Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pathology > Breast > Flashcards

Breast Flashcards

1
Q

What are the 2 types of tissue in the breast?

A

fat

glandular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is glandular tissue made up of?

A

ducts

lobules

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the function of lobules?

A

secretory function
lined by epithelial cells
peripheral layer of myoepithelial cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the chain of ductal

glandular tissue?

A

lobular ducts
extralobular ducts
lactiferous ducts
lactiferous sinuses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Describe the slide

A

lobules
ducts
fat tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Describe the higher magnification

A

myoepithelial cells - smaller dark nuclei
epithelial cells
stroma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are common reasons for breast pain presentation?

A

cyclical - around the menstrual cycle
breast lump
discharge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is cyclical mastalgia?

A

pain usually pre-menstrually

resolves during period

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What can be advised?

A

evening primrose oil

reassure no malignancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How do you describe nipple discharge?

A

single duct or multi-duct

clear, opaque or blood-stained

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is implied by clear discharge?

A

physiological/innocent

prolactin-secreting tumour of pituitary gland

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How can you distinguish between single and multi-duct?

A

single - discharge pressing on one single around nipple

multi - discharge pressing anywhere around nipple

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is implied by multi-duct and opaque discharge?

A

mammary duct ectasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is implied by single duct?

A

underlying pathology
papilloma or papillary lesion
DCIS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

When is duct ectasia common?

A

women 35-45

smokers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the management?

A

no treatment

duct excision if causing extreme problems

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is intraductal papilloma?

A

single duct
may be blood stained
rarely malignant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is this?

A

intraductal papilloma
fibrovascular core
epithelial and myoepithelial cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Name the parts of the clinical assessment for a breast lump

A

history
examination
radiology (mammography/ultrasound)
needle biopsy (FNA/core)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is important in the clinical history of a breast lump?

A 
duration
increase/decrease in size
cyclical or constant
pain
skin changes (inflamm/tethering)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is important in the clinical examination?

A 
location
size
consistency (soft/firm/hard)
character (focal/vague/smooth/irregular)
skin changes (raise arms)
axilla
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Where are benign breast lumps more likely to occur?

A

lateral aspect

medial aspect of the breast are more likely malignant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

How does mammography work?

A

X-ray

2 angles - craniocaudal and oblique

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What kind of patient is mammography more effective in?

A

older patients

fatty tissue>glandular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What can an ultrasound tell you about a breast lump?

A

cystic or solid
outline of lesion
useful for image guided biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is reasassuring on an ultrasound?

A

cysts are almost always benign

smooth outline is likely benign

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What are the 5 types of benign breast lump?

A 
simple cyst
fibrocystic change
fibroepithelial chane
papilloma
fat necrosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Where are simple epidermal inclusion cysts often found?

A

near skin surface

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

How are epidermal inclusion cysts formed?

A

in-folding of squamous epithelium containing trapped keratin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Where do deep-seated simple cysts arise in the breast?

A

dilated ducts or lobules

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What do dilated duct cysts contain?

A

entrapped secretions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What are deep breast cysts often lined by?

A

apocrine epithelium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Why are deep breast cysts’ lining attenuated and thin?

A

because of the pressure of the secretions inside

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What process causes breast cysts?

A

metaplastic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

How are fibrocystic changes often picked up?

A

calcification of cysts or adenosis on mammography

no signs/symptoms

36
Q

How are cysts formed in fibrocystic changes?

A

lobules unfold and coalesce

blockages

37
Q

How does fibrosis occur in fibrocystic change?

A

as cysts rupture a chronic inflammatory response is provoked causing fibrosis

38
Q

What is adenosis in fibrocystic change?

A

increased acini or glands in a lobule with no proliferation of epithelium

39
Q

Describe the fibrocystic change seen here

A

grossly a cyst can be seen which has ruptured causing the adjacent fibrosis

40
Q

Describe the histology seen here?

A

fibrocystic change
cysts seen on left of screen
calcification seen top right
fibrosis between calcification and fatty tissue

41
Q

What is a fibroadenoma?

A

painless palpable mobile mass

42
Q

What is a fibroadenoma also known as?

A

breast mouse

43
Q

What arer fibroadenomas made of?

A

epithelial and stromal elements

44
Q

What are the 2 types of stroma in breast?

A

dense intERlobular stroma and looser intRAlobular stroma

45
Q

What stroma do fibroadenomas arise from?

A

loose intralobular stroma

46
Q

Why do fibroadenomas tend to fluctuate size wise?

A

they are hormonally responsive and so fluctuate with menstruation and pregnancy

47
Q

What can be seen in this gross image?

A

fibroadenoma
well-contained uniform pale, fibrous surface
usually 2-3cm

48
Q

Describe the histology seen in this fibroadenoma

A

epithelial lined spaces surrounded by loose fibrous stroma

no concerning features - nuclear pleomorphism, increased cellularity, mitotic activity or necrosis

49
Q

What happens to a fibroadenoma to lead to a Phyllodes tumour?

