Downloaded 14 times
Uploaded byPradeep Pande
ANDI Benign breast diseases Fiboadenoma
The document provides comprehensive guidance on using PowerPoint presentations for teaching about breast disorders, outlining tips for engaging students through active learning sessions. It covers the anatomy and physiology of the female breast, various benign conditions, and their classifications, clinical features, investigations, and management strategies. Additionally, it includes bibliographic references, learning objectives, and links for further resources.
More Related Content
Similar to ANDI Benign breast diseases Fiboadenoma
More from Pradeep Pande
ANDI Benign breast diseases Fiboadenoma
- 1. Tips on usingmy ppts. 1. You can freely download, edit, modify and put your name etc. 2. Don’t be concerned about number of slides. Half the slides are blanks except for the title. 3. First show the blank slides (eg. Aetiology ) > Ask students what they already know about ethology of today's topic. > Then show next slide which enumerates aetiologies. 4. At the end rerun the show – show blank> ask questions > show next slide. 5. This will be an ACTIVE LEARNING SESSION x three revisions. 6. Good for self study also. 7. See notes for bibliography.
- 2. ANDI Aberrations in theNormal Differentiation and Involution of the breast • AKA fibrocystic disease, fibroadenosis, chronic mastitis and mastopathy
- 3.
- 4. Learning Objectives 1. Introduction& History 2. Relevant Anatomy, Physiology 3. Aetiology 4. Pathophysiology 5. Pathology 6. Classification 7. Clinical Features 8. Investigations 9. Management 10. Prevention 11. Guidelines 12. Take home messages
- 5.
- 6. Physiology The female breastpasses through 5phases during lifetime 1. Prepubertal 2. Post pubertal 3. Pregnancy 4. Lactational 5. Menopausal • Superimposed on this is changes during menstrual cycle.
- 7. Physiology • The resting(non-lactating) breast, consists mostly of fibrous & fatty tissue • During phases of the menstrual cycle the breast epithelium and lobular stroma undergo cyclic stimulation. • Dominant process is hypertrophy and alteration of morphology rather than hyperplasia.
- 8. Physiology • With pregnancy,there is diminution of the fibrous stroma to accommodate the hyperplasia of the lobular units. • Growth is influenced by high circulating levels of estrogen and progesterone and prolactin .
- 9. Physiology • After childbirth,there is a sudden loss of the placental hormones. • A continued high level of prolactin is the principal trigger for lactation. • The actual expulsion of milk is under hormonal control and is caused by the contraction of the myoepithelial cells by hormone Oxytocin. • Stimulation of the nipple is the physiologic signal for both the continued pituitary secretion of prolactin and for the acute release of oxytocin.
- 10. Physiology • When breast-feedingceases, there is a fall in prolactin and no stimulus for release of oxytocin. The breast then returns to a resting state and to the cyclic changes induced when menstruation begins again.
- 11. Physiology • After menopauseprogressive atrophy of lobes & ducts takes place – Involution- • Increased fat deposition • Diminished connective tissue • Disappearance of lobular units.
- 12.
- 13. ANDI Classification ofBenign Breast Disorders Normal Disorder Disease Early reproductive years (age 15–25) Lobular development Fibroadenoma Giant fibroadenoma Stromal development Adolescent hypertrophy Phyllodes tumor Nipple eversion Nipple inversion Subareolar abscess Mammary duct fistula Later reproductive years (age 25–40) Cyclical changes of menstruation Cyclical mastalgia Incapacitating mastalgia Nodularity Epithelial hyperplasia of pregnancy Bloody nipple discharge Involution (age 35–55) Lobular involution Macrocysts Sclerosing lesions Duct involution –Dilatation Duct ectasia Periductal mastitis –Sclerosis Nipple retraction Epithelial turnover Epithelial hyperplasia Epithelial hyperplasia with atypia
- 14. Aetiology • Idiopathic • Congenital/Genetic • Nutritional Deficiency/excess • Traumatic • Infections /Infestation • Autoimmune • Neoplastic (Benign/Malignant) • Degenerative / lifestyle • Iatrogenic • Psychosomatic • Poisoning/ Toxins/ Drug induced
- 15. Idiopathic • Mondor’s disease •Duct ectasia/periductal mastitis • ANDI • Breast cysts • Galactocele • Fibroadenoma • Phyllodes tumour
- 16. Congenital Nipple • Nipple retraction •Cracked nipple • Papilloma of the nipple • Retention cyst of a gland of Montgomery • Eczema • Discharges from the nipple
- 17. Congenital Breast • Amazia • Polymazia •Mastitis of infants • Diffuse hypertrophy
- 18. Traumatic • Haematoma • Traumaticfat necrosis
- 19. Infections • Bacterial mastitisand Abscess. • Chronic intramammary abscess • Tuberculosis of the breast • Actinomycosis
- 20.
