58 T_h e breast

Acute inflammation of the breast Mastitis refers to inflammation of the breast tissue that may or m...

BENIGN BREAST DISEASE Nomenclature The nomenclature of benign breast disease in the past has bee...

Breast cancer in pregnancy Pregnancy is associated with aggressive tumour biology such as TNBC. U...

CARCINOMA OF THE BREAST Breast cancer is the most frequent cancer among women, with an estimated ...

COMPARATIVE AND SURGICAL ANATOMY The breast in adult females overlies the pectoral region, extend...

Carcinoma of the male breast Carcinoma of the male breast ( Figure 58.39 ) accounts for less tha...

Clinical features The most common manifestations of ANDI are breast pain and benign nodularity ....

Clinical presentation A discrete lump in the breast is the most common presentation, and the most...

Congenital abnormalities Amazia Congenital absence of the breast may occur on one or both sides....

Cracked nipple This is observed in about 10% of nursing mothers and is thought to arise from the...

Discharges from the nipple Most nipple discharges are caused by physiological aberrations as part...

Discrete lumps in the breast The main causes of discrete lumps in the breast are listed in Summa...

Eczema Eczema of the nipple and areola is a rare condition and is often bilateral; it is usually...

FURTHER READING Amin MB, Edge S, Greene F et al . (eds). AJCC cancer staging manual , 8th edn. Ch...

Follow-up of operable breast cancer Follow-up after initial therapy routinely includes clinical e...

Haematogenous spread 5 At a tumour size of 1–2 /uni00A0 mm (10 cells) neoangiogenesis occurs. Th...

Hereditary and familial breast cancer Hereditary breast cancer (HBC) runs in families, a ff ect -...

INVESTIGATIONS FOR BREAST SYMPTOMS The assessment of women presenting with symptomatic breast di...

Injuries of the breast Haematoma Haematoma, particularly a resolving haematoma, gives rise to a l...

Introduction No content extracted automatically.

Learning objectives To understand: Appropriate investigation of breast disease • Aberrations of N...

Lymphatic metastasis This occurs mainly to axillary lymph nodes. Tumours from the inner half of ...

Macromastia Macromastia is a benign disorder characterised by massive enlargement of one or both...

Magnetic resonance imaging MRI of the breast ( Figure 58.9 ) is useful in a number of settings: ...

Mammography Mammography in two planes and ultrasonography are the first line investigations for im...

Management of local recurrence The local recurrence should be biopsied as a change in receptor s...

Mastalgia Approximately 50–70% of women attending any breast clinic present with mastalgia (syno...

Mastitis of infants Mastitis of infants may occur in both boys and girls. It is uncommon and is ...

Metastatic carcinoma of the breast (stage IV) Treatment of metastatic cancer is aimed at palliat...

Needle biopsy Tissue for histological examination can be obtained under local anaesthesia using a...

Nipple inversion and retraction At birth the mammary glands in boys and girls are similar. At aro...

Nodular or lumpy breasts Patients who present with painful tender nodularity with mastalgia shoul...

Paget’s disease Paget’s disease is a unique type of DCIS arising in the nipple. It presents as e...

Papilloma of the nipple Papilloma of the nipple has the same features as any cutaneous papilloma...

Pathology This can be considered in three phases: lobule development at 15–25 years, cyclical cha...

Polymazia Accessory breasts ( Figure 58.22 ) have been recorded in the axilla (the most frequent ...

Positron emission tomography Positron emission tomography (PET) scans are used as a staging inves...

Retention cyst of a gland of Montgomery These glands, situated in the areola, secrete sebum. If ...

Risk factors There are several factors known to increase the RR for developing breast cancer. The...

Sarcoma Sarcomas, most commonly fibrosarcoma and angiosarcoma, may arise de novo from the mesenchy...

Screening for breast cancer Screening for breast cancer involves a highly sensitive diagnostic te...

Spread of cancer Local spread The tumour increases in size and invades adjacent breast parenchyma...

Staging of breast cancer Staging refers to the process of finding out the extent of tumour. The ...

Subacute and chronic inflammation of the breast Non-lactational mastitis Non-lactational mastitis ...

THE NIPPLE Absence of the nipple is rare and is usually associated with amazia (congenital absen...

Treatment of breast cancer The treatment of breast cancer is multimodal (includes surgery , syst...

Triple assessment Patients presenting with a breast lump, nipple discharge or other symptoms are ...

Ultrasonography Ultrasonography is the primary imaging modality in young women with dense breast ...

Vacuum-assisted biopsy The sampling error decreases as the biopsy volume increases and using 8G o...

Work-up for metastatic breast cancer Contrast-enhanced CT of the chest, abdomen and pelvis and a...