Breast Pathology

Question 1

types of cells in lobules

Answer 1

myoepithelial cells

epithelial cells

Question 2

E-cadherin do what?

Answer 2

stick cells together

metastasis if non functional

Question 3

4 common clinical presentations of breast pathology

Answer 3

palpable lumps
radiological lesion
pain in breast
nipple discharge

Question 4

3 basic pathological investigations

Answer 4

Fine needle aspiration
Core biopsy
Excisional biopsy

Question 5

fine needle aspiration advantages?

Answer 5

cheap
minimally invasive
could be curative if can drain cyst (clear fluid)
usually instant answer

Question 6

when use fine needle aspiration?

Answer 6

cysts
lymph nodes (pull epithelial cells from them = malignancy)

Question 7

when use excisional biopsy?

Answer 7

core biopsy inconclusive

certain tumours need to

Question 8

3 decisions after getting breast patholgoy investigation

Answer 8

1. no surgery (surveillance)
2. cut out small
3. cut out big

Question 9

what is acute mastitis?

Answer 9

from lactation, mild infection from staph aureus

Question 10

mammary duct ectasia is what?

Answer 10

fibrosis around the ducts from multiparous: ill defined lumpy breasts, benign

Question 11

painless palpable mass with history of trauma usually what?

Answer 11

fat necrosis

Question 12

usual ductal hyperplasia has how many cells above BM?

Answer 12

3 or more cells above BM

Question 13

atypical ductal hyperplasia

Answer 13

look like DCIS but not quite yet, needs increased screening

Question 14

Ductal carcinoma insitu definition?

Answer 14

epithelial cells haven’t invaded basement membrane, can’t metastasize

Question 15

what does it mean if there is myoepithelial cells around it?

Answer 15

DCIS hasn’t metastasized

Question 16

recurrence risk? 3 things:

Answer 16

grade
size
margins

Question 17

lobular carcinoma insitu

Answer 17

loses E-Cadherin

Question 18

precursor lesion vs. risk factor lesion?

Answer 18

precursor: lesion come directly from it

risk factor lesion: higher chance of lesion elsewhere, maybe other breast

Question 19

hereditary breast cancer how many % of all cancers?

Answer 19

13 % of all

Question 20

BRCA 1 and 2 are what kind of genes?

Answer 20

DNA repair genes

increase accumulation of mutation

Question 21

sporadic breast cancer cause?

Answer 21

hormone exposure

Question 22

prognostic factors of breast cancer?

Answer 22

tumour size: corresponds with metastases

Tumour grade: pleomorphism

Question 23

does low grade cancer always progress to high grade?

Answer 23

nope, low grade can go directly to metastasis

Question 24

how to test for sentinel node?

Answer 24

radioactive dye injected into tumour, see if it shows up in axilla

Question 25

why is it important to see if the tumour is Estrogen or progesterone positive?

Answer 25

shows how effective tamoxifen will be

Question 26

HER2 is what kind of gene?

Answer 26

oncogene

Question 27

future of breast cancer classification?

Answer 27

gene profiling

Question 28

4 kinds of breast cancers

Answer 28

luminal A: not bad
luminal B: worse
Her2: herceptin
Basal: bad prognosis

Question 29

Mimics of breast cancer: 2 kinds

Answer 29

benign mimics

malignant mimics of benign: very dangerous