- 21. Clinical Features • Pain •Lump • Nipple discharge
- 22. ANDI :Pathology • Fourfeatures that may vary in extent and degree in any one breast. 1. Cyst formation. 2. Fibrosis. Fat and elastic tissues disappear and are replaced with dense white fibrous trabeculae. The interstitial tissue is infiltrated with chronic inflammatory cells. 3. Hyperplasia of epithelium in the lining of the ducts and acini with or without atypia. 4. Papillomatosis. The epithelial hyperplasia may be soextensive that it results in papillomatous overgrowth within the ducts
- 23. Triple Assesment • ClinicalAssessment • Imaging Studies • FNAC/ True cut
- 24.
- 25. Fibroadenoma • Second mostcommon tumor of breast • ANDI • Represent a hyperplastic or proliferative process in a single lobule • Etiology is unknown, thought to be due to hormonal influence • Between the ages of 15-25 years & size of 2-3cm • Painless lump- capsulated,smooth, firm, well defined, nontender, BREAST MOUSE • Microscope- intracanalicular pericanalicular
- 26. Fibroadenoma • Develops fromsingle lobule. • Well-encapsulated masses that may easily detach from the surrounding breast tissue. • Histologically, a variable proportion of epithelial and stromal proliferation is present, and the stroma may be quite cellular or replaced by acellular swirls of collagen.
- 27. Juvenile Fibroadenoma andGiant Fibroadenoma • Unusually large size, typically greater than 5 cm • Juvenile fibroadenoma occasional large fibroadenoma that occurs in adolescents and young adults and histologically is more cellular than the usual fibroadenoma. • The differential diagnosis for a cellular juvenile fibroadenoma is benign phyllodes tumor
- 28. Fibroadenoma • Treatment-conservative • Surgery- – Very large/increasing in size – Suspicious cytology – Surgery is desired. – Enucleation
- 29. Fibroadenoma • Alternatives tosurgery - 1. Cryoablation 2. Heating with high-frequency ultrasound (echotherapy) 3. Removal with a large core vacuum biopsy system.
- 30.
- 31. PHYLLODES TUMOUR • Proliferationof intralobular stroma • Fusiform fibroblast • 3 types:- benign borderline malignant (cellularity,atypia,mitoses &invasion by edges)
- 32. Management Wide local excision Benign Borderline- Follow up Malignant -SIMPLE MASTECTOMY
- 33. Traumatic Fat Necrosis •Clinical features - Pain & lump in the breast • Lump is hard - extensive fibrosis caused by tissue reaction • D.D : Carcinoma breast • Mammography findings - density lesion; can have calcifications; may mimic carcinoma breast • Treatment - excision of the lump
- 34. Breast cyst Agegroup – 30-50 • Multiple and bilateral • Can mimic malignancy • Confirmed by USG and aspiration
- 35. Breast cyst Aspirate Excision biopsy if- Bloody aspiration Residual mass Suspicious cytology Recurs
- 36.
- 37. MASTALGIA • Menstruating agegroup • Hormone related-ANDI • Dull diffuse bilateral • Upper outer quadrant
- 38. Mastalgia: Introduction • Breastpain is common and a symptom that brings a woman to her physician. Usually it is of functional origin and uncommonly is it a symptom of breast cancer. • Most patients with pain do not have breast cancer.
- 39. Types • Cyclical mastalgia. •Noncyclical mastalgia.
- 40. Cyclical mastalgia • Normalovarian hormonal influences on breast glandular elements frequently produce cyclical mastalgia. • It is most common in women in their mid-30s • Pain is dull, diffuse • Bilaterally symmetrical in the upper outer quadrants. • It is predominantly experienced in the luteal phase of the menstrual cycle and abates with menstruation.
- 41. MASTALGIA • Menstruating agegroup • Hormone related-ANDI • Dull diffuse bilateral • Upper outer quadrant
- 42. Noncyclical mastalgia 1.Non breastetiology specific significant breast condition • Cervical radiculopathy, • Costochondritis, • Intercostal muscle strain. • Gastroesophageal reflux disorder, • symptomatic gallstones, • Cardiovascular disease, • Pulmonary pathology
- 43. Noncyclical mastalgia 2.Specific breastconditions: • Breast cyst • Breast cellulitis (mastitis) . • Inflammatory breast cancer, • Ca. Breast
- 44. Investigations • Laboratory Studies –Routine – Special • Imaging Studies • Tissue diagnosis – Cytology • FNAC – Histlogy
- 45. Diagnostic Studies Imaging Studies •X-Ray: Mammography • USG • CT • Angiography • MRI • Endoscopy • Nuclear scan
- 46. MASTALGIA:MANAGEMENT • 1.Pain diary •2.Reassurance • 3.Exclude caffeine • 4.Low fat diet • 5.Stop OCPs/HRT • 6.stop smoking • 7.drugs
- 47. MASTALGIA:Drugs • Analgesics • Eveningprim rose oil • Goserelin • Prolactin inhibitor Bromocriptine, • Antigonadotrophin Danazol • Antioestrogen Tamoxifen
- 48.
- 49. Duct Papilloma • Proliferativebreast disease without atypia • Polyps of epithelium lined duct • Bloody discharge • Microdochectomy
- 50. Duct ectasia • Dilatationof the breast ducts associated with chronic inflammatory response in the periductal tissue • Greenish discharge • Duct excision
- 51. Breast Abscess /Mastitis •Flucloxacillin or co-amoxiclav • Support of the breast,local heat,& analgesics • Incision & drainage • Now recommended is repeated aspiration under antibiotics • Continue breast feeding.
- 52. MONDOR’S DISEASE • Thromboplebitisof superficial veins of the breast & chest wall • Aetiology not known • C/F – thrombosed subcutaneous cord • DD – breast cancer • Treatment – anti-inflammatory medication warm compresses & support restriction of movement symptoms persist - excision
- 53. Virginal Hypertrophy • Hugeenlargement. • Reduction mastoplasty • Mastectomy
- 54.
- 55.
- 56. MCQs Which of thefollowing is not a treatment for Phyllodes tumor?—karnataka 2007 A. Quadrantectomy B. Enucleation C. Wide local excision D. Simple mastectomy
- 57. MCQs Which of thefollowing is not a treatment for Phyllodes tumor?—karnataka 2007 A. Quadrantectomy B. Enucleation C. Wide local excision D. Simple mastectomy
- 58. MCQs Acute mastitis commonlyoccurs during? (DNB 2000) (A) Pregnancy (C) Lactation (B) Puberty (D) Infancy
- 59. MCQs Acute mastitis commonlyoccurs during? (DNB 2000) (A) Pregnancy (C) Lactation (B) Puberty (D) Infancy
- 60. MCQs • Surgery forperiductal mastitis - ,(MAHE 07) A. Hadfield's operation B. Patey's mastectomy C. Modified radical mastectomy D. None of the above
- 61. MCQs • Surgery forperiductal mastitis - ,(MAHE 07) A. Hadfield's operation B. Patey's mastectomy C. Modified radical mastectomy D. None of the above
- 62. MCQs • Bacteria mastitisis most often caused by - (a) Anaerobic bacteria (b) Staphylococcus (c) Streptococcus (d) Pneumococcus
- 63. MCQs • Bacteria mastitisis most often caused by - (a) Anaerobic bacteria (b) Staphylococcus (c) Streptococcus (d) Pneumococcus
- 64. MCQs • Following aretrue of pubertal mastitis except - – (a) Suppurates frequently – (b) Usually unilateral – (c) Subsides spontaneously – (d) Common in males
- 65. MCQs • Following aretrue of pubertal mastitis except - – (a) Suppurates frequently – (b) Usually unilateral – (c) Subsides spontaneously – (d) Common in males
- 66. Get this pptin mobile 1. Download Microsoft PowerPoint from play store. 2. Open Google assistant 3. Open Google lens. 4. Scan qr code from next slide.
- 67. • Lectures onedrive
- 68. Get this pptin mobile
- 69. Get my pptcollection • https://1drv.ms/u/s!AvOWIE3I3JkugQ7qQv9vsY 8pGHLf?e=CSNFK2 • https://t.me/surgerypresentation • https://www.slideshare.net/drpradeeppande/edit_m y_uploads • https://www.dropbox.com/sh/x600md3cvj85woy/ AACVMHuQtvHvl_K8ehc3ltkEa?dl=0 • https://www.facebook.com/doctorpradeeppande/?r ef=pages_you_manage • https://t.me/+eqNYT21gmWZjMjI9