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Breast > Breast pathology > Flashcards

Breast pathology Flashcards

1
Q

What is the most common histological type of breast cancer?

A

Invasive ductal cancer

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2
Q

What breast disorder is associated with vitamin A deficiency?

A

Periductal mastitis

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3
Q

A postmenopausal woman discovers a breast mass close to the areola of her left breast along with green brown nipple discharge. What condition is she most likely suffering from?

A

Mammary duct ectasia

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4
Q

What is mammary duct ectasia?

A

A condition in which the lactiferous duct becomes blocked or clogged

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5
Q

What is sclerosing adenosis?

A

Extra tissue growth within the breast lobules

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6
Q

What is the most common benign breast tumour in a premenopausal woman?

A

Fibroadenoma

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7
Q

What is Pagets disease of the breast and what is it associated with?

A

Eczema of the nipple

Associated with ductal carcinoma in situ

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8
Q

What is inflammatory carcinoma of the breast?

A

Inflammatory carcinoma involves the dermal lymphatic channels producing an inflamed breast due to the blocked drainage

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9
Q

How does inflammatory carcinoma present?

A

Hot, erythematous, swollen breast

Peu d’orange

Fails to resolve with antibiotic treatment

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10
Q

What is a phyllodes tumour?

A

Large, fast-growing masses that form from the periductal stromal cells of the breast

They can be benign (50-60%), borderline or malignant

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11
Q

What breast disease is associated with a lack of E cadherin and a single file pattern on histology?

A

Invasive lobular carcinoma

Distinguished by its characteristic single file pattern( invasive neoplastic cells line up in orderly rows, also known as ‘Indian file’)

This is as a result of an E cadherin mutation leading to an absence of gland/duct formation

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12
Q

What samples of the breast can be taken for cytology?

A

Fine Needle Aspiration (FNA)

Fluid

Nipple discharge

Nipple scrape

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13
Q

How is cytology from FNA classfied?

A

C1 - Unsatisfactory

C2 - Benign

C3 - Atypia, probably benign

C4 - Suspicious of malignancy

C5 - Malignant

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14
Q

How is a needle core biopsy sample classified in results?

A

B1 - Unsatisfactory / normal

B2 - Benign

B3 - Atypia, probably benign

B4 - Suspicious of malignancy

B5 - Malignant

–B5a - carcinoma in situ

–B5b - invasive carcinoma

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15
Q

What is the difference between core biopsy and vacuum biopsy?

A

Core biopsy must be inserted for every sample taken

Vacuum biopsy only needs to be put in once, and can be used to remove some lesions

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16
Q

What tissue growth occurs in gynaecomastia?

A

Ductal growth without lobular development

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17
Q

What are some of the causes of gynaecomastia?

A

– Exogenous/endogenous hormones

– Cannabis

– Prescription drugs e.g. spironolactone

– Liver disease

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18
Q

What age is fibrocystic change most common in?

A

Occurs from age 20-50 but most common in 40-50

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19
Q

How might fibrocystic change present?

A

Cyclical pain

Smooth, discrete lumps

Lumpy breast

Sudden pain

20
Q

How would a fibroadenoma present?

A

Small, discrete, firm, mobile mass

21
Q

What age is fibroadenoma most common?

A

30’s

22
Q

What is the cause of fat necrosis?

A

Local trauma e.g. seatbelt injury

23
Q

What is the main risk factor for duct ectasia?

A

Smoking

24
Q

How is duct ectasia managed?

A

Antibiotics

Stop smoking

25
Q

What are the two main aetiologies of acute mastitis/abscess?

A

Duct ectasia

Lactation

26
Q

What bacteria affects lactation to cause mastitis/abscess?

A

Staph. aureus

Strep pyogenes

27
Q

Do Phyllodes tumours tend to metastasise?

A

Rarely

28
Q

What is the risk of failing to adequately excising a phyllodes tumour?

A

High chance of local recurrence

29
Q

Which malignant tumour of the breast is associated with post operative radiotherapy?

A

Angiosarcoma

30
Q

From which cancers do metastasis to the breast occur?

A

Bronchial

Ovarian serous carcinoma

Clear cell carcinoma of kidney

31
Q

How can simple epithelial hyperplasia progress to ductal carcinoma in situ?

A
  1. Epithelial hyperplasia
  2. Columnar cell change
  3. Atypical ductal hyperplasia
  4. DCIS
32
Q

What three things are assessed to give breast carcinoma a grading?

A

–Tubular differentiation (1-3)

–Nuclear pleomorphism (1-3)

–Mitotic activity (1-3)

33
Q

What are the gradings for breast carcinoma?

A

3, 4 or 5 = Grade 1

6 or 7 = Grade 2

8 or 9 = Grade 3

34
Q

Is lobular carcinoma more or less common after the menopause?

A

Less

35
Q

Which type of cancer tends to affect both breast or can give diffuse disease in one breast?

A

Lobular

36
Q

Which type of breast cancer tends to affect young people or BRCA positive?

A

Triple negative

37
Q

Which type of breast cancer has the worst prognosis?

A

Triple negative

38
Q

What chromosome is the BRCA1 gene located on?

A

17

39
Q

What chromosome is the BRCA2 geen located on?

A

Chromosome 13

40
Q

Which type of cancer has the second worst prognosis?

A

Her2 +ve

41
Q

What breast condition typically causes bloody discharge from the nipple?

A

Intraductal papilloma

42
Q

What is the most common type of breast cancer?

A

ER +ve

PR +ve

Her2 -ve

43
Q

Which type of breast cancer has the best prognosis?

A

ER +ve

PR +ve

Her2 -ve

44
Q

When is sclerosing adenosis classified as a radial scar?

A

When the lesions is <1cm

45
Q

What bacteria causes mastitis in smokers?

A

Anaerobes

Breast (5 decks)

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