Your SlideShare is downloading. ×
Benign breast disease by Dr. Kong
Benign breast disease by Dr. Kong
Benign breast disease by Dr. Kong
Benign breast disease by Dr. Kong
Benign breast disease by Dr. Kong
Benign breast disease by Dr. Kong
Benign breast disease by Dr. Kong
Benign breast disease by Dr. Kong
Benign breast disease by Dr. Kong
Benign breast disease by Dr. Kong
Benign breast disease by Dr. Kong
Benign breast disease by Dr. Kong
Benign breast disease by Dr. Kong
Benign breast disease by Dr. Kong
Benign breast disease by Dr. Kong
Benign breast disease by Dr. Kong
Benign breast disease by Dr. Kong
Benign breast disease by Dr. Kong
Benign breast disease by Dr. Kong
Benign breast disease by Dr. Kong
Benign breast disease by Dr. Kong
Benign breast disease by Dr. Kong
Benign breast disease by Dr. Kong
Benign breast disease by Dr. Kong
Benign breast disease by Dr. Kong
Benign breast disease by Dr. Kong
Benign breast disease by Dr. Kong
Benign breast disease by Dr. Kong
Benign breast disease by Dr. Kong
Benign breast disease by Dr. Kong
Benign breast disease by Dr. Kong
Benign breast disease by Dr. Kong
Benign breast disease by Dr. Kong
Benign breast disease by Dr. Kong
Benign breast disease by Dr. Kong
Benign breast disease by Dr. Kong
Benign breast disease by Dr. Kong
Benign breast disease by Dr. Kong
Benign breast disease by Dr. Kong
Benign breast disease by Dr. Kong
Benign breast disease by Dr. Kong
Benign breast disease by Dr. Kong
Benign breast disease by Dr. Kong
Benign breast disease by Dr. Kong
Upcoming SlideShare
Loading in...5
×

Thanks for flagging this SlideShare!

Oops! An error has occurred.

×
Saving this for later? Get the SlideShare app to save on your phone or tablet. Read anywhere, anytime – even offline.
Text the download link to your phone
Standard text messaging rates apply

Benign breast disease by Dr. Kong

1,253

Published on

Published in: Health & Medicine
1 Comment
2 Likes
Statistics
Notes
No Downloads
Views
Total Views
1,253
On Slideshare
0
From Embeds
0
Number of Embeds
0
Actions
Shares
0
Downloads
132
Comments
1
Likes
2
Embeds 0
No embeds

Report content
Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
No notes for slide

