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Benign Breast Diseases
By: Ismah Haron & Hamidah Aziz
1
Part 1: Outline
• Fibroadenosis/fibrocystic disease
• Fibroadenoma
• Giant fibroadenoma
• Phyllodes tumor
• Traumatic fat ...
Case 1
• Madam Z, 40 y/o presented with multiple lumps
at right breast that associated with cyclical pain.
PE revealed sof...
4
http://www.ultrasound-images.com/breast.htm
Hypoechoic, well defined mass with a few
anechoic spaces
Fibroadenosis: loca...
• If aspirated fluid is blood stained or cyst recur
many times core biopsy or local excision
• Exclude cystadenocarcinoma...
Case 2
• Miss Y, 22 y/o presented with a small painless
mobile lump at right breast that not increased in
size. She is oth...
7
http://medicalcenter.osu.edu
Fibroadenoma: benign overgrowth of lobule of the breast (common: <30 y/o)
8
Ultrasonogram demonstrates a
hypoechoic mass, well defined margin
Craniocaudal mammograms
demonstrate a mass in the oute...
Giant fibroadenoma
9
Ultrasound images of the left breast in a 15 y/o girl
show a large (the mass measured 8.2 cms.), hypo...
• Occasionally during puberty
• >5 cm in diameter
• Rapidly growing
• Excision
• Potential for malignancy is low
10
Povosk...
Case 3
• Miss X, 48 y/o admitted with small breast lump
had been present over many years and had
started to enlarge in the...
12
• Right breast showing a large
fleshy tumour protruding from
the lower outer quadrant with
most of the remaining breast...
• Diagnosis:
Phyllodes tumor
▫ Rare breast tumor that forms from the connective
tissue of the breast.
▫ Benign, malignant ...
Traumatic fat necrosis
▫ Fibrosis
▫ Local hematoma/bruising
▫ Calcification
• New, painless/painful breast lump
• Poorly d...
Summary
15
P. Youssefi, et al. Mind Maps in Surgery
Benign breast disease
(part 1)
• Middle age, > 40 y/o
• Slow growing, ...
Other references:
1. Bailey & Love’s Short Practice of Surgery 25th edition
2. Oxford Handbook of Clinical Surgery 3rd edi...
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benign breast disease

  1. 1. Benign Breast Diseases By: Ismah Haron & Hamidah Aziz 1
  2. 2. Part 1: Outline • Fibroadenosis/fibrocystic disease • Fibroadenoma • Giant fibroadenoma • Phyllodes tumor • Traumatic fat necrosis 2
  3. 3. Case 1 • Madam Z, 40 y/o presented with multiple lumps at right breast that associated with cyclical pain. PE revealed soft and fluctuated lumps. • Fibroadenosis/fibrocystic disease • Triple assessment • Reassurance, cyst aspiration, hormone manipulation e.g. COC pill 3
  4. 4. 4 http://www.ultrasound-images.com/breast.htm Hypoechoic, well defined mass with a few anechoic spaces Fibroadenosis: localized fibrosis, inflammation, cyst formation and hormone driven breast pain (15-55 y/o)
  5. 5. • If aspirated fluid is blood stained or cyst recur many times core biopsy or local excision • Exclude cystadenocarcinoma 5
  6. 6. Case 2 • Miss Y, 22 y/o presented with a small painless mobile lump at right breast that not increased in size. She is otherwise well. PE revealed fixed, firm, well defined margin, freely mobile breast lump. • Fibroademona • Triple assessment • Treatment depends on its size <3 cm: reassurance >3 cm: excision 6
  7. 7. 7 http://medicalcenter.osu.edu Fibroadenoma: benign overgrowth of lobule of the breast (common: <30 y/o)
  8. 8. 8 Ultrasonogram demonstrates a hypoechoic mass, well defined margin Craniocaudal mammograms demonstrate a mass in the outer part of the breast http://emedicine.medscape.com/article/345779-overview 2 cm
  9. 9. Giant fibroadenoma 9 Ultrasound images of the left breast in a 15 y/o girl show a large (the mass measured 8.2 cms.), hypoechoic and well defined mass http://www.ultrasound-images.com/breast.htm
  10. 10. • Occasionally during puberty • >5 cm in diameter • Rapidly growing • Excision • Potential for malignancy is low 10 Povoski World Journal of Surgical Oncology 2007 5:124 http://www.indianpediatrics.net/jan2005/jan-72.htm Enlarged right breast due to fibroadenoma
  11. 11. Case 3 • Miss X, 48 y/o admitted with small breast lump had been present over many years and had started to enlarge in the last 3 months. The lump is mobile. • She was single and nulliparous but without a family history of breast cancer 11
  12. 12. 12 • Right breast showing a large fleshy tumour protruding from the lower outer quadrant with most of the remaining breast also containing tumour. • The surrounding skin although bluish is not oedematous • A large heterogeneous mass of 5.6 x 3.4 cm with multiple lobulations and cystic spaces also present. • The appearance of the tumour was leaf like in its internal architecture http://casereports.bmj.com
  13. 13. • Diagnosis: Phyllodes tumor ▫ Rare breast tumor that forms from the connective tissue of the breast. ▫ Benign, malignant or borderline by histological ▫ Surgical removal  Benign:- removing the mass and a 2 cm area of normal breast tissue from around the tumor.  Malignant:- removed with a wider margin of breast tissue or by total mastectomy if needed 13 Tumor
  14. 14. Traumatic fat necrosis ▫ Fibrosis ▫ Local hematoma/bruising ▫ Calcification • New, painless/painful breast lump • Poorly defined margin lump • History of trauma • Triple assessment • Resolved spontaneously, excision biopsy 14 http://www.makemeheal.com
  15. 15. Summary 15 P. Youssefi, et al. Mind Maps in Surgery Benign breast disease (part 1) • Middle age, > 40 y/o • Slow growing, smooth, large, big enough to cause skin necrosis, unevenly surface • Potentially malignant • Rx : surgical removal Phyllodes tumor
  16. 16. Other references: 1. Bailey & Love’s Short Practice of Surgery 25th edition 2. Oxford Handbook of Clinical Surgery 3rd edition 16
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