Benign Breast disease

Breast Anatomy Mammary tissues represents anatomically mature modified sweat glands. Lobule is the basic structural unit of mammary gland. 10 to over 100 lobules empty in lactiferous duct. Lymphatics of breast drain predominently in axillary and internal mammary lymph nodes.

Investigations Mammography. Ultrasound. MRI. Needle biopsy | Cytology. Triple assesment.

Classification of Benign Breast DiseasesCongenital diseases Injury Inflammation and Infections ANDI (Aberrations of normal development and involution) include. Cyclical nodularty and mastalgia. Cyst Fibroadenoma Duct ectasia\Periductal mastitis. ectasia\ Pregnancy related Galactocele.

Bacterial Mastitis Most common variety Caused by staph aurus Associated with lactation. Treated with antibiotics. If infection did not resolve within 48 hrs then I/D done.

Operative drainage of Breast Abscess Under local Anesthesia, a circumareolar incision or radial incision over affected part given. Then long artery forcep is then inserted in to abscess cavity and all loculi that can be felt are entered. Finally a finger is introduced and remaining septa are disrupted. Ribbon gauze inserted with in abscess cavity.

Duct Ectasia/Periductal Mastitis This is dilatation of breast ducts associated with periductal inflammation. C/F include Nipple discharge,Subareolar mass,Abcess,Mammary duct fistula,Nipple retraction. Treated with Antibiotics 2nd option is Excision of all major ducts (hadfield operation).

ANDI Disturbances in the breast physiology that occur thru out a woman's reproductive life, and superimposed upon this, cyclical changes thru out the menstrual cycle, which results in an extreme of normality to well defined disease. Disease consist of four features,cyst formation,fibrosis,hyperplasia, papillomatosis. C/F lumpiness and breast pain. Cyclical mastalgia treated with Danazole (antigonadotrophin)100mg tds. Non cyclical mastalgia with analgesics.

Breast Cyst Most common in last decade of life. Multiple ,may be bilateral and can mimic malignancy. Diagnosis confined by Aspiration or u/s. Solitary cyst or small collection of cyst can be aspirated. 30% will recur and require reaspiration. If fluid is blood stained a core biopsy or local excision for histological diagnosis is advisable, this exclude cystadenocarcinoma.

Fibroadenoma Most common in young females of age 15 to 25. They aride from hyperplasia of single lobule,usually group up to 2-3 cm in size. 2 Surrounded by a capsule and can be enucleated through cosmetically appropriate incision.

Phyllodes tumor Benign Tumor. Previously known as serocystic disease of Brodie or cystosarcoma phyllodes. Usually occur in women of >40 y of age. Present as a large,sometimes Massive tumor with an unevenly bosselted surface. Mobile on chest wall. If tumor is benign type then enucleation or wide local excision done Massive tumor,recurrent tumor,malignant tumor,then Mastectomy done.

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