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Cell Path II > Breast Pathology > Flashcards

Breast Pathology Flashcards

1
Q

function of the breast

A

production and expression of milk

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2
Q

what happen to the breast in pregnancy

A

lobules proliferate
epithelial cells differentiate - secretion of milk

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3
Q

what happens to the breast in ageing

A

lobules decrease in size and number and interlobular stroma is replaced by adipose tissue

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4
Q

diagnostic methods to breast cancer

A

Mammography- Densities, Calcification
Ultrasonography– Solid v cystic lesion
Biopsy– FNAB– Core biopsy
Screening– every 2y for women 50-69y

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5
Q

4 developmental abnormalities of the breast

A

Failure of development– Rare: ovarian agenesis, eg Turner Syndrome
Juvenile hypertrophy– Rapid, disproportionate development during puberty
– Surgery
Milkline Remnants– Supernumerary nipples, hormone responsive
Nipple Inversion– Congenital: usually revert during pregnancy– Acquired: concerning

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6
Q

3 causes of breast inflammation

A
  • Infection
  • Mammary duct ectasia
  • Fat necrosis
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7
Q

what is Squamous metaplasia of lactiferous ducts

A

Painful erythematous subareolar mass
Keratin plugs, block ducts -> dilation, rupture
Chronic inflammation

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8
Q

what is duct ectasia

A

post-menopausal, parous women
periareolar palpable mass - painless
duct dilation, rupture
fibrosis leads to nipple retraction

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9
Q

what cells are seen in necrotic tissue

A

macrophages, giant cells, fibrosis,

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10
Q

what are fibrocystic changes

A

non proliferating breast changes
normal but exaggerated response to hormones in pre menopausal women

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11
Q

types of fibrocystic changes

A
  1. cystic change
  2. fibrosis
  3. adenosis - normal in pregnancy
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12
Q

proliferative breast changes without atypia

A
  1. epithelial hyperplasia
  2. sclerosing adenosis
  3. complex sclerosing lesion
  4. papilloma
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13
Q

what is sclerosing adenosis

A

over double number of acini in terminal ducts

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14
Q

complex sclerosing lesion

A

epithelial hyperplasia, sclerosing adenosis, papillomas

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15
Q

proliferative breast changes with atypical hyperplasia

A

Atypical ductal hyperplasia (ADH)
Duct filled with cells
Spaces: some round, regular, some slit like

Atypical lobular hyperplasia (ALH)
Population of cells partially fill lobule
Some intracellular lumens
Usually incidental finding

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16
Q

heterogenous disease in breast carcinoma

A

oestrogen receptor ER and HER2 expression

17
Q

hereditary breast cancer genes

A

BRCA1 gene - 50% hereditary
BRCA2 gene - 30% hereditary

18
Q

main risk of sporadic breast cancer

A

hormone exposure - menopause, pregnancy, breastfeeding

19
Q

what type of cancer is most common in the breast

A

adenocarcinomas (95%)

20
Q

types of carcinoma in situ

A

ductal carcinoma in situ
lobular carcinoma in situ

21
Q

types of invasive carcinoma

A

invasive carcinoma no special type
invasive lobular carcinoma
medullar, mucinous, metaplastic, papillary, tubular

22
Q

what is ductal carcinoma in situ

A

malignant clonal proliferation of epithelial cells limited to ducts and lobules by the basement membrane

23
Q

presentation of ductal carcinoma in situ

A

calcifications (50%) and rarely nipple discharge

24
Q

what is paget disease of the nipple

A

unilateral erythematous eruption with scale crust

25
Q

do malignant cells breach the basement membrane in pagets disease of the nipple

A

no

26
Q

what is lobular carcinoma in situ

A

clonal proliferation of cells within ducts and lobules that grow in a discohesive fashion usually due to acquired loss of e cadherin

27
Q

what is seen on a mammography of lobular carcinoma in situ

A

no calcifications of densities

28
Q

histology of lobular carcinoma in situ

A

loosely cohesive clusters within lobules, mucin positive signet ring cells, e cadherin loss

29
Q

treatment of lobular carcinoma in situ

A

chemoprevention with tamoxifen, bilateral prophylactic mastectomy

30
Q

indications of invasive carcinoma

A

palpable mass
nipple retraction
blocked lymphatics
radiodense mass detected by mammography

31
Q

histological features of invasive ductal carcinoma

A

firm, irregular border, grating sound when cut, chalky areas of stroma, foci of calcification

32
Q

histological feature of invasive lobular carcinoma

A

poorly defined, irregular border, loose clusters of tumour cells, invade dense fibrous stroma, signet ring shape, absence of e cadherin

33
Q

prognostic factors for breast cancer survival

A

lymph node status - >10 nodes - 10-15%
tumour size - >2cm 77%
invasive in situ - 50%
distant metastases
locally advanced disease
histological subtype

34
Q

what is the most common benign tumour in young women

A

fibroadenoma

35
Q

what is a phyllodes tumour

A

stromal tumour arises from intralobular stroma - leaflike architecture

36
Q

what is gynaecomastia

A

benign enlargement of male breast caused by hormones, liver cirrhosis, klinefelter syndrome

Cell Path II (7 decks)

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