Your patient is a 64-year-old female who presents with complaints ...

[swpotter12]

Your patient is a 64-year-old female who presents with complaints of a red, scaly rash on her nipple and areola of one breast. It has been present for a few months. There is no mass or nipple discharge. You should be suspicious of:
 
  A. Contact dermatitis
  B. Mastitis
  C. Paget's disease
  D. Eczema

Question 2

A 52-year-old female complains of discharge from one of her breasts. There is no pain, no mass, and no skin changes. The physical examination is normal.
 
  When putting pressure on the affected breast, the nipple expresses a small amount of thick, white discharge. These findings are consistent with:
  A. Duct ectasia
  B. Mastitis
  C. Fibroadenoma
  D. Fibrocystic breasts

[nicoleclaire22]

Answer to Question 1

ANS: C
In Paget's disease of the breast, the patient may describe the persistence of skin changes for several months. The typical presentation involves skin changes of the nipple and/or areola, with the nipple being involved first. The condition does not always involve a palpable mass or nodule. The skin changes of the nipple and areola range from scaling redness to various degrees of ulceration.

Answer to Question 2

ANS: A
Discharge from one breast is commonly benign and frequently caused by duct ectasia or an intraductal papilloma. Duct ectasia results in dilation of one major breast duct and causes approximately one-third of the cases of pathological discharge. Papillomas are responsible for 44 of pathologic discharge. Because the discharge associated with ductal ectasia is often stagnant, the discharge is cheesy in appearance. It is often associated with noncyclic breast discomfort and a subareolar lump at the site of the dilated duct. Because one major duct is involved, the discharge comes also from one duct or nipple area.