5/ Breast Pathology

Question 1

What would a fine needle aspiration cytology show from a malignant tumour?

Answer 1

• discohesive large pleomorphic cells

Question 2

Describe the histology of fibroadenoma

Answer 2

ducts stretched around cellular stroma
two cell layers
no cellular atypia

Question 3

Describe a fibroadenoma on palpation

Answer 3

benign firm mobile mass

Question 4

What is fibrocystic change?

Answer 4

cysts, often with apocrine epithelium with fibrous stroma around them

Question 5

Are papillomas removed?

Answer 5

• 4% associated with malignancy so would usually be excised

Question 6

What is a radial scar?

Answer 6

• these resemble cancer on mammogram due to their speculate shape
• 30% are associated with malignancy

Question 7

What makes up the triple assessment?

Answer 7

• clinical examination
• imaging
• cytology or biopsy

Question 8

Describe the histology of an invasive carcinoma

Answer 8

• normal breast ducts and lobules absent
• sheets of malignant cells are invading into the stroma with no gland formation
• the cells show large hyper chromatic nuclei and mitoses
• myoepithelial layer is absent

Question 9

What are the 4 histological subtypes of breast carcinoma? What is the main feature of each?

Answer 9

• no special type carcinoma = absence of specific features
• lobular carcinoma = single file pattern
• mucinous carcinoma = pools of mucin
• tubular carcinoma = tubule formation (excellent prognosis)

Question 10

What type of lesion is DCIS?

Answer 10

Ductal carcinoma in situ
An obligate precursor of invasive carcinoma
It is characterised by the proliferation of malignant cells within the breast ducts without invasion of the stroma
- Treatment is by local excision either breast conserving surgery or mastectomy