N.

B: for breast
Haw to deal with breast mass:
 First step …. Hestory & examination
 2nd step ………. Imagin
 If young ……. U/S
 Old .. mammografy
 If solid mass: …… core biopsy …..initial step
 Exisional biopsy … invest of choise
 F cystic lesion ……… aspiratin
 Fibroadenoma : young female with breast mass … invest.
U/S
 Fibroadenosis : painfull swelling in breast increased befor
period
TTT : analgesics , If failed : Danazol
 Intraductal papilloma : most common cause of bleeding
discharge per nipple.
 Mastitis and Acute breast abscess :
TTT: antibiotics
Incision and drainage for B. abscess
Continue breast feeding from affected breast and
start wit it 1st
If suction for milk she can feed the baby from it
 Gynecomastia : ask for steroids and anabolic hormons in
young atheletic male.
 Mamary ductectasia : yellow serous or creemy white
discharg.
 Breast cancer:
…General role: any old female with any breast
abnormality … cancer breast untill prove other wise.
-Duct carcinoma ….. most common.
-Lobular carcinoma ….. bilateral.
-BRCA1 , BRCA2 : done if there is strong 1st degree +ve
family history.
 Screeaning for breast cancer :
Mammography : all female 50-74 y every 2 years
Age 40-49 :
1-if she asked
2-if 1st degree +ve family history of breast cancer <50 y
and do it annually.
 Pagets disease : old woman with unilateral nipple
discharge.
 Breast hematoma : hard some times painfull mass with
history of truma …. TTT : excision.
 Women with history of cancer breast at one side now
come with cancer in other side ….. primary cancer not
metastasis.
 Why female in aust. Scared from mammograohy…..pain.