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Clinical Pathology > Breast pathology > Flashcards

Breast pathology Flashcards

1
Q

Where do the majority of malignancies arise in the breast?

A

Epithelial cells - therefore, CARCINOMAS

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2
Q

Where do the majority of malignancies arise in the breast?

A

Epithelial cells - therefore, CARCINOMAS

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3
Q

What is the breast comprise?

A

Mammary glands (lobes) - where epithelium are

Lactiferous ducts

Fat (adipose tissue)

Epithelial tissue - fibrous bis of breast

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4
Q

Why are breast in younger people more lumpy?

A

More glandular and fibrous - therefore mammograms = less useful in young people

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5
Q

What age of people are more likely to get breast CARCINOMAS?

A

Peri/post menopausal - below 35yrs lumps = benign mostly!

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6
Q

What do mobile lumps of the breast indicate in different age groups

A

Fibroadenoma in 55 yrs

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7
Q

What do ill defined lumps/lump areas indicate in different age groupo?

A

Fibrocycstic changes in perimenopausal women

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8
Q

What do firm lump +/- tethering indicate in different age groups?

A

Carcinoma (>25yrs)

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9
Q

What does clear nipple discharge indicate in different age groups?

A

Duct ectasia

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10
Q

What does bloody nipple discharge indicate in different age groups?

A 
Duct papiloma 
Duct carcinoma (in situ)
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11
Q

What are the risk factors for breast cancer?

A
  • Genetic - first degree relative (BRCA1/2)
  • Obesity
  • Oestrogenic environment e.g. oestrogen-progesterone contraceptive, HRT (oestrogen
  • obesity
  • Radiation
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12
Q

What are the risk factors for breast cancer?

A
  • Obesity
  • Oestrogenic environment e.g. oestrogen-progesterone contraceptive, HRT (oestrogen
  • obesity
  • Radiation
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13
Q

What is protective for breast cancer?

A

Breast feeding

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14
Q

What is the breast comprise?

A

Mammary glands (lobes) - where epithelium are

Lactiferous ducts

Fat (adipose tissue)

Epithelial tissue - fibrous bis of breast

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15
Q

Why are breast in younger people more lumpy?

A

More glandular and fibrous - therefore mammograms = less useful in young people

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16
Q

What are duct papillomas? How do they present and what population do they mostly effect?

A

-Middle aged women
- Nipple discharge (bloody)
- Solitary lesion in large breast duct
- Papillary structures, with fibrovascular core covered by
benign epithelium
- Benign

17
Q

What are phyllodes tumours?

A
  • Occur at any age
  • Discrete lump with firm and soft areas
  • rare fibroepithelial neoplasm - stroma can become aggressive
18
Q

How are great biopsies graded?

A

B grade

19
Q

Name so presentations for breast disease

A
  • puckered skin/withdrawn nipple fibroblasts pull structures inwards

Peau d’orange - inflammatory breast cancer - lots of tumour blocking lymphatics - lumpy

Inflammation e.g. TB, carcinoma, mastitis following breast feeding

Nipple discharge

Pain (rare though!)

20
Q

What gene is overexpressed with paget’s disease/invasive breast carcinoma? How is it characterised in the nipple?

A

HER2

Eczema like irritation of nipple - associated with underlying carcinoma

21
Q

What is protective for breast cancer?

A

Breast feeding

22
Q

What is the nickname for fibroadenomas?

A

Breast mouse

23
Q

Where do fibroadenomas arise from?

A

Lobules - involve proliferation of connective tissue stroma and glands

24
Q

What are the characteristics of fibroadenomas?

A
  • Non-malignant
  • Untethered (therefore, mobile)
  • compression of overlying breast tissue
25
Q

What are duct papillomas? How do they present and what population do they mostly effect?

A
  • Middle aged women
  • Nipple discharge (bloody)
  • Solitary lesion in large breast duct
  • Non-malignant
26
Q

What are phyllodes tumours?

A
  • Occur at any age
  • Discrete lump with firm and soft areas
  • stroma and epithelial parts - stroma can become aggressive and reoccurrence
27
Q

If a breast lump is found, what 3 investigative parameters should be performed? (triple assessment)

A

Clinical - exam and palpation

Radiological

Pathological - cytological/histopathology

28
Q

What investigations can be performed to diagnose breast malignancies?

A
  • imaging – mammography and ultrasonography
  • fine-needle aspiration cytology
  • core biopsy or vacuum-assisted biopsy
29
Q

How are great biopsies graded?

A 
B grades
B1 - normal 
B2 - benign
B3 - Atypical, prob benign
B4 - atypical, prob malignant
B5 - malignant a) in situ; b) invasive
30
Q

What characterised fibrocystic changes?

A

Physiological changes

  • ductal hyperplasia
  • cysts
  • apocrine metaplasia
  • micro calcifications
  • oestrogenic environment
31
Q

Name so presentations for breast disease

A
  • puckered skin/withdrawn nipple fibroblasts pull structures inwards

Peau d’orange - inflammatory breast cancer - lots of tumour blocking lymphatics - lumpy

Inflammation e.g. TB, carcinoma, mastitis following breast feeding

Nipple discharge

32
Q

What gene is overexpressed with pages disease?

A

HER2

Clinical Pathology (50 decks)

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