A

stromal component proliferates out of proportion to epithelial component
(stromal overgrowth)
usually benign

50
Q

What is a papilloma?

A

benign epithlium covering connective tissue cores

51
Q

What kind of pattern is seen in papillomas?

A

branching

52
Q

WHere does a papilloma occur?

A

within wall of breast duct causing blockage/widening of duct

53
Q

What is the common presentation of a papilloma?

A

discharge (can be bloody)

lump

54
Q

Why can papilloma discharge be bloody?

A

[papillomas are richly vascular and segments can twist and become infarcted

55
Q

What is significant about a solitary papilloma?

A

large duct
near nipple
lower risk of malignancy

56
Q

What is significant about multiple papillomas?

A

terminal ducts
deep tissue
higher risk of malignancy

57
Q

What can be seen in this histological image?

A

papilloma in duct wall

58
Q

Describe the histology of this papilloma?

A

epithelial lining
fibrovascular core
blood vessels seen upper right quadrant

59
Q

Describe this histological image

A

fat necrosis
fat globules
surrounded by foamy macrophages and giant cells

60
Q

Risk factors for breast cancer?

A 
increased age
family history
previous history
genetic - BRCA 1 and 2
increased breast density
61
Q

What hormonal and reproductive risk factors contribute to breast cancer?

A

early menarche
late menopause
older first childbirth
oral contraceptives

62
Q

What is protective from breast cancer?

A

breast feeding

63
Q

What general risk factors contribute to breast cancer?

A

obesity
smoking
alcohol
ionising radiation

64
Q

What are the 2 types of presentation of breast cancer and how do they differ?

A

symptomatic - breast lump/discharge/skin abnormalities

screening - mammographic abnormality (calcification/mass lesion)

65
Q

How often are women screened for breast cancer? When does it begin?

A

3 yearly

50-70 y/o

66
Q

What is the triple assessment for diagnosis?

A

clinical
radiological - mammogram/USS/MRI +/- biopsy
pathological - FNA/core biopsy

67
Q

What pathological investigation is this?

A

FNA

68
Q

Describe the 2 slides seen

A 
L:
benign FNA
cells form cohesive groups
well-defined outlines
dots are myoepithelial cells that have lost their cytoplasm during FNA
R:
malignant FNA
pleomorphic
nuclei different shapes and sizes
discohesive
necrotic
69
Q

What pathological investigation can be seen here?

A

core biopsy

70
Q

Describe the 2 slides seen

A

L:
DCIS
basement membrane seen around malignant cells
pleomorphic cells
darker area probably what presented as calcification on mammogram

R:
benign intraductal papilloma

71
Q

Describe this slide

A

invasive carcinoma

dark purple malignant cells infiltrating lighter pink fibrous tissue

72
Q

What kind of breast cancer is seen here?

A

in-situ
neoplastic cells
confined by basement membrane
no potential for metastasis

73
Q

What can be seen here?

A

invasive carcinoma
neoplastic cells
basement membrane breached
can metastasize

74
Q

Ductal v lobar classification

Clinical findings, radiology, micro and macro pathology

A

table

75
Q

How is grade classified?

A 
tubule formation
mitotic activity
nuclear pleomorphism
scored 1-3 and added up
grade 1: 3-5
grade 2: 6-7
grade 3: 8-9
76
Q

How does staging work?

A

TNM
T - increases with increasing size, skin/chest wall involvement
N - increases with increasing lymph node involvement
M - presence or absence of metastases

77
Q

Describe this slide

A

well differentiated low grade carcinoma

78
Q

Describe this slide

A

high grade tumour

79
Q

Explain the T staging

A

T1 <20mm
T2 20-50mm
T3 50-100mm or <50 with infiltration
T4 >100mm

80
Q

Explain the N staging

A

N0 node negative
N1 node involved, mobile
N2 node involved, fixed
N3 supraclavicular nodes or oedema

81
Q

Explain the M staging

A

M0 no metastases

M1 metastases

82
Q

What are teh 2 predictive tests?

A

oestrogen receptor status

HER-2 (human epidermal growth factor)

83
Q

What do patients with oestrogen receptor positive tumours benefit from?

A

hormone manipulation
tamoxifen
arimidex

84
Q

What do patients with HER-2 positive tumours benefit from?

A

herceptin treatment

85
Q

What can be done for BRCA 1 and 2 mutations

A

screening for mutation

elective prophylactic bilateral mastectomy with?hysterectomy and oophrectomy

86
Q

When is BRCA screening recommended?

A

age 25

87
Q

What preexisting breast conditions are risk factors?

A 
breast cancers
atypical ductal hyperplasia x4
hyperplasia of unusual type x2
LCIS x4
DCIS x6-8

Pathology (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions