Breast Pathology Flashcards
What is the classification of breast disease?
Non neoplastic benign
Neoplastic
Non neoplastic benign Inflammatory Infective Benign fibrocystic changes Diffuse nodularity (proliferative)
Neoplastic
Primary
Secondary
Primary
Benign
Malignant
Benign
Malignant
Non invasive
Invasive
Invasive
Low grade
Medium grade
High grade
What are the non neoplastic benign breast diseases?
Inflammatory Fat necrosis Duct ectasia Granulomatous lobular mastitis Mondors disease (superficial thrombophlebitis)
Infective
Acute mastitis/ breast abscess
Benign fibrocystic changes (non proliferative breast disease)
Proliferative breast disease (epithelial hyperplasia)
Without atypia (sclerosing adenosis)
With atypia
What are the primary benign neoplasms of the breast?
Fibroadenoma
Phyllodes tumour
Intraduct papilloma
Lipoma
What are the primary malignant breast cancers?
Non invasive
Invasive
Non invasive
DCIS (Paget’s disease of the nipple)
LCIS
Invasive Infiltrative DC NOS 80% Infiltrative LC 20% Medullary Mucinous colloid Tubular Inflammatory
What are the risk factors for breast cancer?
Non modifiable
Modifiable
Non modifiable Female gender Advanced age Age at menarche <12 Age at menopause >55 Age at first child >30 Breast fed or not and how long breastfed done Nulliparity Genetics (BRCA , TP53 , PTEN) Family history of BEBO HRT Previous breast / endometrial carcinoma Proliferative breast disease Radiation exposure to chest (Hodgkin lymphoma)
Modifiable
Alcohol > 2 units per day
Obesity
Sedentary lifestyle
What are the steps in the triple assessment of a breast lump?
Clinical palpation and staging
Radiological imaging (USS, MXR, MRI + Mets )
Pathology (histological and IHC) by USS guided core cut Bx
What are the common metastatic sites in breast cancer?
Bone Lung Liver Pleura Adrenals Skin Brain
Bones Lumbar vertebrae Femur Thoracic vertebrae Ribs Skull
What are the imaging modalities used to find breast cancer Mets?
Isotope bone scan CXR CT lung and liver CT Brain MRI
What are the skin changes in breast disease?
Puckering Orange peel Nodules Discoloration Ulceration Thrombophlebitis
What are the nipple changes in breast disease?
Destruction Depression Discoloration Displacement Deviation Discharge Duplication
What are the important examination findings for a breast lump?
Site Size Shape Surface Edge Consistency Fixation to skin and base Tethering of skin
What are the clinical presentations of breast disease?
Lump (painless / painful)
Pain (cyclical / non cyclical)
Nipple (discharge / inversion or change)
Size, shape, skin change (benign / significant)
Also Arm lymphedema Backache Pathological fractures Haemoptysis Neurological
What are the familial patterns conferring high risk of breast cancer?
MS with BCA before age 40 MSD + blood relative with BCA 3 blood relatives with BCA FB with BCA MS with BL BCA MSD + blood relative with OvCA and BCA
