Breast Pathology Flashcards
List the different methods of obtaining breast histopathology specimens
Needle core biopsy Fine needle aspiration Vacuum-assisted biopsy Skin biopsy Incisional biopsy of mass
What types of therapeutic excision can be done for breast pathology?
Excisional biopsy of mass
Wide local excision of cancer
Mastectomy
What is gynaecomastia?
Breast development in the male with ductal growth without lobular development
List some causes of gynaecomastia
Exogenous/endogenous hormones
Cannabis
Drugs (furosemide)
Liver disease
Fibrocystic change is non-neoplastic and typically affects women of what ages?
Aged 20-50, majority are 40-50
List the clinical features of fibrocystic change of the breasts
Menstrual disturbance
Smooth, discrete lump
Sudden/cyclical pain
Fibrocystic change of the breasts is associated with late menarche and late menopause. True/False?
False
Early menarche, late menopause
Describe the pathological appearance of fibrocystic change of the breasts
Blue-domed cysts with pale fluid
Thin-walled but may be fibrous
How is fibrocystic change managed?
Reassurance
Excision if necessary/symptomatic
What is a hamartoma?
Circumscribed lesion consisting of normal breast tissue but present in abnormal proportion or distribution
A fibroadenoma is a common benign lesion of the breasts - list some clinical features
Painless
Discrete, mobile mass
Peak incidence in 30’s
Describe the pathological appearance of fibroadenoma of the breasts
Circumscribed
Rubbery
Grey-white colour
Biphasic - consists of epithelium and stroma
How is fibroadenoma of the breasts managed?
Reassurance
Excision if necessary
What is sclerosing adenosis?
Benign, disordered proliferation of acini and stroma that can cause a mass or calcification
Describe the pathological appearance of a radial scar
Stellate architecture
Central puckering
Sclerosing adenosis and radial scars may mimic carcinoma. True/False?
True
List some common causes of fat necrosis of the breasts
Local trauma (seatbelt injury) Warfarin
What is duct ectasia of the breast?
Lactiferous duct becomes blocked/clogged
List clinical features of duct ectasia
Pain
Bloody/purulent discharge
Fistulation
Nipple retraction/distortion
What are the 2 main aetiologies that cause acute mastitis?
Duct ectasia Lactatory infection (Staph aureus, Step pyogenes)
What is a Phyllodes tumour?
Slow-growing unilateral benign breast mass
List the main metastatic tumours to the breast
Bronchial carcinoma Ovarian serous carcinoma Clear cell carcinoma of kidney Malignant melanoma Leiomyosarcoma
Where does breast carcinoma arise?
Glandular epithelium of terminal duct lobular unit (TDLU)
What type of carcinoma is breast carcinoma?
Adenocarcinoma
List the precursor lesions that can give rise to breast carcinoma
Epithelial hyperplasia Columnar cell hyperplasia Atypical ductal hyperplasia Ductal carcinoma in situ Lobular in situ neoplasia
How is in situ carcinoma of the breast defined?
Confined to basement membrane of acini and ducts, i.e. non/pre -invasive
What are the 2 subtypes of lobular in situ neoplasia and how are they defined?
Atypical lobular hyperplasia (less than 50% of lobule affected)
Lobular carcinoma in situ (more than 50% of lobule affected)
Lobular in situ neoplasia is palpable. True/False?
False
Not palpable or grossly visible
Which disease is essentially high-grade ductal carcinoma in situ involving the nipple skin?
Paget’s disease
What is the peak age range of incidence of breast carcinoma?
50-70’s
List risk factors for breast carcinoma
Age Abnormal reproductive history Hormone therapy (OCP, HRT) Previous breast disease Poor lifestyle Genetics
NSAIDs lower the risk of breast carcinoma. True/False?
True
An affected first-degree relative increases the risk of breast cancer by how much?
Doubles the risk
What 2 factors/receptors help predict and offer prognosis for breast carcinoma?
HER2 Oestrogen receptor (ER)
