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Anatomy > Breast pathology > Flashcards

Breast pathology Flashcards

1
Q

C1

A

Unsatisfactory

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2
Q

C2

A

Benign

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3
Q

C3

A

Atypia, probably benign

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4
Q

C4

A

Suspicious of malignancy

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5
Q

C5

A

Malignant

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6
Q

B1

A

Unsatisfactory/normal

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7
Q

B2

A

Benign

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8
Q

B3

A

Atypia, probably benign

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9
Q

B4

A

Suspicious of malignancy

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10
Q

B5

A

Malignant

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11
Q

B5a

A

Carcinoma in situ

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12
Q

B5b

A

Invasive carcinoma

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13
Q

This breast change is associated with:

  • menstrual abnormalities
  • early menarche
  • late menopause
A

Fibrocystic change

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14
Q

When do fibrocystic changes resolve?

A

Usually resolve by themselves after menopause

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15
Q

Age group affected by fibrocystic change?

A

Women aged 20-50

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16
Q

Presentation of fibrocystic change

A 
Presentation
Smooth discrete lumps
Sudden pain
Cyclical pain
Lumpiness
Incidental finding
Screening
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17
Q

Thin walled but may have fibrotic wall

Lined by APOCRINE epithelium

A

Cysts

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18
Q

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

A

Hamartoma

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19
Q

Fibroadenomas are commoner in which race?

A

African women

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20
Q

Peak incidence of fibroadenoma?

A

3rd decade

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21
Q

Biphasic tumour

A

Fibroadenoma:

  • epithelial tissue
  • stromal tissue

(Phyllodes also biphasic)

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22
Q

Benign, disorderly proliferation of acini and stroma

A

Sclerosing lesions

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23
Q

Can cause a mass or calcification

May mimic a carcinoma

A

Sclerosing lesions

24
Q

Damage and disruption of adipocytes
Infiltration by acute inflammatory cells
“foamy” macrophages
Subsequent fibrosis and scarring

A

Fat necrosis

25
Q

What medication could cause fat necrosis?

A

Warfarin

26
Q 
Affects sub-areolar ducts
Pain
Acute episodic inflammatory changes
Bloody and/or purulent D/C
Fistulation
Nipple retraction and distortion
A

Duct ectasia

27
Q 
Associated with smoking
Sub-areolar duct dilatation
Periductal inflammation
Periductal fibrosis
Scarring and distortion
A

Duct ectasia

28
Q

What is duct ectasia associated with?

A

Smoking

29
Q

Management for duct ectasia

A

Treat acute infections
Exclude malignancy
Stop smoking
Excise ducts

30
Q

2 main causes of acute mastitis/abscess?

A

Duct ectasia:
Mixed organisms
Anaerobes

Lactation:
Staph aureus
Strep pyogenes

31
Q

What age group are affected by phyllodes tumour?

A

Age 40-50

32
Q

What does a biphasic tumour contain?

A

Epithelial and stromal components

33
Q

Papillary fronds containing a fibrovascular core

A

Intraduct papilloma

34
Q

Covered by myoepithlelium and epithelium

A

Intraduct papilloma

35
Q

Phyllodes tumours are often benign but what can make them malignant?

A

If they have a sarcomatous stromal component

36
Q

What could cause a breast angiosarcoma?

A

Radiation therapy

37
Q

What type of ovarian cancer could metastasise to the breast?

A

Serous cell

38
Q

What kidney cancer could metastasise to the breast?

A

Clear cell carcinoma

39
Q

What soft tissue tumour could metastasise to the breast?

A

Leiomyosarcoma

40
Q

Definition of breast sarcoma?

A

Malignant proliferation of breast epithelial cells

41
Q

Significance of Lobular in situ neoplasia?

A

It is a marker of subsequent risk,

it is also a true precursor lesion

42
Q

Difference between atypical lobular hyperplasia and lobular carcinoma in situ?

A

Atypical lobular hyperplasia - 50% of the lobule involved

43
Q

ER finding in lobular carcinoma?

A

ER positive

44
Q

E-cadherin finding in lobular carcinoma?

A

E-cadherin negative

45
Q

Risk of epithelial hyperplasia of usual type progressing to cancer?

A

2x

46
Q

Risk of atypical ductal hyperplasia progressing to cancer?

A

4x

47
Q

Risk of ductal carcinoma in situ progressing to cancer?

A

10x

48
Q

Where doe ductal carcinoma in situ arise from?

A

TDLU (terminal duct lobular unit)

49
Q

What is pagets disease? Is it in situ?

A

Pagets disease is when DCIS extends along the ducts to reach the epidermis of the nipple
-still in site (i.e. non invasive)

50
Q

Which common drug reduces the risk of breast cancer?

A

NSAIDS

51
Q

Lifetime risk of breast cancer if you have BRCA 1 / BRCA 2

A

45-64% life-time risk (v high)

52
Q

Commonest female cancer?

A

Invasive breast carcinoma

53
Q

Breast cancer prognostic factors

A 
ER positive (good response to hormonal therapy)
HER 2 positive (good response to trastuzumab/herceptin)
54
Q

What does the Nottingham prognostic index look at?

A

Histopathology only

55
Q

What does the Adjuvant! Online prognostic index look at?

A
  • histopathology
  • ER
  • clinical factors
56
Q

What does the PREDICT prognostic index look at?

A
  • histopathology
  • ER
  • clinical factors
  • HER 2
  • mode of detection

Anatomy (13 decks)

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