(Clinical Imaging) (Surgery)

Overview

• Second most common malignancy in women
• Peak Incidence → postmenopausal, incidence increases with age (50% of breast cancers are diagnosed in women >65)
• Risk Factors → increased exposure to oestrogen (not having kids, early menarche <13yrs, late menopause >51yrs, obesity, COCP, HRT), smoking, alcohol consumption, family history of breast cancer, increasing age
• Genetics → BRCA-1 and BRCA-2 genes
• Different Types → Ductal carcinoma in Situ (DCIS - Noninvasive), Invasive ductal carcinoma (Most Common)

NHS Breast Screening Programme ⇒ mammogram every 3 years for women 50-70 yrs old

Making Diagnosis

Clinical Features:

• Breast Lump → single, nontender, poorly defined margins, painless, hard mass usually located in upper outer quadrant
  • May be fixed to deep tissue
• Changes in breast shape → asymmetric breasts
• Nipple Discharge → may be bloody (single duct more concerning than multiple duct)
• Axillary Lump → due to lymphadenopathy
• Lump is firm & rigid → doesn't change shape upon compression
• Paget’s Disease of the Nipple ⇒ eczema-like hardening of the skin on the nipple (usually caused by ductal carcinoma in situ infiltrating the nipple).