MindMap Gallery Medical breast disease mind map
This is a mind map about medical breast diseases, mainly including breast examination, acute mastitis, cystic breast disease, breast tumors, etc.
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breast disease
Anatomy
Breast examination
Inspection
Observe whether the shape and size of the breasts on both sides are symmetrical/whether there is any bulge
palpation
order
Outer upper→Outer lower→Inner lower→Inner upper (the healthy side first→the affected side)
Palpate with palmar surface of fingers
Axillary lymph node examination
method
Ask the patient to abduct his upper limbs
Group
One group→axillary lymph nodes lateral to the pectoralis minor muscle
Group 2→Between pectoralis major and pectoralis minor muscles
Three groups → pectoralis minor internal test
Film degree exam
Mammography→Common imaging screening methods
Ultrasound → has advantages in detecting cystic lesions (can observe blood supply) (has advantages in detecting cystic changes)
Biopsy
gold standard
★★When suspected breast cancer needs to be resected, it is not advisable to do partial resection and biopsy, but complete resection.
acute mastitis
Cause (the main pathogenic bacteria is Staphylococcus aureus)
Milk stasis (conducive to bacterial growth and reproduction)
bacterial invasion
Broken/Cracked Nipples
Bacteria invade along lymphatic vessels
Directly invades the milk duct → ascends to the glandular lobule
Occurs more often in primiparous women
★Main causes
Milk stasis Bacterial invasion
clinical manifestations
Breast pain/local redness and swelling
local manifestation
Initially (appearance of cellulitis)
After a few days (abscess formation)
Retromammary abscess after ulceration
Abscess formation
Local fluctuating sensation B-ultrasound proves abscess formation
Puncture the place with the most obvious tenderness → draw pus (diagnostic indicator)
treat
cellulitis
Before abscess formation → antibiotic treatment (the main bacteria is Staphylococcus aureus)
Penicillin treatment of choice
Penicillin allergy → erythromycin
★Tetracyclines/glucosamine/quinolones can affect the fetus → banned
abscess formation
Abscess incision and drainage
superficial abscess
radial incision
deep abscess
Curved incision under the breast
Finger separation and drainage
★Cannot cut milk ducts for drainage
breast cystic disease
clinical manifestations
Soreness/lumps in one or both breasts
Often cyclical (obvious before menstruation/reduced after menstruation)
Single or multiple nodules of varying sizes/toughness in one or both breasts
There is tenderness and unclear demarcation
★Related to the menstrual cycle
concept
The formation of cysts of varying sizes around the glandular ducts (the cysts contain light yellow or brown fluid)
Intraductal papillary hyperplasia with cystic dilatation
best diagnosis
Biopsy
Breast tumors
concept
benign tumor
Fibroadenoma is the most common → papilloma
breast fibroadenoma
benign
intraductal papilloma
benign
Generally no symptoms
It usually attracts attention because nipple discharge contaminates underwear.
The liquid can be bloody/yellow/dark brown liquid
Small tumor/non-palpable mass
treat
Mainly surgery
Removal of milk ducts and surrounding breast tissue
breast sarcoma
Malignant (phyllodes tumors are more common)
Rare
breast cancer
clinical manifestations
Dimple sign (involving Cooper's ligament)
Orange peel (subcutaneous lymphatic vessels blocked by cancer cells)
★Inflammatory breast cancer → rare/but develops rapidly and has extremely poor prognosis (local skin inflammation-like changes → redness/edema/thickening/roughness)
transfer pathway
local metastasis
Spread along the duct
lymphatic metastasis
Can enter veins through lymph
blood supply diversion
Early metastasis to bone, lung, liver
Can directly invade the blood circulation
The most effective detection method
Mammography
treat
Surgical treatment
breast-sparing mastectomy
Purpose → Complete removal of the mass (tumor, 1-2cm around the tumor)
Applicable to stage 1 and 2 patients
Postoperative → Supplementary radiotherapy is required
modified radical mastectomy for breast cancer
Preservation of pectoralis major muscle Resection of pectoralis minor muscle
Preserve pectoralis major/pectoralis minor
Radical Breast Cancer Surgery/Extended Radical Breast Cancer Surgery
The entire breast, pectoralis major muscle, pectoralis minor muscle, axillary one, two and three groups of lymph nodes are removed, thoracic arteries and veins, peripheral lymph nodes
total mastectomy
Sentinel lymph node biopsy Axillary lymph node dissection
Replenish
inflammatory breast cancer
No breast pain/no pain in lymph nodes/rapid development/low body temperature
acute mastitis
Breast pain/tenderness/slow development/obvious fever
Replenish
Colorless discharge related to menstrual cycle
cystic hyperplasia
bloody liquid
intraductal papilloma
Ball-like elasticity, easy to push
breast fibroadenoma
Tumor with ill-defined borders
breast cancer