00:01
Our first benign tumor
here will be fibroadenoma.
00:05
Characteristics:
Small, mobile,
firm mass with sharp edges.
00:10
This is well encapsulated.
00:13
Small, maybe freely mobile.
00:16
Who is your patient?
Young female.
00:18
Just like fibrocystic change.
00:21
Both of these
patients are young.
00:25
Increase in size and tenderness
with increased estrogen.
00:28
Here once again,
we’re looking at hormonal
type of changes.
00:33
Fibrocystic change,
we did the same.
00:35
Not a precursor for
breast cancer.
00:37
True benign tumor.
00:40
Then we have a papilloma,
intraductal papilloma.
00:44
What’s occurring here?
A small tumor that grows
in the lactiferous duct.
00:48
So if you’re clearly not
at all good with your --
as I said, your
breast apparatus,
I’ll bring this to
your attention.
00:55
But if you want to get
ahead a little bit,
at least take a look at
what’s your breast --
and what it looks like as we go
from the nipple back to the stroma.
01:02
Your lactiferous duct would be –
well, as the name implies,
lactiferous means milk.
01:08
So you have your
lactiferous sinuses
that are responsible
for ejecting the milk
so that the nipple, when the
newborn is ready to suckle,
the milk then comes out with the help
of oxytoxin and company, correct?
What happens here is that
the lactiferous duct
may then undergo, well,
in other words, a tumor.
01:28
And so therefore when that happens,
you can imagine that this --
you call this a papilloma.
01:33
So you can actually
call this a tumor.
01:36
Now the notes are the
following, it’s important here.
01:38
Here, this is a benign tumor.
01:40
However, the nipple discharge
here will be bloody.
01:43
So if therefore, if your
female patient tells you
that her shirt, her undershirt or
whatnot or even her bras and such,
when she takes of her bras, that
she finds blood in her breasts.
01:56
At first, you are a little –
oh actually not just a little --
you’re very much concerned
and you want to rule out
breast cancer, correct?
However, at the same time,
if you do a mammography
and then perhaps you’ll find
that it’s intraductal papilloma.
02:11
Serous and bloody
nipple discharge,
slight increase in the
risk for breast cancer.
02:17
But for the most part, benign.
02:19
Intraductal papilloma.
02:21
We have phyllodes tumor.
02:23
A phyllodes tumor.
02:24
Well, here, what I’d like you
to do is compare and contrast
your fibroadenoma
to phyllodes.
02:32
It’s pretty much a
derivative of it.
02:34
I’m not going to spend a
lot of time with this.
02:36
Understand that the
description here
in the clinical characteristics
will be quite different.
02:42
If it’s small and fibroadenoma,
it will be large and bulky.
02:46
In fact, we call this
“leaf-like projections”
and you might have cysts.
02:54
Characterstics become of utmost
importance for you with phyllodes.
02:58
I would know fibroadenoma
in greater detail.
03:01
Most common with phyllodes
will be in the?
Look at your age group here.
03:05
If it’s a patient who’s a young
female, with fibroadenoma.
03:09
Your patient with phyllodes will be
an elderly patient, sixth decade.
03:13
And with phyllode tumor,
because of a larger size,
there might be a greater chance
of going onto breast cancer.
03:20
So as you go through phyllode,
you’re comparing and contrasting
this with fibroadenoma.
03:24
When you go into fibroadenoma,
you’re comparing and contrasting
this with fibrocystic change.
03:29
And if you’re thinking
about bloody nipple,
maybe perhaps and hopefully
it’s just a benign tumor
known as an intraductal papilloma
by the lactiferous sinus.