Breast Pathology - 2

Question 1

List some benign breast pathologies

Answer 1

Fibrocystic disease
Fibroadenoma
Phyllodes tumour
Radial scar
Intraductal papilloma

Question 2

What is the similarity between phyllodes tumour and fibroadenomas?

Answer 2

They both arise in the intralobular areas

Question 3

Define fibroadenoma + types

Answer 3

Benign neoplasm made of both stromal fibrous tissue and epithelial tissue (adenoma).

Can be subclassified depending on Be the fibrosis squashes the ducts or whether the duct also grows independently.

Intracanalicular - squashes the ducts into cord like structures

Pericanalicular - ducts retain potency

Question 4

What is seen on cytology of fibroadenomas?

Answer 4

Bipolar nuclei which has lost cytoplasm
Branching sheets of epithelium

Question 5

Who gets fibroadenomas? What’s the presentation?

Answer 5

Young people aged 20-30

mobile breast lump

Question 6

Treatment for fibroadenoma

Answer 6

Excision

Question 7

What is a phyllodes tumour?

Answer 7

Intraductal stromal overgrowth - literally branches into the ducts, hence the name phyllodes meaning leaf-like

Question 8

Who gets phyllodes tumour?

Answer 8

People aged 50+

Question 9

Is phyllodes tumour benign or malignant? Treatment?

Answer 9

Benign, but it can become malignant so wide excision advised

Question 10

What is an intraductal papilloma? What are the two types and where are they found?

Answer 10

Papilloma within ducts, can be peripheral in terminal ducts or central in lactiferous ducts

Question 11

Which type of intraductal papilloma is clinically silent and which type presents with signs? What signs are present?

Answer 11

Peripheral intraductal papilloma - clinically silent
Central intraductal papilloma - bloody discharge and subareolar mass

Question 12

What is seen on mammogram with intraductal papillomas?

Answer 12

Nothing, doesn’t show up on mammogram

Question 13

Which age group gets intraductal papillomas?

Answer 13

40-60

Question 14

Is intraductal papilloma benign or malignant? What is the treatment for intraductal papilloma?

Answer 14

Benign but can become malignant (more risk of bloody) and can can have cancerous changes inside.

Question 15

What is a radial scar?

Answer 15

Not actually a scar

Central zone of scarring with glandular proliferation in a stellar form

Question 16

What does a mammogram show in radial scars?

Answer 16

Shows a stellate mass which looks like carcinoma

Question 17

If the radial scar is above 1cm, what do you call it?

Answer 17

Complex sclerosing lesions

Question 18

What is fibrocystic disease?

Answer 18

Benign exaggerated changes in breast tissue to hormonal changes. Loose stroma is replaced with fibrosis and the ducts are dilated.

Question 19

Presentation of fibrocystic disease

Answer 19

Lumps

Question 20

Is fibrocystic disease benign or malignant?

Answer 20

Benign, no increased risk of cancer