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GP Breast Diseases Education Forum 2021 

GP Breast Diseases Education Forum 2021 

GP Breast Diseases Education Forum 2021 

On Saturday 2nd October, we held our inaugural Perth Breast Cancer Institute (PBCI) GP Education Forum at the Pan Pacific Perth. As approved education providers with the RACGP, the event attracted CPD points for RACGP members. 

The program was aimed specifically at GPs as a vital part of the clinical team in the care of patients with breast cancer and other breast issues. The speakers were members of PBCI including our medical oncologists, oncoplastic breast surgeons, genetic counsellor, and breast physician as well as Dr Jo Lazberger from Perth Radiological Clinic who spoke about the role of MRI in the ongoing surveillance of women with dense breasts.  

The feedback was uniformly positive with many GPs commenting that the emphasis on multidisciplinary care and protocols for following up benign breast conditions would translate into their daily practice. 

During the presentations, attendees were able to send questions via text message. Here are some of the questions and the responses from the speakers: 

  1. Should we be avoiding MHT in pts with no hx breast ca but hx of papilloma/multiple fibroadenoma?
    (answered by Mr Richard Martin: Yes we should be cautious in giving HRT to women with a diagnosis Papillomas, Papillomatosis etc as they are at higher risk of developing Breast cancer and HRT is known  stimulant to breast tissue proliferation particularly Papillomas.)
  2.  Is there a lot of lymphoedema after SLNB?
    (answered by Dr Farah Abdul Aziz: The risk of lymphoedema is 2-5% after sentinel node biopsy, it’s a lifetime risk and patients need to be educated regarding prevention and seeking early management)
  3. Where is fat usually harvested from for grafts?
    (answered by Dr Kallyani Ponniah: Fat is usually harvested from the lateral thigh and anterior abdominal wall. It can also be harvested from the flanks and from the back.)
  4. Is there a place for mirena + topical oestrogen for menopausal symptoms?
    (answered by Dr Hilary Martin: The safety of this option has not been absolutely established in the breast cancer survivor population.  For patients on tamoxifen circulating oestrogen is blocked and so the effect of any topical oestrogen absorption should be counteracted by this but for those on aromatase inhibitors the mechanism of action differs and so there is still a theoretical risk from circulating oestrogen from the topical oestrogen.  Mirena also is generally not recommended for this population.  At an individual level it may be that the patient does decide to go with these options balancing risk against quality of life.)
  5.   Premenopausal ladies with menorrhagia/fibroids and wanting contraception Mirena safety?
    (answered by Dr Hilary Martin: We recommend removal of Mirena’s for patients with a history of hormone receptor positive breast cancer and avoidance therefore of future Mirena due to the systemic progesterone absorption.  Non-hormonal contraception is recommended.  Goserelin may be a suitable option for such patients with ovarian suppression, along with additional non-hormonal contraception.  Or potentially for those not planning any future pregnancy hysterectomy could be considered.  At an individual patient level there may be some who opt to continue to use Mirena weighing quality of life against their risk but would recommend avoiding this option if possible) 

The presentations were recorded and will be available to view by registered healthcare professionals soon. 

GP Breast Disease Education Forum

BCRC-WA are presenting a one day GP education event featuring specialists in breast care from Perth Breast Cancer Institute and Perth Radiological Clinic.

Topics will include:

  • Benign Breast Diseases
  • Diagnostics
  • Early Breast Cancer Contemporary Issues
  • Advanced Breast Cancer and Survivorship.
  • Panel discussion. Submission of interesting cases for discussion by the panel is encouraged

Lunch and morning/afternoon tea included. FREE EVENT for registered attendees.

This is a CPD Activity under the RACGP CPD Program

On Saturday 2 October 2021 at 9:00 AM to 3:30 PM

*Please note this Education Forum is not for the general public*

Lets talk about….Breast Cysts

Breast cysts are fluid-filled sacs inside the breast. They are usually benign (non-cancerous). They can be single or multiple and be present in one or both breasts. Some large cysts are palpable and feel firm to touch. Most cysts are small and only found on imaging. Breast cysts are commonly seen in women before menopause. Although less common after menopause, they can occur at any age and are sometimes seen in women taking hormone replacement therapy.

On examination, breast cysts are rounded with smooth edges. They sometimes feel like a small, tense balloon. Breast pain or tenderness over the lump or surrounding area can occur. Breasts cysts commonly undergo changes in size before and after the menstrual cycle. We don’t exactly know what causes breasts cysts but think they result from hormonal changes during monthly menstruation. The breasts are made up of glandular tissue that produces milk and a supportive framework consisting of fatty tissue and fibrous connective tissue. Breast cysts occur as a result of fluid accumulating within this glandular tissue.

Your doctor should check a new lump that persists or gets bigger. Rarely, breast cysts may develop an infection resulting in associated skin changes such as redness or increase warmth. These changes should be checked immediately. Diagnosis of breast cysts involves a clinical breast examination and ultrasound or mammogram. Occasionally, a sample of fluid from the cyst is required and is taken from the cyst through a needle; this is called Fine Needle Aspiration (FNA). On a mammogram, cysts appear as smooth rounded lumps. Further review with ultrasound can then differentiate these lumps into either fluid-filled simple cysts or solid lumps. Some cysts are partly fluid-filled and partly solid; these are called complex cysts. A complex cyst may require a further biopsy.

Simple breast cysts don’t require treatment, but large cysts may cause discomfort or pain. A simple outpatient drainage procedure often relieves these symptoms. A breast cyst can re-fill after it has been drained. Recurring cysts are not dangerous and are treated the same way. It is important to remember that there is no evidence that breasts cysts result in cancer. However, any breastrelated symptom or concerning finding on imaging will be investigated to rule out cancer.

For more information on breast cysts or other benign breast conditions visit our Resources page.