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Repro > Breast pathology > Flashcards

Breast pathology Flashcards

1
Q

Who is involved in the Multi Disciplinary Team (MDT)?

A 
Surgeon
Radiologist
Pathologist
Oncologist
Breast care nurse
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2
Q

What imaging is used?

A

Mammography
USS
MRI

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3
Q

What pathology is looked at?

A

Cytopathology

Histopathology

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4
Q

What is used for breast cytopathology?

A

Fine needle aspiration
Fluid
Nipple discharge
Nipple scrape

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5
Q

How is Breast FNA Cytology classified?

A 
C1 - Unsatisfactory
C2 - Benign
C3 - Atypia, probably benign
C4 - Suspicious 
C5 - Malignant
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6
Q

How is breast histopathology done (Diagnostic)?

A

Needle core biopsy
Vacuum assisted biopsy (large volume/mammotome)
Skin biopsy
Incisional biopsy of mass

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7
Q

How is breast histopathology done (Therapeutic)?

A

Excisional biopsy of mass

Resection of cancer - wide local excision, masectomy

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8
Q

How are Needle Core Biopsy results categorised?

A 
B1 - Unsatisfactory/ normal
B2 - Benign
B3 - Atypia, probably benign
B4 - Suspicious
B5 - Malignant
B5a - carcinoma in situ
B5b - Invasive carcinoma
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9
Q

What developmental problem can occur in benign breast disease?

A

Hypoplasia

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10
Q

What anomalies can occur in benign breast disease?

A

Juvenile hypertrophy
Accessory breast tissue
Accessory nipple

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11
Q

What non-neoplastic problems can occur in benign breast disease?

A 
Gynaecomastia
Fibrocystic change
Hamartoma
Fibroadenoma
Sclerosing lesions - sclerosing adenosis, radial scar/complex sclerosing lesions
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12
Q

What inflammatory problems can occur in benign breast disease?

A

Fat necrosis
Duct ectasia
Acute mastitis/abscess

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13
Q

What tumours can occur in benign breast disease?

A

Phyllodes tumour

Intraduct papilloma

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14
Q

What is gynaecomastia?

A

Breast development in males

Ductal growth without lobular development

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15
Q

What are causes of gynaecomastia?

A

Exogenous/endgenous hormones
Cannabis
prescription drugs
Liver disease

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16
Q

Describe Fibrocystic change

A 
Women aged 20-50 (Majority 40-50)
Very common
Menstrual abnormalities
Early menarche
Late menopause
Often resolved or diminished after menopause
17
Q

How do fibrocystic changes present?

A 
Smooth discrete lumps
Sudden pain
Cyclical pain
Lumpiness
Incidental finding
Screening
18
Q

How do fibrocystic changes look? (Gross pathology)

A 
Cysts
1mm-several cm
Blue domed with pale fluid
usually multiple
Associated with other benign changes
Intervening fibrosis
19
Q

What is the microscopic pathology of fibrocystic changes?

A

Cysts
Thin walled but may have fibrotic wall
Lined by apocrine epithelium
Intervening fibrosis

20
Q

How do you manage fibrocystic change?

A

Exclude malignancy
Reassure
Excise if necessary

21
Q

What is a hamartoma?

A

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

22
Q

In whom is Fibroadenoma more common in?

A

African women

23
Q

Describe clinically fibroadenoma?

A 
Peak incidence in 3rd decade
Screening used
Painless, firm, discrete, mobile mass
"Breast mouse"
Solid on USS
24
Q

Describe a fibroadenoma?

A

Circumscribed
Rubbery
Grey-white colour
Biphastic tumour/lesion- Epithelium, stroma

25
Q

How do you manage a fibroadenioma?

A

Diagnose
Reassure
Excise

26
Q

What are sclerosing lesions?

A 
Sclerosing adenosis
Radial scar / complex sclerosing lesion
Benign, disorderly proliferation of acini and stroma
Can cause a mass or calcification
May mimic carcinoma
27
Q

How do sclerosing adenosis present?

A

pain, tenderness or lumpiness/thickening
Asymptomatic
Age 20-70

28
Q

Is sclerosing adnosis malignant?

A

Benign

29
Q

Describe a radial scar?

A

Wide age range
Common
Incidental finding
Mammographically detected

30
Q

Describe the pathology of a radial scar?

A 
RS - 1-9mm
CSL - >10mm
Stellate architecture
Central punching
Radiating fibrosis
31
Q

What’s the histology of a radial scar?

A

Fibroelastotic core
Radiating fibrosis containing distorted ductules
Epithelial proliferation

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