Breast Flashcards
What type of biopsy is used to investigate breast lumps?
Core needle biopsy or mammotome
What is Paget’s Disease of the Nipple?
Inflammatory breast cancer causing erythematous eczema-type rash over the nipple.
May also have a sub areolar lump (ductal carcinoma in-situ).
How do you differentiate between Paget’s disease of the nipple and nipple eczema?
Breast eczema usually begins on the areolar, Paget’s disease usually begins at the nipple.
If unsure, give 2 weeks of steroids and if it persists do a punch biopsy.
What is a ductal carcinoma in situ?
irregular (no pattern) cells within the milk ducts, basement membrane has not been breached as cells only sit in ducts.
Usually asymptomatic.
What is a Lobar carcinoma in situ?
abnormal, small, round, lobular cells in a regular pattern. No infiltration of basement membrane.
What is meant by an ‘invasive’ ductal carcinoma?
Cancer originates in milk ducts and then spreads to the fatty tissues and into/through the basement membrane.
What is meant by an invasive lobular carcinoma?
Cancer originating in the milk-producing glands and spreads through the basement membrane and to other tissues in the body.
What is a Phyllodes tumour?
smooth, rapidly growing tumour (faster than fibroadenoma), often found in 40-60 y/o women
may be benign, borderline, or malignant
made of fibrous and epithelial tissue
How do you differentiate inflammatory breast cancer from an infection?
Unresponsive to 2 weeks of abx = refer to secondary care.
Peri-menopausal women presenting with nipple inversion, breast tenderness, and thick sticky discharge is likely what?
Mammary duct ectasia.
There may also be a lump felt in the area.
What is Stuart-Treeves Syndrome?
Long term lymphoedema leads to lymphangiosarcoma.
What is a fibroadenoma, what is the mx?
Benign tumour made of fibrous and glandular parts, they are usually firm and mobile.
If >3cm can be removed, but no need to follow up as they do not carry the risk of becoming cancerous.
What causes a breast angiosarcoma?
10-20 years after radiotherapy,
OR, primary (younger pts).
What is the Triple assessment for breast cancer? How is this scored?
Clinical assessment, imaging, histology.
Each stage is ranked 1-5:
- normal
- benign
- indeterminant
- suspicious
- malignant
E.g., fir physical exam it is P1-5.
When is it preferred to do a breast USS rather than mammogram?
- <35 (breast tissue too dense)
- pregnant
- ?infective collection (assess cystic vs solid)
