Breast pathology 1

Question 1

Assessment methods of patient with breast disease?

Answer 1

Clinical

Imaging

Pathology

Question 2

Methods of assessing breast cytology?

Answer 2

FNA
Fluid
Nipple discharge
Nipple scrape

Question 3

What is a wide local excision?

Answer 3

A type of biopsy where the suspect area is removed along with a margin around the area

Question 4

Developmental breast conditions?

Answer 4

Hypoplasia
Juvenile hypertrophy
Accessory breast tissue
Accessory nipple

Question 5

Non neoplastic breast conditions?

Answer 5

Gynaecomastia
Fibrocystic change
Hamartoma
Fibroadenoma
Sclerosing lesions

Question 6

Inflammatory breast conditions?

Answer 6

Fat necrosis

Duct ectasia

Acute mastitis/abcess

Question 7

Tumour breast conditions?

Answer 7

Phyllodes tumour

Intraduct papilloma

Question 8

What is gynaecomastia?

Answer 8

Breast development in the male

Ductal growth without lobular development

Question 9

Causes of gynaecomastia?

Answer 9

Exo/Endogenous hormones
Cannabis
Prescription drugs
Liver disease

Question 10

When do fibrocystic changes tend to occur/

Answer 10

20-50

Early menarche or late menopause

Often diminish or resolve after menopause

Question 11

Presentation of fibrocystic changes?

Answer 11

Smooth discrete lump

Sudden pain

Question 12

Gross pathology of Fibrocystic breasts?

Answer 12

Cysts
Blue domed with pale fluid
Usually multiple

Question 13

Microscopic pathology of fibrocystic changes?

Answer 13

Thin walled but may be fibrotic wall

Lined by apocrine epithelium

Question 14

Management of fibrocystic breasts

Answer 14

Exclude malignancy
Reassure
Excise if necessary

Question 15

What is a hamartoma?

Answer 15

Circumscribed lesion made of normal cell types but in an abnormal proportion or distribution

Question 16

Presentation of fibroadenoma?

Answer 16

Peak in 3rd decade

Painless
Firm
Discrete
Mobile

Solid on US

Question 17

Treatment of fibroadenoma?

Answer 17

Diagnose
Reassure
Excise

Question 18

Pathophysiology of sclerosing lesions?

Answer 18

Benign, disorderly proliferation of acini and stroma causing mass

May mimic cancer

Question 19

Presentation of sclerosing adenosis?

Answer 19

Pain, tenderness or lumpiness
Asymptomatic
Age 20-70

Question 20

Presentation of Radial scar?

Answer 20

Wide age range
Incidental finding
Mammographically detected

Question 21

Pathology of radial scar?

Answer 21

1-9mm
Stellate architecture
Central puckering
Radiating fibrosis
Mimic carcinoma radiologically

Question 22

Causes of fat necrosis?

Answer 22

Seat belt injury
Frequently no history

Associated with warfarin therapy due to minor trauma causing bleeding

Question 23

Pathology of fat necrosis?

Answer 23

Damage and disruption of adipocytes
Infiltrate by acute inflamm cells
Foamy macrophages

Question 24

Clinical features of duct ectasia?

Answer 24

Sub areolar ducts
Pain
Acute episodic inflamm
Blood and or purulent discharge
Fistula
Retraction

Question 25

Management of duct ectasia?

Answer 25

Treat acute infecion
Exclude malig.
Stop smoking
Excise ducts

Question 26

Causes of acute mastitis/abcess?

Answer 26

Duct ectasia

Lactation (Staph aureus, strep pyogenes)

Question 27

Management of acute mastitis?

Answer 27

Antibiotics
Drain
Treat underlying cause

Question 28

Clin features of phyllodes tumour?

Answer 28

40-50
Slow growing unilateral mass
Biphasic
Bengign borderline malignant

Question 29

Clin features of intraduct papilloma

Answer 29

35-60

Nipple discharge +/- blood

Question 30

Pathology findings of intraduct papilloma?

Answer 30

2-20mm diameter

Covered by myoepithelium and epithelium