Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Reproductive > Breast Lectures > Flashcards

Breast Lectures Flashcards

1
Q

Describe the location and relations of breasts

A
  • 2nd/3rd rib to 6th rib
  • Sternal edge to midaxillary line
  • Lies on the deep pectoral fascia
  • A small part (axillary tail) may extend towards the axillary fossa
  • Retromammary space - helps some degree of movement
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Describe the structure of the breast

A
  • Nipple
  • Areola
  • 15-20 lobules of glandular tissue (parenchyma)
  • Each lobule is drained by a lactiferous duct
  • Each duct has a dilated portion (lactiferous sinus)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Describe the structure of the nipple

A
  • No fat or hair
  • Contains collagenous dense connective tissue, elastic fibres and bands of smooth muscle
  • The tips of the nipples are fissured with lactiferous ducts opening into them
  • Position: 4th intercostal space (roughly)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Describe the structure of the areola

A
  • Skin covering the nipple and areola contains numerous sweat and sebaceous glands
  • Oily secretion lubricates the nipple and areola
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Name the four quadrants of the breast

A
  • Superolateral
  • Superomedial
  • Interolateral
  • Inferomedial
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Describe the development of the breast

A
  • Mammary crests or ridges appear during the 4th week
  • These crests extend from the axillary region to inguinal region
  • The crests usually disappear (except in the pectoral region)
  • Primary mammary buds > secondary mammary buds > lactiferous ducts and their branches
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the blood supply to the breasts?

A
  • Branches of axillary, internal thoracic and some intercostal arteries
  • Thoraco acromial a.
  • Lateral thoracic a.
  • Internal mammary a.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the innervation of the breasts?

A
  • Anterior and lateral cutaneous branches of 4-6th intercostal nerves
  • Sensory fibres and sumpathetic fibres to the blood vessels and smooth muscle
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Which lymph nodes drain lymph from the breasts?

A

-Axillary lymph nodes
-Supraclavicular nodes
-Inferior cervical nodes
-Parasternal
(can drain to the opposite breast)

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

What is the function of the terminal duct lobular unit?

A

Milk secretory component of the breast

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

Describe the features of breast tissue prepuberty

A
  • Neonatal breast contains lactiferous ducts but no alveoli
  • Until puberty, little branching of the ducts occurs
  • Slight breast enlargement reflects the growth of fibrous stroma and fat
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Describe the features of breast tissue at puberty

A
  • Branching of lactiferous ducts
  • Solid, spheroidal masses of granular polyhedral cells
  • Accumulation of lipids in the adipocytes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Describe the features of breast tissue post menopausal

A
  • Progressive atrophy of lobules and ducts

- Fatty replacement of glandular tissue

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

Name the signs of breast cancer

A
  • Skin dimpling
  • Abnormal contours
  • Oedema of the skin
  • Nipple retraction or deviation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Name some of the benign breast tumours

A
  • Fibroadenoma
  • Duct papillomas
  • Adenomas
  • Corrective tissue tumours
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is cytology and how can samples be obtained?

A
  • Miscroscopic examination of a thin layer of cells on a slide
  • FNA
  • Direct smear from nipple discharge
  • Scrape of nipple with scalpel
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Which groups of patients should get cytology?

A
  • Symptomatic patients (discrete mass, diffuse thickening and nipple lesion)
  • Breast screening
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What would you see on a benign cytology?

A
  • Low/moderate cellularity
  • Cohesive groups of cells
  • Flat sheets of cells
  • Bipolar nuclei in the background
  • Cells of uniform size
  • Uniform chromatin pattern
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What would be seen on a malignant cytology?

A
  • High cellularity
  • Loss of cohesion
  • Crowding/ overlapping of cells
  • Nuclear pleomorphism
  • Hyperchromasia
  • Absence of bipolar nuclei
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Which features on a cytology would suggest a specific type of cancer?

A
  • Cytoplasmic vacuoles: lobular carcinoma

- Cells arranged in tubes: tubular carcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Describe the cytology scoring system

A
  • C1: unsatisfactory
  • C2: benign
  • C3: atypia (probably benign)
  • C4: suspicious
  • C5: malignant
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the treatment for cysts?

A

Aspiration: fluid is then discarded unless blood stained or there is residual mass

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

What are the advantages of cytology?

A
  • Simple procedure
  • Well tolerated
  • Inexpensive
  • Immediate results
24
Q

What are the limitations of cytology?

