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Reproduction & Sexual Health > Breast Pathology > Flashcards

Breast Pathology Flashcards

1
Q

breast cytopathology classifications

A

C1 - unsatisfactory
C2 - Benign
C3 - Atypia, probably benign (equivocal)
C4 - atypia, suspicious of malignancy
C5 - malignant

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2
Q

epithelial and myoepithelial cells lie on the _________ __________

A

basement membrane

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3
Q

gynaecomastia causes

A
  • exogenous/endogenous hormones
  • cannabis
  • prescription drugs
  • liver disease
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4
Q

what age of women does fibrocystic change most commonly affect

A

40-50

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5
Q

fibrocystic change presentation

A
  • smooth discrete lumps
  • sudden pain
  • cyclical pain
  • lumpiness
  • incidental finding
  • screening
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6
Q

fibrocystic change pathology

A

-cysts, blue domed with pale fluid
- intervening fibrosis around them
- metaplasia (from ductal lineage cell to apocrine)

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7
Q

fibrocystic change management

A
  • exclude malignancy
  • reassure
  • excise if necessary (unusual)
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8
Q

hamartoma definition

A

circumscribed lesion composed of cell types normal to the breast but present in an abnormal proportion or distribution

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9
Q

fibroadenoma epidemiology

A
  • common
  • usually solitary
  • commoner in African women
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10
Q

fibroadenoma clinical features

A
  • screening
  • painless, firm, discrete, mobile mass
  • “breast mouse”
  • solid on ultrasound
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11
Q

when is fibroadenoma peak incidence

A

age 20s

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12
Q

fibroadenoma is a biphasic tumour/lesion because it contains both _____ and _____

A

epithelium and stroma

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13
Q

fibroadenoma pathological features

A
  • circumscribed
  • rubbery
  • grey-white colour
  • biphasic tumour/lesion
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14
Q

fibroadenoma management

A

diagnose
reassure
excise

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15
Q

what are sclerosing lesions

A

benign, disorderly proliferation of acini and stroma

can cause a mass or calcification

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16
Q

sclerosing lesions may mimic ___________

A

carcinoma

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17
Q

what age do people get sclerosing adenosis

A

age 20-70 (wide range)

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18
Q

sclerosing adenosis clinical features

A
  • pain, tenderness or lumpiness/thickening
  • asymptomatic
19
Q

Radial scar vs complex sclerosing lesion

A

radial scar is <10mm, CSL is >10mm

20
Q

radial scar pathological features

A
  • 10mm or less
  • stellate architecture
  • central puckering
  • radiating fibrosis
  • stromal elastosis
21
Q

radial scar classical features

A
  • fibro-elastotic core
  • radiating fibrosis containing distorted ductules
  • fibrocystic change
  • epithelial proliferation
22
Q

radial scar can mimic ____ radiologically and pathologically

A

carcinoma

23
Q

radial scar management

A

excise if large, awkward position, or had atypia, or associated malignancy
otherwise, if no atypia, sample extensively by vacuum biopsy to prove there is nothing of concern.

24
Q

two types of breast biopsy

A
  • core (14 G) biopsy
  • vacuum assisted biopsy
25
Q

why would axilla be scanned

A

look for lymph node mets

26
Q

what percentage of breast cancer patients have mets at presentation

A

4-6%

27
Q

what is fat necrosis usually due to

A

local trauma e.g. seat belt injury, falls

28
Q

what is fat necrosis

A

common condition caused by an acute inflammatory response in the breast, leading to ischaemic necrosis of fat lobules

29
Q

pathophysiology of fat necrosis

A
  1. damage and disruption of adipocytes
  2. infiltration by acute inflammatory cells
  3. aggregation of ‘foamy’ macrophages
  4. subsequent fibrosis and scarring
30
Q

fat necrosis management

A

confirm diagnosis
exclude malignancy

31
Q

duct ectasia clinical features

A
  • affects sub-areolar (behind nipple) ducts
  • pain
  • acute episodic inflammatory changes
  • bloody and/or purulent discharge
  • can lead to abscess formation and fistulation
  • nipple retraction and distortion can follow
  • associated with smoking
32
Q

is duct ectasia associated with smoking

A

yes

33
Q

duct ectasia pathological features

A
  • periductal inflammation
  • periductal fibrosis
  • scarring and distortion
34
Q

duct ectasia management

A
  • treat acute infections
  • exclude malignancy
  • stop smoking
  • excise affected ducts if severe
35
Q

what organisms are involved in acute mastitis/abscess if lactation is the aetiology

A
  • staph aureus
  • strep pyogenes
36
Q

acute mastitis/abscess management

A
  • antibiotics
  • percutaneous drainage
  • incision and drainage
  • treat underlying cause
37
Q

what is a phyllodes tumour

A

slow growing unilateral breast mass

38
Q

phyllodes tumour typical age

A

40-50

39
Q

true or false, phyllodes tumours can be benign, borderline, or malignant

A

true

40
Q

intraduct papilloma age

A

35-60

41
Q

what is an intraduct papilloma

A

benign tumour that develops within the milk ducts of the breast.
typically small wart-like growth that may be found near the nipple or deeper within the breast tissue.

42
Q

intraduct papilloma clinical features

A
  • nipple discharge +/- blood
  • asymptomatic at screening
  • palpable nodules
  • calcification
43
Q

intraduct papilloma treatment

A

depends on symptoms/wishes/atypia or malignancy
- excise
- vacuum excision - if there’s no malignancy or atypia

Reproduction & Sexual Health (36 decks)

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