00:01
Acute mastitis, inflammation.
00:04
What then happens here?
Well, now at this point the newborn
is suckling on the nipple.
00:08
And while suckling,
well, perhaps the newborn ends up
biting on the nipple too hard.
00:13
At this point, there’s an introduction
of a laceration into the nipple,
when such laceration
takes place,
the number one organism that
you want to keep in mind
or a very common organism
that you want to keep in mind
with entry into the nipple
and thus causing acute
mastitis will be Staph aureus.
00:31
Usually, unilateral.
00:33
You have a newborn that
basically is suckling on one
causing lesion, localized area
of inflammation, acute mastitis.
00:42
May then form abscesses
as you can imagine
because this is a
bacterial infection.
00:47
And to the point where what
you want to pay attention to,
is that whenever
there’s inflammation
and if you’re
thinking abscesses,
because inside the abscess,
all the neutrophils
releasing an enzyme causing
liquefactive necrosis
within the abscess,
localized in that
area of the abscess,
perhaps it appears
purulent or yellow-like.
01:09
However, the surrounding
tissue as you can imagine,
whenever there’s an
inflammatory process,
you would expect there
to be erythema.
01:15
Diffuse spreading of the
infection is a possibility.
01:21
Other breast
inflammatory syndromes.
01:24
I want you to break
up this name here.
01:28
Mammary,
duct,
ectasia.
01:31
Ectasia means enlargement.
01:34
Good. Or dilation.
01:36
What is being dilated?
The duct.
01:38
Why?
Let’s take a look.
01:40
It occurs most commonly in the
fifth or sixth decade of life.
01:44
Usually postmenopausal.
01:46
Usually in multiparous women,
presents with palpable periarealoar
mass with skin retraction.
01:54
So what exactly
is occurring here?
Well, there’s every
possibility that
there might be an
inflammatory process.
01:59
During the inflammatory
process, there might be
increased dilation or
ectasia of the mammary duct
and during the repair process,
what does that mean to you?
Fibrosis or scar formation.
02:10
If there is fibrosis or scar formation,
you can only imagine that now –
Remember, a scar always
is going to contract
the respective muscle or
the respective tissue.
02:20
Here, the respective tissue
might be the nipple.
02:22
It literally is then going
to cause skin retraction.
02:25
Do not confuse this with
breast cancer, is that clear?
This is mammary duct ectasia.
02:31
Thick, cheesy nipple secretion.
02:34
You’re thinking about an
inflammatory process.
02:39
Here we have focal necrosis
of fat, tissue, and breast.
02:42
Here, remember
in basic pathology, you
have learned about necroses
and the specific necrosis
you’re paying attention
would be fat necrosis.
02:52
Under fat necrosis, you
then divide it into
enzymatic and traumatic
fat necrosis.
02:57
This obviously is going to be an
example of traumatic fat necrosis.
03:02
In a lady with breasts,
she has increased amounts
of adipose tissue.
03:06
If she gets into an accident,
in which then let’s say,
she’s driving a car
and she hits a tree.
03:12
And at this point, there’s trauma
that’s being introduced to the breast.
03:15
What kind of necrosis are
the breasts undergoing?
Good.
03:19
Trauma or traumatic
fat necrosis.
03:23
When there’s such
necrosis taking place,
obviously, there might be
hemorrhage into the
early stages of the
lesion.
03:29
Next,
you want to be able to identify and
understand the description of
the traumatic fat necrosis.
03:36
At this point,
all of the ill-defined nodule
of gray-white firm tissue
containing small foci,
what then accumulates with any type
of necrosis if there’s enough damage?
Oh, there might be calcium
So whenever calcium accumulates,
then you can expect
that to be chalky white
white or perhaps
hemorrhagic debris.
03:56
All components of necrosis,
use common sense,
understand that whenever
there’s damage to tissue,
there’s surrounding blood vessels
which may then leak into it
or perhaps enzymes
that come into play
and causing liquefactive
type of necrosis.