Breast- Cytology & Radiology Flashcards
what is cytology?
microscopic examination of cells, obtained by:
- Fine Needle Aspiration (FNA)
- direct smear from nipple discharge
- scrape of nipple with scalpel
describe the 2 techniques of FNA
- palpable technique
- examine to locate lump
- localise lump between fingers
- insert needle
- impalpable technique
- use US to locate lump + needle
outline 3 features of benign cytology
- low number of cells
- uniform cell size
- uniform chromatin pattern
outline 3 features of malignant cytology
- high number of cells
- overlapping of cells
- loss of cohesion
what is the cytology scoring system
C1 – Unsatisfactory
C2 – Benign
C3-Atypia (probably benign)
C4- Suspicious (probably malignant)
C5 – Malignant
after aspiration of a cyst, fluid is discarded unless…
- fluid is blood stained
- there is a residual mass
when is core biopsy done?
all cases with clinical /radiological suspicion
what info does a core biopsy allow you to gain?
- confirms invasion
- tumour type and grade
- immunochemistry-receptor status
what are the indications for mammography?
- Over 35
- Under 35 if
- strong suspicion of cancer
- family history of cancer
what are the signs of a malignant soft-tissue mass?
- irregular / ill-defined outline
- spiculated
- dense
- distortion of architecture
- acoustic shadowing
what are the signs of a solid benign soft-tissue mass?
- normal density
- smooth or lobulated
- oval shape
- halo can be seen
- acoustic enhancement
what can US differentiate and in who is it used
- solid from cystic mass
- solid benign from malignant
used in under 35s
what does triple therapy consist of
- clinical examination
- imaging
- FNA cytology
what are the indications of MRI of breast
- implants
- indeterminate lesion following triple assessment
- screening high risk women
- dense breasts
- lobular malignancy
outline what is involved in sentinel node sampling
- peritumoral injection of contrast
- Lymphoscintigraphy
