Peau d’orange (orange peel skin)
Lymphatic obstruction from breast cancer
Skin dimpling when arms raised
Cooper ligament involvement → breast cancer
Most common breast cancer
Invasive ductal carcinoma
Single-file infiltration pattern + bilateral disease
Invasive lobular carcinoma
Microcalcifications on mammogram
Ductal carcinoma in situ (DCIS)
Red, swollen breast + peau d’orange + rapid onset
Inflammatory breast cancer
Breast looks like mastitis but no response to antibiotics
Inflammatory breast cance
Eczematous nipple rash + crusting + itching
Paget disease of nipple
Young woman + painless + highly mobile lump
Fibroadenoma
Breast mouse
Fibroadenoma
Painful lump that fluctuates with menstrual cycle
Breast cyst / fibrocystic change
History of trauma + firm irregular breast lump
Fat necrosis
Breast pain + fever + breastfeeding
Mastitis (usually Staph aureus)
Breastfeeding woman + fluctuant painful lump + fever
Breast abscess
Bloody nipple discharge + small subareolar mass
Intraductal papilloma
Milky nipple discharge (not breastfeeding)
Galactorrhoea → think hyperprolactinaemia
Early menarche + late menopause
↑ Lifetime oestrogen → breast cancer risk
First investigation in women <35 with breast lump
Breast ultrasound
Most common lymph node involved in breast cancer
Axillary lymph nodes
Mastitis not improving after 48 hours antibiotics
Breast ultrasound → rule out abscess
ER-positive breast cancer (premenopausal)
Tamoxifen
HER2 positive breast cancer
Trastuzumab
ER-positive breast cancer (postmenopausal)
Aromatase inhibitor (e.g. anastrozole)
or
Letrozole
multinucleated giant cells with calcification
fat necrosis of breast
