US
Salicylates, warm compresses, limit
motion of affected upper extremity. Usually resolves within 2–6weeks
surgery to divide the vein above and below the site of
thrombosis or resect the affected segment.

Front 3

Breast swelling (often bilateral), tenderness, and/or pain.fluctuate
with the menstrual cycle
Physical exam: Discrete areas of nodularity within fibrous breast tissue.
20s to 40s.

Back 3

Fibrocystic Changes

Hint 3

a classic history or absence of a persistent mass: Conservative management = NSAIDs, OCPs, danazol, tamoxifen

Front 4

Noncyclical breast pain with lumps under nipple/areola
with or without a nipple discharge.
Exam: Palpable lumps under areola, possible nipple discharge.

Back 4

Mammary Duct Ectasia (Plasma Cell Mastitis):
Infl ammation and dilation of mammary ducts.

Hint 4

Diagnosis: excision biopsy r/o cancer.
Excision of affected ducts.

Front 5

Large, freely movable mass with overlying skin changes. Indistinguishable from fibroadenoma by ultrasound or
mammogram.

Back 5

Phyllodes Tumor (Cystosarcoma Phyllodes)

Hint 5

Diagnosis: biopsy to diff from fibroadenoma.
 Smaller tumors: Wide local excision with at least a 1-cm margin.
 Larger tumors: Simple mastectomy.

Front 6

Unilateral serosanguineous or bloody nipple discharge.
Subareolar mass and/or spontaneous nipple discharge.

Back 6

Intraductal Papilloma:
benign local proliferation of ductal epithelial cells

Hint 6

Diagnosis: biopsy
Excise affected duct.

Front 7

palpable mass in breast

Back 7

Sclerosing Adenosis:
A sclerosing disorder causing palpable mass in breast.

Front 8

Physical exam: Focal tenderness with erythema and warmth of overlying
skin, fluctuant mass occasionally palpable.
1st wk breast feeding

Back 8

Mastitis

Hint 8

Diagnosis: U/S for abscess
aspirate fluid from abscess
continue breast feeding

Front 9

Firm, irregular mass of varying tenderness.
 Physical exam: Irregular mass without discrete borders that may or may not be tender; later, collagenous scars predominate
Hx of breast trauma

Back 9

Fat Necrosis

Hint 9

Diagnosis and treatment: Excisional biopsy with pathologic evaluation
for carcinoma