Syllabus

Breast diseases (lecture-3hrs, SDL-3hrs)

Concept
[Teaching Aim]
1.Understand the relationship between breast with Zang Fu organs and meridians and collaterals.
2.Understand the clinical breast physical examination method.
3.Master the characteristics of etiology and pathogenesis of breast diseases.
4.Master the syndrome differentiation and therapeutic principle of breast diseases.
[Teaching Content]
1.Introduce the relationship between breast with Zang Fu, meridians and collaterals.
2.Physical Examination of breast : Upon inspection, examiner should focus on the size of breast, the position of nipple, sinking and protrusion of nipple, skin colour,etc. Upon palpation, learn the sequence of palpation,and examiner should check whether there are masses or swelling of the breast, location, size, shape, texture, tender, abnormal discharge of the nipple and etc.
3.Etiology and pathogenesis: Suppurative breast diseases mostly caused by damage to the nipple, infected by pathogenic toxin or fatty sweet diet, heat in the spleen and stomach, breast milk stagnation, trouble in excretion, prolonged stagnation transformed into heat, putridity transformed into pus. Tumor related breast diseases are due to emotional injury, over thinking and depression, liver and spleen is damaged and therefore causes Qi stagnation and phlegm congealing.
4.Treatment:
（1）Internal therapy: Treating according to syndrome differentiation based on different disease stages, Zang Fu organs and meridians and collaterals involved and the excess or deficiency of Qi and blood.
（2）External therapy: Choose different medication medicinal forms according to yin syndrome and yang syndrome;choose different external treatment according to disease stages, introduce the indication and time of surgery.
[Teaching Method]
Multimedia lecture.

Acute Mastitis
[Teaching Aim]
1.Master the definition and clinical manifestation of acute mastitis.
2.Master the methods of treatment by stages and combined internal and external therapy of acute mastitis.
3.Acquainted with the etiology and pathogenesis of acute mastits.
[Teaching Content] 1. Concept: This disease tends to occur during breast-feeding period, mostly found in post-labour women. Clinical features include breast mass,pain and swelling,thick pus after rupture, accompanied with systemic symptoms like chills, fever,etc.
2. Etiology and pathogenesis: Exogenous factor can be invasion of pathogenic toxin. Endogenous factor can be stagnation and accumulation of breast milk, Liver depression and Stomach heat accumulation.
3. Syndrome differentiation: Disease progresses from early stage, middle stage to late stage.
4. Treatment:
(1) Internal therapy:Soothe the liver,clear the stomach, unblock collaterals in the initial stage,clear heat and remove toxins and pus in the middle stage,supplement Qi,harmonize ying-nutrients,remove toxins and promote tissue regeneration in the late stage.
(2) Local management: Apply medication therapy in the early stage,apply incision therapy after pus formation,use drainage and cotton pad method after rupture to promote tissue regeneration.
[Teaching Method]
Multimedia lecture

Plasma Cell Mastitis
[Teaching Aim]
1.Master the definition and clinical manifestation of plasma cell mastitis.
2.Acquainted with the differential diagnosis of plasma cell mastitis.
3.Acquainted with the treatment principles of plasma cell mastitis.
[Teaching Content]
1. Concept: This disease is a chronic suppurative condition occurring neither during lactation nor pregnancy..
2. Clinical manifestations:nipple retraction or nipple discharge in the initial stage,with painful breast lumps,coupled with pus containing comedo-like secretions after rupture,breast fistula is commonly seen after rupture and it is difficult to heal.
3. Differential diagnosis: Acute mastitis,furuncles around areola,carcinoma of the breast,bleeding nipples or intraductal papilloma of the mammary gland..
4. Treatment principles:
It is necessary to combine internal therapy with external therapy.Internal therapy is used prior to rupture of the abscess,whereas external therapy is used more after rupture of the abscess.
[Teaching Method]
Multimedia lecture.

Breast lumps (Hyperplasia of Mammary gland)
[Teaching Aim]
- Master the diagnosis and treatment of breast lump and its difference with breast carcinoma.
[Teaching Content]
1. Concept: Definition，Characteristics and onset of disease.
2. Etiology and pathogenesis: Caused by Liver Qi stagnation, disharmony of Thoroughfare and Conception vessel or Qi stagnation, phlegm congealing and blood stasis
3. Differential diagnosis: Carcinoma of the breast.
4. Treatment: Apply Qi regulating and phlegm resolving method to treat syndrome of Liver depression and phlegm congealing. Regulate thoroughfare and conception vessels in the case of disharmony of thoroughfare and conception vessels
[Teaching Method]
Multimedia lecture.

Gynecomastia
[Teaching Aim]
1.Master the definition and diagnosis of gynecomastia.
2.Acquainted with the etiology of gynecomastia.
[Teaching Content]
1. Concept: Defintiion, susceptible population.
2. Etiology and pathogensis:Liver qi stagnation or kidney qi deficiency induced phlegm production or the binding of fire and phlegm.
3. Disease differentiation:oblate nodules below the areola,with slightly pain or tenderness.
4. Treatment:For liver qi stagnation syndrome,sooth the liver and relieve stagnation;for kidney qi deficiency syndrome,tonify kidney qi.
[Teaching Method]
Self-study.

Breast nodules (Fibroadenoma of the breast)
[Teaching Aim
- Master the diagnosis and treatment of breast nodules, understand its difference with breast carcinoma.
[Teaching Content]
1.Concept: Defintiion, clinical manifestation.
2.Etiology and pathogensis:Emotional disturbance induced liver qi stagnation and phlegm production or disharmony between the chong and ren channels induced qi stagnation and blood stasis.
3.Disease differentiation: Tend to happen on young ladies. Nodules are spherical, single, well-demarcated, smooth surface and mobility is well.
4. Differential diagnosis:. breast carcinoma, hyperplasia of mammary gland.
5. Treatment:Principles are soothe the liver,resolve phlegm and dissipate lumps.Surgical excision is necessary when the mass is large or rapid increase in size in a short time.
[Teaching Method]
Multimedia lecture.

Breast Carcinoma
[Teaching Aim]
- Master the diagnosis and syndrome differentiation of breast carcinoma to make early diagnosis and treatment.
[Teaching Content]
1. Concept: Characteristics and onset of disease
2. Etiology and pathogenesis: Caused by invasion of six pathogenic factors, Liver and Spleen Qi stagnation and disharmony of Thoroughfare and Conception vessels which in turn lead to Qi stagnation and blood stasis, congealing of phlegm and accumulation of pathogenic toxin
3. Diagnosis: B-mode ultrasound and mammography examination can be done to come out with pathological diagnosis
4. Treatment: Treat according to syndrome differentiation.
[Teaching Method]
Multimedia lecture.