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Semester 4- Reproduction > 11.2 Breast Disease > Flashcards

11.2 Breast Disease Flashcards

1
Q

What is the breast made up of made up of?

A

15-24 lobulated masses
Lobules are stroma with many acini. The acini are made up of cuboidal cells surrounded by myoepithelium which can contract.

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2
Q

How does the breast change at puberty?

A

Increased number of lobules

Increased stroma

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3
Q

How does the breast change within a menstrual cycle?

A

Follicular phase- lobules inactive
After ovulation- cell proliferation and stromal oedema
Menstruation- decreased size of lobules

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4
Q

How does the breast change in pregnancy?

A

Increased size
Increased number of lobules
Decrease in stroma
Secretory changes

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5
Q

How does the breast change postmenopause?

A

Decreased size
Decreased number of lobules
Intralobular stroma replaced with adipose tissue

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6
Q

What type of mass is worrying to find in the breast?

A

Craggy, fixed, hard

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7
Q

What may milky breast discharge be a symptom of?

A

Endocrine disorder

Side effect of medication

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8
Q

What may bloody breast discharge be a symptom of?

A

Benign lesions

Duct ectasia

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9
Q

What is a worrying mammogram finding?

A

Calcifications

Densities

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10
Q

What is the most common benign breast tumour?

A

Fibroadenoma

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11
Q

What is polythelia?

A

More than 2 nipples

Can appear anywhere in milk line

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12
Q

What is acute mastitis?

A

Occurs during lactation

Usually S. aureus infection from nipple cracks

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13
Q

How does acute mastitis present?

A

Painful breast
Pyrexia
Breast abscesses

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14
Q

Who is at risk of fat necrosis presenting in the breast?

A

Recent trauma or surgery

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15
Q

How does a benign epithelial lesion present?

A

Presents as a mass or mammographic abnormality

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16
Q

How does a fibroadenoma present?

A

Mobile, elusive mass (breast mouse)

17
Q

What does a fibroadenoma look like macroscopically?

A

Rubbery, greyish-white, well-circumcised

18
Q

What does a phyllodes tumour look like?

A

Nodule of proliferating stroma covered by epithelium

19
Q

What is gynaecomastia?

A

Enlargement of male breast

20
Q

What causes gynaecomastia?

A

Puberty- oestrogen levels peak before testosterone
Oestrogen excess- liver cirrhosis
Gonadotrophin excess- testicular tumour
Drug-related- spironolactone, alcohol
Klinefelter syndrome- XXY not enough testosterone

21
Q

What are some risk factors of breast cancer?

A 
Female
Long oestrogen exposure
Exogenous oestrogen 
Previous breast cancer
Geography
22
Q

What is an in situ carcinoma?

A

Neoplastic population of cells limited to ducts and lobules by the basement membrane.
Myoepithelial cells of acini are maintained.
Vessels not invaded.
No metastases

23
Q

How does DCIS present?

A

Mammographic calcifications or a mass

24
Q

What does DCIS look like histologically?

A

Central necrosis with calcification

25
Q

How does Paget’s disease present?

A

Neoplastic cells spread to nipple skin without crossing basement membrane. Presents with unilateral red and crusting nipple.

26
Q

What is an invasive carcinoma?

A

Neoplastic cells invade beyond basement membrane and into stroma.
Can invade vessels
Metastasise to other sites

27
Q

What is peau d’orange?

A

Lymphatic drainage of the skin of the breast is compromised so hairs retract and skin turns orange colour

28
Q

How does invasive ductal carcinoma present histologically?

A

Atypical cells lining tubules

Poorly-differentiated

29
Q

Where does invasive lobular carcinoma spread to?

A 
Peritoneum 
Retroperitoneum 
GI Tract
Ovaries
Uterus
30
Q

Where do breast cancers often spread to?

A 
Lymph nodes
Bones
Liver 
Lungs
Brain
31
Q

What are the aims of mammographic screening?

A

Detect small impalpable tumours and pre-invasive cancers

Looks for densities, calcifications and parenchymal abnormalities

32
Q

Who is eligible for mammographcic screening?

A

Women aged 47-73

Done every 3 years

33
Q

What surgery can be done to eliminate breast cancer?

A

Massectomy
Breast-conserving surgery
Axillary dissection
Sentinel lymph node biopsy

34
Q

What is Herceptin?

A

Drug containing antibodies against the Her2 protein

35
Q

How can survival rates of breast cancer be improved?

A 
Early detection 
Neoadjuvent chemotherapy
New therapies- herceptin 
Gene expression profiling
Prevent familial cases

Semester 4- Reproduction (17 decks)

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