Breast pathology Flashcards

1
Q

FNA classification

A
  • C1 = unsatifactory
  • C2 = benign
  • C3 = atypical, probably benign
  • C4 = Suspicious of malignancy
  • C5 = malignant
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2
Q

Resection of cancer options include?

A
  • wide local excision

- mastectomy

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3
Q

Explain normal histology of the breast

A
  • myo-epithelial cells on basement membrane

- epithelial cells more luminal

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4
Q

Define gynaecomastia?

A
  • breast development in males without lobular development
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5
Q

Causes of gynacomastia?

A
  • exogenous/endogenous hormones
  • cannabis
  • prescription drugs
  • liver disease
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6
Q

Fibrocystic disease of breast presentation

A
  • smooth discrete lumps
  • sudden pain
  • cyclical pain
  • lumpiness
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7
Q

Types of fibrocystic disease

A
  • apocrine metaplasia
  • sclerosing adenosis
  • atypical hyperplasia
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8
Q

Define metaplasia?

A
  • change from one differentiated cell into another
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9
Q

What is a hamartoma?

A
  • circumscribed lesions composed of cell types normal to the breast but abnormal proportion or distribution
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10
Q

Fibroadenoma is ___ dependant

A
  • oestrogen
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11
Q

Typical presentation of fibroadenoma?

A
  • painless
  • discrete
  • mobile mass
  • solid on USS
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12
Q

Typical age presentation of fibroadenoma?

A
  • 20-30s

- afro-carribean

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13
Q

Why is a fibroadenoma called a biphasic tumpour

A
  • epithelial and stroma tissue
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14
Q

Radial scars presentation

A
  • usually < 10mm

- fibroelastic core with radiating fibrosis

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15
Q

Causes of fat necrosis

A
  • breast trauma

- warfarin

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16
Q

Histological appearance of fat necrosis of the breast

A
  • giant cells

- calcification

17
Q

Features of duct ectasia?

A
  • sub-alveolar ducts
  • pain
  • inflammatory
  • purulent / bloody discharge
  • nipple retraction
18
Q

Aetiologies of mastitis?

A
  • lactation

- duct ectasia

19
Q

Age of presentation for a phyllodes tumour?

A
  • 40-50s
20
Q

Phyllodes tumour is what ___ overgrowth

A
  • stromal

- rare to metastasis

21
Q

Explain symptoms of intraductal papilloma?

A
  • nipple discharge
  • sub alveolar ducts
  • fibrovascular core
  • epithelial proliferation
22
Q

Where does breast adenocarcinoma arise?

A
  • glandular epithelium of the terminal duct lobular unit (TDLU)
23
Q

Precursor lesions of breast cancer?

A
  • epithelial hyperplasia
  • columnar cell change
  • ductal carcinoma in situ
  • lobular in situ neoplasia
24
Q

What does in situ carcinoma refer to?

A
  • confined within the membrane of acini and ducts

- can be lobular or ductal

25
Q

Lobular in situ hyperplasia can be divided into what 2 types?

A
  • atypical lobular hyperplasia

- lobular carcinoma in situ

26
Q

Explain the histological findings in lobular in situ neoplasia?

A
  • E-cadherin negative

- bilateral

27
Q

What is a precursor of invasive ductal carcinoma?

A
  • ductal carcinoma in situ
28
Q

Management of ductal carcinoma in situ?

A
  • surgery

- adjuvent radiotherapy

29
Q

Explain Padgett disease of the nipple

A
  • high grade DCIS
  • extends to epidermis
  • carcinoma in situ
30
Q

Define microinvasive carcinoma?

A
  • rare

- DCIS high grade, invasion <1mm

31
Q

Risk factors for invasive breast cancer

A
  • age
  • parity
  • OCP
  • HRT
  • Early menarche, late menopause
  • lifestyle
32
Q

What familial mutation is associated with breast cancer?

A
  • BRCA 1 and BRCA 2
33
Q

ER and PR meaning when describing breast cancer

A
  • oestrogen receptor positive
  • progesterone receptor positive
  • can indicate potential therapies
34
Q

Name a prognostic index used in breast cancer?

A
  • NHS Predict