Breast Cancer Flashcards
(33 cards)
What are the symptoms of breast cancer?
> Peay d’orange
Dimpling
Nipple deformity (retraction, discharge etc.)
Ulceration
How do you diagnose breast cancer?
History Examination of the breast Mammography/ US Fine needle biopsy Core biopsy
What do you ask in a breast history?
> How long the lump has been there?
Has it changed? (size/ shape/ discharge/ pain)
Cyclical/ mestrual
Pain (fat necrosis/ haematoma)
General Hx (age, menopause)
Ask about periods
Children, breast fed, age at first child and how many
FHx of Breast cancer- relationship and age
What is the most common presentation of breast cancer?
Hard painless lump
What other presenting features may occur in breast cancer?
Change in shape or size of breast
Simpling
Lymphoedema
How do you examine a breast?
> Inspect Sitting up at edge of couch with arms at side Ask them to lift arms up lie at 45 degrees and arms above head > Palpate Use tips of fingers in each quadrant, then nipple and then axilla Examine supravicular fossa Examine back Examine abdomen for enlarged liver
How is a mammogram obtained?
> Two plates squash the breast
> CC vs MLO
What might you see on a mammogram?
> Irregular shadow (e.g. spiculated lesion)
> Micro calcifications
What might you see on the US?
> Irregular dense Shadow
When do you send a FN biopsy to cytology?
> Uniformly blood stained
> Mass exists after aspiration of fluid
How many breast lumps are cancer?
10% (others are benign proliferations, neoplasms like fibroadenomas)
Cancers can be invasive or in situ
What does in situ mean?
Not penetrated through the basement membrane
What is a fibroadenoma like?
A well circumscribed benign mass
What is Fibrocystic disease like?
A well circumscribed cyst
Fibrocystic disease- Proliferation of the breast lobules become infectedd particularly in breast feeding women
How do abscesses form in the breast?
Neutrophils that are attracted to bacteria coagulate together, die off, to form pus and form a hard painful lump.
How may tumours manifest in the breat?
Spiculated lumps as seen by US and mamography
What do cytopathologists do?
Say if a lump is benign or malignant via clinic, imaging and fine needle aspiration
What are the benefits of an FNA?
Minimally invasive
Speedy
Results in hours (benign or malignant)
What is needed for an FNA?
Syringe 22G needle Cyst fluid Glass slides for cells Stained rapidly
What is the difference between benign and malignant cells?
Benign > Orderly > Reasonable cytoplasm > Identical > Rounded and regular
Malignant > Clustered > Huge irregular nuclei > Hypochromatic > Pleiomorphic nuclei
What is the meaning of C1, C2, C3, C4 and C5 in cytology nomenclature?
C1- Inadequate C2- Benign C3- Atypical/ indeterminate (>benign) C4- Suspicious of malignancy (>malignancy) C5- Falze negative rate or malignant
If there is unsureness what do you do after an FNA?
Core biopsy (requires 24-48 hrs)
What are the types of malignancy?
In situ
Invasive
Not assessable
What is the coding for biopsy results?
B1- inadequate B2- Benign B3- Uncertain malignant potential B4- Suspicious B5- Malignant
