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Breast Health > Breast Pathology > Flashcards

Breast Pathology Flashcards

1
Q

What is more commonly used in breast pathology - cytology or histopathology?

A

Histopathology

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2
Q

What method is used for breast cytology?

A

Fine needle aspiration

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3
Q

Give some methods that can be used in breast histopathology

A

Needle core biopsy
Vacuum-assisted biopsy
Skin biopsy
Incisional biopsy

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4
Q

What is the main difference between needle core biopsy and FNA biopsy staging?

A

Can tell if cancer is in-situ or invasive in needle core biopsy

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5
Q

How may fibrocystic breast disease present?

A

Smooth discrete lumps

Pain

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6
Q

What pathology occurs in fibrocystic breast disease?

A

Multiple cysts (lined by apocrine epithelium) form with intervening fibrosis

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7
Q

What is a hamartoma?

A

A lesion of the breast composed of normal cell types present in an abnormal proportion/distribution

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8
Q

How do fibroadenomas present?

A

Painless firm discrete mobile mass

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9
Q

What is the best imaging modality for fibroadenomas?

A

USS

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10
Q

What pathology occurs in fibroadenoma?

A

Hyperplasia of glandular epithelium with proliferation of the intralobular stroma

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11
Q

What is the most common age group for fibroadenomas?

A

20-30

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12
Q

What pathology occurs in sclerosing lesions of the breast?

A

Benign disorderly proliferation of acini and stroma

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13
Q

What are the main sclerosing lesions of the breast?

A

Sclerosing adenosis

Radial scar

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14
Q

How are radial scars treated?

A

Excision or vacuum biopsy sample

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15
Q

What are the main causes of breast fat necrosis?

A 
Local trauma (seat belt injury)
Warfarin therapy
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16
Q

What occurs in fat necrosis?

A

Damage and disruption of adipocytes causing infiltration by inflammatory cells

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17
Q

How does duct ectasia present?

A

Pain
Bloody/purulent discharge
Fistulation

18
Q

Duct ectasia is associated with which group of women?

A

Smokers

19
Q

What occurs in duct ectasia?

A

Lactiferous duct becomes blocked leading to periductal inflammation and fibrosis

20
Q

What are the two main causes of acute mastitis?

A

Duct ectasia

Lactation

21
Q

How is acute mastitis managed?

A

Antibiotics

Percutaneous drainage

22
Q

What pathology occurs in Phyllodes tumour?

A

There is overgrowth of the periductal stromal cells

23
Q

What are the main benign papillary lesions?

A

Intraductal papilloma

Nipple adenoma

24
Q

How does intraductal papilloma commonly present?

A

Nipple discharge +/- blood

25
Q

How are intraductal papillary lesions graded?

A

Level of epithelial proliferation

26
Q

Breast carcinoma arises where?

A

Glandular epithelium of TDLU

27
Q

What are the two main precursor lesions of breast cancer?

A

Ductal

Lobular

28
Q

An in-situ breast carcinoma is confined within what?

A

Basement membrane of acini and ducts

29
Q

What is neoplasm of <50% of the lobule called?

A

Atypical lobular hyperplasia

30
Q

What is neoplasm of >50% of the lobule called?

A

Lobular carcinoma in-situ

31
Q

Why is lobular in-situ neoplasia significant?

A

As it increases relative risk of invasive carcinoma eightfold

32
Q

What types of intraductal proliferation can occur?

A

Columnar cell change
Atypical ductal hyperplasia
Ductal carcinoma in-situ

33
Q

What occurs in ductal carcinoma in-situ?

A

Cytologically malignant epithelial cells are confined within the basement membrane of the duct

34
Q

What occurs in Paget’s disease of the nipple?

A

A high grade DCIS extends along ducts to reach the epidermis of the nipple

35
Q

What occurs in microinvasive carcinoma?

A

DCIS with invasion of <1mm

36
Q

What occurs in invasive breast carcinoma?

A

Malignant epithelial cells have breached the basement membrane

37
Q

Give some gene mutations that can predispose to breast cancer

A

BRCA1/2
TP53
PTEN

38
Q

Breast carcinomas are graded under which three parameters?

A

Tubular differentiation
Nuclear pleomorphism
Mitotic activity

39
Q

Invasive breast cancer can express which hormone receptors?

A

Oestrogen receptors
Progesterone receptors
HER2

40
Q

What is the clinical significance of oestrogen receptor expression?

A

As it predicts response to anti-oestrogen therapy

41
Q

What is the clinical significance of HER2 expression?

A

Predicts repsonse to trastuzamab (herceptin)

42
Q

How is breast cancer staged?

A

T - invasion of adjacent tissues
N - lymphatic spread
M - blood-borne spread

Breast Health (5 decks)

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