Breast Conditions Flashcards
Disorders of the breast - Types
Congenital
- Aplasia, accessory/ectopic breasts
Inflammatory
- Mastitis - acute, chronic
- Trauma - traumatic fat necrosis
- Duct ectasia, abscess, galactocele
Proliferative
- Fibrocystic disease
- Cysts, andenosis, metaplasia
Neoplastic
- Benign - fibroadenoma, duct papilloma
- Malignant - carcinoma, ductal carcinoma in situ
Breast Neoplasms - types
Benign - round, smooth, soft, mobile
- Fibroadenoma (stromal)
- Duct papilloma (epithelial)
- Others - rare (lipoma, fibroma)
Malignant - irregular, hard, rough, fixed
- Ductal carcinoma
- Lobular carcinoma
- Others - rare (angiosarcoma, lymphoma, melanoma)
Breast tumours - comparison of benign vs. malignant
Benign
- Young <35
- Multiple lumps (fibrocystic disease)
- Painful
- Soft, cystic, rubbery
- Regular, nodular
- Mobile
- No lymph nodes
- No weight loss
Malignant
- Older >35
- Single lump
- Painless
- Hard, gritty
- Irregular
- Fixed
- Lymph node involvement
- Weight loss
Invasive Duct Carcinoma - Classification
Classified based on genetic composition into 4 types:
- Luminal A: ER+, PR+, HER2-
- Luminal B: ER+, PR+, HER2+
- HER2+: ER-, PR-, HER2+
- Basal like (triple negative): ER-, PR-, HER2-
Breast Triple Assessment
- Designed for the early and rapid detection of breast cancer
3 parts:
1) History and examination
- Hx - presenting complaint, risk factors, family hx, current medications
- Full breast examination
2) Imaging
- Mammography
- Ultrasound - more useful in women <35yrs
3) Histology
- Biopsy is required of any suspicious mass or lesion -> core biopsy
Breast tissue sampling - types
Fine Needle Aspiration (FNA)
- Least invasive
- Uses small needle (18-21G)
- Appropriate for well-circumscribed, usually tender masses that are thought to be simple cysts
- Cytology
Core Needle Biopsy
- Retrieves more tissue than FNA
- Histology
- Tumour grade, hormone receptor status, genomic analysis, cancer profiling
- Performed using a larger needle (9-14G) than FNA
- 3-5 cores of solid tissue are collected