Transcript

  • 1.  On pectoral fascia and musculature of the chest wall Over upper anterior rib cage 2nd or 3rd to 6th Fat surrounding Internal mammary artery & lateral thoracic artery Axillary vein, internal mammary veins & intercostal veins
  • 2.  A – Ducts B – Lobules C – Lactiferous sinus D – Nipple E – Fat F – Pectoralis major G – Ribs and intercostal muscles A – Duct cells B – Basement membrane C – Duct lumen
  • 3. Cooper’s ligament
  • 4.  Axillary lymph nodes defined by pectoralis minor muscle › Level 1 – lateral › Level 2 – posterior › Level 3 – medial
  • 5.  Estrogen - Development of the breast and lactiferous ducts Progesterone - Together with estrogen causes lobular and alveolar growth Prolactin - Synergizes the effect of estrogen and progesterone
  • 6. Inspection Overall inspection - symmetry, size, shape, skin color, venous pattern, lump, local dimpling Nipple - excoriation, inversion, discharge, edema and redness Skin - redness, edema, Peau d’orange
  • 7. Palpation Gentle palpation - quadrant by quadrant Mass - number, size, consistency and mobility Lymph node - anterior, posterior, lateral, central and apical Character of the discharge - Milky, serous, or green-brown discharge - Bloody discharge
  • 8.  90% of the breast lump are found by patients themselves. Encourage female have regular self breast examination.
  • 9. In Front a Mirror
  • 10. In The Shower
  • 11. Lying Down
  • 12.  Mammography Ultrasound Magnetic Resonance (MR) Computed tomography (CT) Positron Emission Tomography (PET)
  • 13. Mammographic screening is key to the early detection of breast cancer
  • 14.  Fine needle aspiration - Cytology Core biopsy - Image guided - Stereotactic Excisional biopsy - Needle localization
  • 15.  Abnormalities of Normal Development and Involution Most benign disorders are related to normal process of reproductive life There is a spectrum that ranges from normal to aberration and occasionally to disease
  • 16.  These include conditions of well define etiology Example: fat necrosis, breast abscess
  • 17.  Cyst formation Fibrosis Hyperplasia of epithelium in the lining of the ducts and acini may occur Papillomatosis
  • 18.  Breast lump Mastalgia – cyclical and non cyclical Nipple discharge Infection
  • 19.  Normal breast nodularity or cyclical nodularity - Upper quad and axillary tail - Assessment is clinical, supplemented by USG cytology or core needle histology - Excisional biopsy if doubt persists
  • 20.  Fibroadenoma - 15-25 yrs - Firm, smooth or lobulated and extremely mobile - increase in size during pregnancy and involutes after parturition - 5cm is giant fibroadenoma - Estrogen may play an important role in its pathogenesis - If age<25 conservative. - Excision is done, if age>25, size increases, giant fibroadenoma and positive family h/o of carcinoma
  • 21.  Breast cysts - 40-50 years - smooth and tense and easily palpable against the chest wall - USG and needle aspiration confirms - Excisional biopsy is done if residual mass is present or blood stained fluid is present
  • 22.  Galactocele - Painless swelling appears in breast during or after cessation of lactation - Cyst filled with milky material and has same character as other cysts - Mainly found towards areola - Repeated aspiration
  • 23. Galactocele
  • 24.  Cyclical - Related to menstrual cycle - Duration of >1 week per cycle is significant and called “pronounced” symptoms - Etiology 1. Hyperprolactenemia 2. Increase level of estrogen after ovulation 3. Abnormality of prostaglandin secondary to deficient essential fatty acid intake in diet
  • 25.  Non Cyclical Mastalgia - True non cyclical mastalgia - Chest wall pain
  • 26.  Non Medical Measures - Reassurance - Breast support - Dietary measures Medical Measures - NSAIDS - Evening primrose oil - Danazol - Tamoxifen Surgical measures - subcutaneous mastectomy – the last resort
  • 27.  Discharge from single duct - Blood stained 1. Intraductal carcinoma 2. Intraductal papilloma 3. Duct ectasia - Serous 1. Fibrocystic disease 2. Duct ectasia 3. Carcinoma
  • 28.  Discharge from more than one duct - Blood Stained 1. Carcinoma 2. Duct ectasia - Grumous 1. Duct ectasia - Purulent 1. Infection - Serous 1. Duct ectasia 2. Fibrocystic disease 3. Carcinoma
  • 29. Cause Hormonal imbalance Excessive estrogen production
  • 30. Clinical present Pain or lump, nipple discharge (15%) Tense cyst no fluctuant Cyst may appear rapidly and then maintain their size or shrink after next menstraual flow Most painful in pre-menstraual period
  • 31.  Diagnosis - Pain or lump - FNA Management - Hormonal therapy - Mastectomy
  • 32.  Dilation of ducts associated with periductal inflammation Presented as nipple discharge, subareolar mass, abscess, mammary fistula and/or nipple retraction To rule out malignancy if lump or nipple retraction - if suspicion remain excisional biopsy - excision of all major ducts
  • 33.  Bacterial mastitis - cellulitic stage - abscess form Tuberculosis Actinomycosis Syphilis
  • 34.  40-50 years old. 6%-8% malignant tendency. Forming from the epithelial linings of the main ducts. Nodule at the areola margin. Pressure reproduces the bloody discharge.
  • 35. Types of Intraductal Papilloma Solitary intraductal papillomas – one lump, usually near a nipple, causes nipple discharge Multiple papillomas – groups of lumps, farther away from a nipple, usually doesnt cause discharge, and cant be feltTreatment Surgical excision (involved duct or radical resection if it is proved malignant by frozen section)
  • 36.  Cause - Lactic stasis - Bacterial invasion Clinical present - Swelling pain - Painful mass with reddish skin General features: Chill, fever, ipsilateral LN enlargement, bacteriaemia Abscess formation
  • 37.  Thermo therapy - 25% Magnesium sulfate Antibiotic therapy - Local and general administration Drainage Prevention
  • 38.  After breast surgery or breast injury Bruised, injured, or dead fatty tissue Clinical features - Hard lump - Tender or painful - drainage from nipple - nipple will pull inward Triple assessment Management - NSAIDS - Vacuum-assisted core needle or lumpectomy
  • 39. THE END

×