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Reproduction > Breast Pathology 1: Benign Breast Disease > Flashcards

Breast Pathology 1: Benign Breast Disease Flashcards

1
Q

Describe the part of the triple assessment

A 
Clinical = history and examination
Imaging= Ultrasound, mammography or MRI
Pathology = cytopathology or histopathology
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2
Q

What specimens can be sent for cytopathology

A

Fine needle aspiration
Fluid
Nipple discharge
Nipple scrape

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3
Q

Describe the results that can come back on FNA cytology

A 
C1- unsatisfactory
C2- benign
C3- atypia, probably benign
C4- suspicious of malignancy
C5 - malignant
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4
Q

Describe the results that can come back for a needle core biopsy

A 
B1 - Unsatisfactory / normal
B2 - Benign
B3 - Atypia, probably benign
B4 - Suspicious of malignancy
B5 - Malignant
B5a - carcinoma in situ
B5b - invasive carcinoma
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5
Q

Define cynaecomastia

A

Breast development in the male

Ductal growth without lobular development

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6
Q

Causes of gynaecomastia

A

Exogenous/endogenous hormones
Cannabis
Prescription drugs e.g.rispiredone, spironolactone
Liver disease

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7
Q

What age group does fibrocystic change usually occur in

A

woman aged 40-50 most commonly

can occur in 20-50s group though

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8
Q

What usually causes fibrocystic change

A

menstrual changes/abnormalities
early menarche
late menopause

usually resolves after menopause

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9
Q

How does fibrocystic change present

A 
Smooth discrete lumps
Sudden pain
Cyclical pain
Lumpiness
Incidental finding
Can be detected at screening
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10
Q

What is a hamartoma

A

A circumscribed lesion of cell types normal to the breast but present in abnormal proportion or distribution.
It is benign.

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11
Q

In what race are fibroadenomas more common

A

African

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12
Q

How common is it to have multiple fibroadenomas

A

only 10 percent have multiple

usually solitary

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13
Q

What are the clinical features of a fibroadenoma

A 
Peak incidence in 3rd decade
Screening 
Painless, firm, discrete, mobile mass
“Breast mouse”
Solid on ultrasound
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14
Q

What is a fibroadenoma

A

localised hyperplasia

Proliferation of intralobular stroma

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15
Q

what are the features of a fibroadenoma

A 
Circumscribed
Rubbery
Grey-white colour
Biphasic tumour/lesion
Epithelium
Stroma
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16
Q

How are fibroadenomas treated

A

Rule out malignancy
Reassure
Exise

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17
Q

What are sclerosing breast lesions

A

benign, disorderly proliferation of acini and stroma causing a mass or calcification which may mimic carcinoma

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18
Q

What are the main causes of breast sclerosinf lesions

A

radial scar

sclerosing adenosis

19
Q

When does sclerosis adenosis usually present and how does it usually present

A

any age between 20-70
pain, tenderness, lump/thickening
asymptomatic sometimes

20
Q

Is there a risk of carcinoma developing from a sclerosing adenosis

A

yes but it is negligible

21
Q

WHat is a radial scar

A

is a benign breast lesion that can radiologically mimic malignancy

22
Q

how common are bilateral radial scars

A

in about 43 percent of cases they are bilateral

23
Q

what is the difference between a radial scar and complex sclerosing lesion

A

RS is 1-9mm

CSL- more than 10mm

24
Q

what are the histological features of a radial scar

A

Fibroelastotic core
Radiating fibrosis containing distorted ductules
Fibrocystic change
Epithelial proliferation

25
Q

Is a radial scar pre malignant

A

No but often show epithelial proliferation

In situ or invasic carcino may occur within these lesions

26
Q

What is fat necrosis of the breast

A

damage and disruption of adipocytes usually following trauma to the breast
infiltration of acute inflammatory cells
subsqequent fibrosis and scarring

27
Q

what are the usual causes for fat necrosis

A

local trauma such as seat belt injury
can occur with no history or history of very insignificant/minor trauma
warfarin therapy

28
Q

what are the symptoms of duct ectasia

A 
Pain
Acute episodic inflammatory changes
Bloody and/or purulent D/C
Fistulation
Nipple retraction and distortion
29
Q

Where does duct ectasia affect

A

sub areolar ducts

30
Q

What is the risk factor for duct ectasia

A

smoking

31
Q

what are the pathological features of duct ectasia

A

Sub-areolar duct dilatation
Periductal inflammation
Periductal fibrosis
Scarring and distortion

32
Q

What are the two main aetiologies of mastitis or abscess in the breast

A

duct ectasia

lactation

33
Q

What is usually the causal organism of mastitis/abscess in lactation

A

Staph aureus

Step pyogenes

34
Q

What usually causes an infection in duct ectasia

A

mixed organisms

anaerobes

35
Q

How is mastitis/abscesses managed

A

Antibiotics
Percutaneous drainage
Incision & drainage
Treat underlying cause

36
Q

what is a phyllodes tumour

A

A tumour of the breast characterised by peri ductal stromal overgrowth. can be benign, borderline or malignant.

37
Q

how do phyllodes tumours behave

A

they are prone to local recurrence if not excised adequately

rarely metastasize

38
Q

What papillary lesions can occur in the breast

A

intraductal papilloma
nipple adenoma
encysted papillary carcinoma

39
Q

what age range do intraductal papillomas usually occur in

A

35-60

40
Q

What is a common symptom of intraduct papillomas

A

nipple discharge +/- blood

41
Q

What may be seen on screening with an intraductal papilloma

A

nodules

calcification

42
Q

what are the features of an intraductal papilloma

A

Sub-areolar ducts
2-20 mm diameter
Papillary fronds containing a fibrovascular core
covered by myoepithelium and epithelium
Epithelium may show proliferative activity

43
Q

What epithelial proliferation may be seen in intraductal papillomas

A

None
Usual type hyperplasia
Atypical ductal hyperplasia
Ductal carcinoma in situ

Reproduction (52 decks)

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