Baghdad College of Medicine / 4
th
grade
Student’s Name :
Dr. Tariq Al-Obaidi
Lec. 6
DISEASES OF BREAST
Mon. 28 / 12 / 2015
DONE BY : Ali Kareem
مكتب اشور لالستنساخ
2015 – 2016
Diseases of Breast Dr. Tariq Al-Obaidi
2015
2
©Ali Kareem 2015-2016
Diseases of Breast
Diseases of the nipple : absence of the nipple is rare and usually associated
with amazia. Supernumerary nipples not un commonly occurs along a line
extending from the anterior fold of the axilla to the fold of the groin this is
called milk line.
Retraction of the nipple : this may be occurred at puberty or later in life in
puberty is called simple nipple inversion and of unknown etiology. It might
be bilateral in 25%, usually it cause problems with breast feeding and
infection can occur specially during lactation, recent retraction of nipple
may be of considerable pathological significance.
Discharge of the nipple : it can occur from one or more lactiferous ducts,
management depends on the presence of lump and presence of blood in
discharge from single duct. Mammography is done to exclude presence of
underlying mass. Cytology is useful to exclude malignancy. a clear serous
fluid means physiological in parous women, or it might associated with duct
papilloma or mammary dysplasia.## blood stained discharge occurs in duct
papilloma, duct carcinoma and in duct ectasia. Black or green secretion
usually occurs in duct ectasia. Treatment: carcinoma should be excluded by
occult blood and cytology. Surgical treatment of single duct is done by
excision of the duct by microdecotomy, or multiple duct excision by core
excision of major ducts.
Diseases of Breast Dr. Tariq Al-Obaidi
2015
3
©Ali Kareem 2015-2016
o Discharge from the nipple
o ------------------------------------------------------------------
o associated with lump no lump present
o remove the lump localized to one duct from many
ducts
o Microdecotomy Hb+ve
Hb-ve
o over40 year under 40 years
observe and repeat
o core excision
o discharge disappear
o Locloised tone duct--
microdectomy
o Lump appears---
lumpectomy
Diseases of Breast Dr. Tariq Al-Obaidi
2015
4
©Ali Kareem 2015-2016
Gynecomastia : hypertrophy of a male breast, may be unilateral or
bilateral. The breast enlarges at puberty and sometimes present the
characteristic female breast causes
(1) Hormonal cause as in patient with carcinoma of prostate and treated by
stilbestrol (now rarely used), in teratoma of the testis, anarchism, after
castration, bronchial carcinoma, adrenal and pituitary disease and using
of steroids in young body builder.
(2) associated with leprosy due to bilateral testicular atrophy.
(3) associated with liver failure as in cirrhosis due to failure of metabolism
of estrogen.
(4) drugs as cemitidine, digoxine and spirenolactone.
(5) Klinefelter, s syndrome: sex chromosome anomaly has 47 XXY trisomy.
Treatment : reassurance, drugs as dostinix (antiprolactin), parlodel, or
surgery by mastectomy with preservation of nipple and areola.
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