1. Approach to a breast Lump- what should you do in the clinic
2. Breast surgery in 2024- what are we doing
- Breast Conservation taken to new level- Oncoplastic breast surgery
- Axillary management- SLNB, LVA
- Whole Breast reconstruction- Autologous, Implants
Why do you need to know about breast ?
- Very common complaint- 3% of OPD of a general practitioner.
- OBGYN will usually be the first dept to be seeing breast patient.
- You will determine how quickly a breast malignancy is detected and how prompt treatment is started –making the huge difference in outcome.
Approach to a Breast Lump
- Breast lumps can be anything – a benign fibroadenoma or a ductal cancer
- 80% breast lumps presenting to clinic will be benign
Clinical examination
Exceptions
- Inflammatory Breast Cancer-Malignant lump, painful, associated with warm, erythematous, edematous, inflamed skin – can be mis-diagnosed as breast abscess.
- Phyllodes tumour- well defined, mobile, firm, overlying skin usually free (stretched and shiny with dilated veins in case of large lump) often mis-diagnosed as fibroadenoma especially in initial stages when small. Ultrasonography features are also similar to Fibroadenoma.
- Granulomatous mastitis– mimics breast cancer. Presents as a breast lump- irregular, firm to hard, associated with skin tethering and nipple retraction.
Imaging- BIRADS
Pathology- Tissue diagnosis
- FNAC
- Trucut Biopsy
- VABB
- Excision biopsy
Common Differentials – Benign
Common Differentials – Malignant