A
  • Accuracy not 100%
  • False positives and false negatives
  • Invasion cannot be assessed
  • Grading cannot be done
  • Sampling: lesion can be missed
  • Suboptimal smears
  • Interpretation: features are similar
25
What are the complications of FNA?
- Pain - Haematoma - Fainting - Infection - Pneumothorax (rare)
26
Which nipple lesions can be diagnosed from cytology of nipple discharge?
- Duct ectasia: macrophages only - Intraduct papilloma: benign cells in papillary groups - Intraduct carcinoma: malignant cells
27
What can cytology of a nipple scrape determine?
Whether there is Paget's disease or eczema
28
What is an axillary lymph node FNA used for?
Pre-operative planning
29
When is a core biopsy performed?
- All cases with clinical/ radiological/ cytological suspicion - Breast screening - Pre-operative classification
30
What can a core biopsy do?
- Confirms invasion - Tumour typing and grading - Immuno histochemistry - receptor status
31
Which imaging techniques can be used for imaging breast tissue?
- Mammography - USS - MRI - Nuclear medicine - Image guided techniques - CT
32
When should a mammography be used?
- Over age 40 | - Under 40: if strong suspicion of cancer or FH risk > 40%
33
When should an USS be used?
- To differentiate solid from cystic and benign from malignant - First line for under 40yrs
34
What is involved in a triple assessment?
- Clinical examination - Imaging - FNA cytology
35
What are the indications for an MRI of the breast?
- Recurrent disease - Implants - Indeterminate lesion following triple assessment - Screening for high risk women
36
Describe how the breast screening programme works
- Women aged 50-70 invited every 3 yrs for a mammography - Detects 5 cancers for every 100 screened - Aims to detects cancers at DCIS stage or less than 15mm in size - Additional views: clinical exam, USS, FNA or core biopsy
37
Give examples of benign breast conditions
- Fibrocystic change: fibrosis, adenosis, cysts, apocrine metaplasia, ductal epithelial hyperplasia - Fibroadenoma: circumscribed mobile nodule - Intraduct papilloma: lactiferous ducts and nipple discharge - Fat necrosis: traumatic - Duct ectasia: nipple discharge
38
Describe the features of a fibroadenoma
- Proliferation of epithelial and stromal elements - Most common breast tumour in adolescent and young adult women - Well circumscribed, freely mobile and non painful mass - May regress with age if left untreated
39
Describe the features of a tubular adenoma
- Far less common - Young women - Discrete, freely movable masses - Uniform sized ducts
40
Describe the features of a lactating adenoma
- Enlarging masses during lactation or pregnancy | - Prominent secretory changes
41
Describe the features of a phyllodes tumour
- Fleshy tumour: leaf like pattern and cysts on cut surface - Benign, borderline or malignant - Metastases are haematogenous
42
Describe the features of breast carcinoma
- Hard, fixed mass which is tethered to the skin - Peau d' orange dimpling of the skin - Soft tissue opacity and microcalcification on a mammogram
43
What are the risk factors for breast cancer?
- Gender - Age - Menstrual history - Age at first pregnancy - Radiation - FH - Hormonal treatment - Genetic factors (BRCA1 and 2) - Obesity and lack of physical activity - Alcohol
44
Name the histological classification of breast cancer
- Non Invasive: ductal carcinoma in situ and lobular carcinoma in situ - Invasive: invasive ductal carcinoma and invasive lobular carcinoma
45
Describe the features of in situ carcinoma
- Preinvasive (not a palpable tumour) - Not detected clinically - Multicentricity and bilaterality - No metastatic spread - Risk of invasion depends on the grade
46
How can breast cancer be diagnosed?
- Clinical examination - Radiology: mammogram, USS and MRI - FNA cytology - Needle core biopsy - Wide local excision
47
What are microcalcifications and what is their significance?
- Tiny deposits of calcium - Majority are harmless - Minority may be in precancerous or cancerous tissue
48
What is included in the histology report?
- Invasive vs non invasive - Histological type - Grade - Size - Margins - Lymph nodes - Oestrogen/progesterone receptor - HER-2
49
How does breast cancer spread?
- Local: skin and pectoral muscles - Lymphatic: axillary and internal mammary nodes - Blood: bone, lungs, liver and brain
50
Which factors affect the prognosis of breast cancer/
- Node status - Tumour size - Type and grade - Age - Lymphovascular space invasion - Oestrogen and progesterone receptors - HER-2 - Proliferation rate of tumour - Gene expression profiling - Nottingham prognostic index
51
What do ER ad PR receptors show?
Presence is strong predictor of response to hormonal therapies
52
How is breast cancer managed?
- Staging - Surgery - Radiotherapy - Antihormonal therapy (Tamoxifen) - Chemotherapy
53
Describe the features of Paget's disease of the nipple
- Result of intraepithelial spread of intraductal carcinoma - Large pale staining cells within the epidermis of the nipple - Limited to the nipple or extend to the areola - Pain or itching, scaling and redness - Ulceration, crusting and serous or bloody discharge
54
Which investigations are used to assess the severity of the breast cancer?
- FBC, U&Es, LFTs, calcium and PO2 | - CXR
55
What are the two main types of surgery to the breast?
- Breast conservation surgery | - Mastectomy
56
Which patients are suitable for breast conservation surgery?
- Breast/tumour size ratio - Suitable for radiotherapy - Single tumours < 4cm (in olden days)
57
What are the complications of axillary treatment?
- Lymphoedema - Sensory disturbance - Decreased ROM of the shoulder joint - Nerve damage - Vascular damage - Radiation induced sarcoma

Reproductive (26 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions