Benign breast pathology Flashcards
Imaging modalities in assessment of breast disease (3)
Mammogram; US; MRI
Developmental anomalies in breast tissue (3)
Hypoplasia
Juvenile hypertrophy
Accessory breast tissue/nipple
Breast development in the male
Gynaecomastia
Which part of the breast tissue is hypertrophic in gynaecomastia?
The ducts- no lobular involvement
Causes of gynaecomastia (4)
Exogenous/endogenous hormones
Cannabis
Liver cirrhosis
Prescription drugs
Most common breast lesion
Fibrocystic change
Peak incidence of fibrocystic change
Pre-menopausal
Presentation of fibrocystic change (3)
Smooth discrete lumps, sometimes with pain; incidental on screening
Macroscopic appearance of fibrocystic change
Multiple thin-walled cysts, often appearing “blue-domed”
How should fibrocystic change be managed? (3)
Exclude malignancy, reassure, excise if necessary
Circumscribed lesion composed of cell types normal to the breast but present in abnormal proportion/presentation
Hamartoma
Peak incidence of fibroadenoma
3rd decade
Presentation of fibroadenoma
Painless, firm, discrete, fixed mass
Microscopic pathology of fibroadenoma
Localised hyperplasia of the intralobular stroma, with “tufts” of epithelium
Two main types of sclerosing lesions
Sclerosing adenosis
Radial scar
Most commonly presents as mammographic calcifications
Sclerosis adenosis
Radiating “stellate” connective tissue with a fibrovascular core
Radial scar
Cause of fat necrosis
Trauma to adipose tissue
Why does fat necrosis present as a lump?
Infiltration of acute inflammatory cells, leading to subsequent fibrosis and scarring
Underlying pathology of duct ectasia (3)
Duct dilatation, inflammation, fibrosis
How does duct ectasia usually present?
Nipple discharge
Two main aetiologies of acute mastitis
Duct ectasia, lactation/breastfeeding
Large lobulated mass with a gross “leaf-like” structure
Phyllodes tumour
Benign epithelium over a dense fibro-vascular core
Papillary breast lesions
How do papillary breast lesions present?
Discharge +/- blood
