Breast pathology 1 Flashcards
Assessment methods of patient with breast disease?
Clinical
Imaging
Pathology
Methods of assessing breast cytology?
FNA
Fluid
Nipple discharge
Nipple scrape
What is a wide local excision?
A type of biopsy where the suspect area is removed along with a margin around the area
Developmental breast conditions?
Hypoplasia
Juvenile hypertrophy
Accessory breast tissue
Accessory nipple
Non neoplastic breast conditions?
Gynaecomastia Fibrocystic change Hamartoma Fibroadenoma Sclerosing lesions
Inflammatory breast conditions?
Fat necrosis
Duct ectasia
Acute mastitis/abcess
Tumour breast conditions?
Phyllodes tumour
Intraduct papilloma
What is gynaecomastia?
Breast development in the male
Ductal growth without lobular development
Causes of gynaecomastia?
Exo/Endogenous hormones
Cannabis
Prescription drugs
Liver disease
When do fibrocystic changes tend to occur/
20-50
Early menarche or late menopause
Often diminish or resolve after menopause
Presentation of fibrocystic changes?
Smooth discrete lump
Sudden pain
Gross pathology of Fibrocystic breasts?
Cysts
Blue domed with pale fluid
Usually multiple
Microscopic pathology of fibrocystic changes?
Thin walled but may be fibrotic wall
Lined by apocrine epithelium
Management of fibrocystic breasts
Exclude malignancy
Reassure
Excise if necessary
What is a hamartoma?
Circumscribed lesion made of normal cell types but in an abnormal proportion or distribution
Presentation of fibroadenoma?
Peak in 3rd decade
Painless
Firm
Discrete
Mobile
Solid on US
Treatment of fibroadenoma?
Diagnose
Reassure
Excise
Pathophysiology of sclerosing lesions?
Benign, disorderly proliferation of acini and stroma causing mass
May mimic cancer
Presentation of sclerosing adenosis?
Pain, tenderness or lumpiness
Asymptomatic
Age 20-70
Presentation of Radial scar?
Wide age range
Incidental finding
Mammographically detected
Pathology of radial scar?
1-9mm Stellate architecture Central puckering Radiating fibrosis Mimic carcinoma radiologically
Causes of fat necrosis?
Seat belt injury
Frequently no history
Associated with warfarin therapy due to minor trauma causing bleeding
Pathology of fat necrosis?
Damage and disruption of adipocytes
Infiltrate by acute inflamm cells
Foamy macrophages
Clinical features of duct ectasia?
Sub areolar ducts Pain Acute episodic inflamm Blood and or purulent discharge Fistula Retraction
Management of duct ectasia?
Treat acute infecion
Exclude malig.
Stop smoking
Excise ducts
Causes of acute mastitis/abcess?
Duct ectasia
Lactation (Staph aureus, strep pyogenes)
Management of acute mastitis?
Antibiotics
Drain
Treat underlying cause
Clin features of phyllodes tumour?
40-50
Slow growing unilateral mass
Biphasic
Bengign borderline malignant
Clin features of intraduct papilloma
35-60
Nipple discharge +/- blood
Pathology findings of intraduct papilloma?
2-20mm diameter
Covered by myoepithelium and epithelium
