Benign Breast disorders 4

3.5 FIBROADENOMA

Firm well defined painless lesion.

this is a benign tumour and is usually present in young females.

The lump is :

   *  Freely mobile

   *  Non Tender

and there is:

   *  No nipple distortion

   *  No discharge

   *  No lymph gland enlargement

Treatment is the removal of the lump

 

3.6 Phylloides Tumour also named cystosarcoma phylloides is  most

often a benign unilateral enlargement of the breast normally seen

in women over 40 years.  It can also occur in young females.  Can

ulcerate but remains mobile on chest wall (no adherance). 

 

It is a variant of fibroadenoma showing rapid growth and assuming

giant size.

 

and  gives  rise  to  local recurrence  if  there  is  incomplete

removal.

 

About 10% of these lesions produce metastasis.

 

TREATMENT

By surgical excession.

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Benign Breast disease 3

OTHER BENIGN LESIONS

3.4  Mammary dysplasia : (Fibrocystic  disease,Chronic  mastitis,

Fibroadenosis)

Patients usually present with complaints of  pain,

tenderness  and small lump in any part of the breast usually  the upper  and  outer quadrant there may be more than one  lump 

The lesion may be bilateral, the disorder is suspected to be due to hormonal imbalance probably excess estrogen and low  progestogens (anovular cycle).

 

Clinical features include :

   *  Middle aged females

   *  Pain and lump in both breasts

   *  Pain worst in premenstrual period

   *  15% have nipple discharge

   *  On Examination:

      a)  Tenderness is present

      b)  More than one ill-defined lump

      c)  Felt best with tip of fingers rather than flat of the

          hand

      d)  Cysts may feel firm and palpable with flat of the hand

      e)  There are no lymph glands in the axilla

A mammogram is required.

A fine needle aspiration cytology, or a biopsy may be required to

eliminate the possibility of carcinoma.

 

TREATMENT

Is  for symptom of pain.

 Hormone progesterone or danazol  may  be

prescribed.

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Breast Disorders Benign 2

 

3.2 Nipple Discharge

 

This  occurance  in  a  non-lactating  female  is  a   disturbing

complaint  for the patient.  
If it is a blood colored  discharge,

it  needs  follow up.  
If there is no palpable lump  and  nothing

detected  on a mammogram.  
There may be a small pappiloma in  one

of the ducts.  If the discharge is from both nipples it should be

investigated for hormone levels especially prolactin.

 

3.3 GYNECOMASTIA

This term refers to the development of female type breast  tissue

in pubertal boys it is seen frequently between the ages of  13-17

years.   This  disappears and is treated by  reassurance.   Where

this  occurs on both sides a cause must be looked for. Among  the

areas to be investigated are:

   1.  Liver for function(estrogen levels can be high in cirrhosis

   2.  Exogenous estrogen intake

   3.  External genitalia(for any signs of ambiguity of

       genitalia or testicular tumours)

 

If no cause is found and there is pain or  
the size is large surgical excision is required

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Breast disorders benign

2. CONGENITAL AND DEVELOPMENTAL DISORDER

Extra  Breast  tissue may be found anywhere along the  milk  line

(mid-clavicular to midinguinal point) 

These supernumerary breasts may or may not have a nipple. 

Absence  of  breast development (amastia) is  a  rare  occurance. 

Unilateral underdevelopment of breast is more commonly observed.

3. BENIGN BREAST DISEASE

3.1 BREAST ABSCESS

Acute  mastitis occurs most often in the first fourteen  days  of

lactation,the   infecting   organisms   are   Staphylococcus   or

Streptococci  and they enter through an injury to the  nipple  or

through the opening of the lactiferous ducts.

The patient presents with a :

   *  Firm tender mass in the breast

   *  Fever and toxaemia

   *  Local redness and cellulitis

Treatment includes

   -  Stoppage of breast feeding

   -  Use of breast pump to relieve engorgement with milk.

   -  Antibiotics

   -  Drainage of abscess (with a radial incision is required

      

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