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Reproductive System > Breast- Pathology > Flashcards

Breast- Pathology Flashcards

1
Q

identify the 5 benign breast conditions

A
  • fibrocystic change
  • fibroadenoma
  • intraductal papilloma
  • fat necrosis
  • duct ectasia
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2
Q

what is fibrocystic change?

A

hyperplastic overgrowth of all of the components of the mammary gland unit

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3
Q

what is fibrocystic change caused by?

A

abnormal response of breast to ovarian hormones

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4
Q

features of fibrocystic change?

A
  • fibrosis
  • adenosis
  • cysts
  • ductal epithelial hyperplasia
  • apocrine metaplasia
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5
Q

what is the epidemiology of fibroadenoma?

A

most common breast tumour of adolescents / young women

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6
Q

key features of fibroadenoma?

A
  • circumsized, mobile, non-tender nodule
  • may regress with time if left untreated
  • proliferation of stromal and epithelial elements
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7
Q

in who does intraductal papilloma usually occur in and how does it present?

A
  • middle aged women
  • nipple discharge
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8
Q

what is the aetiology of fat necrosis?

A
  • previous trauma
  • past surgery
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9
Q

what are features of fat necrosis (clinically and radiologically)?

A
  • can simulate carcinoma both clinically and radiologically
  • clinically a hard, irregular breast lump
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10
Q

what are features of fat necrosis on histology?

A

histiocytes with foamy cytoplasm

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11
Q

how does duct ectasia present?

A

nipple discharge

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12
Q

what is Phyllodes tumour?

A
  • a fleshy tumour with a leaf-like pattern and cysts on cut surface
  • circumscribed with epithelial and stromal elements
  • may be benign/ borderline /malignant
  • <1% of breast tumours
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13
Q

Breast carcinoma

  • Epidemiology?
A
  • most common cause of female cancer death
  • 1/8 women will get it
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14
Q

Symptoms / signs of Breast carcinoma?

A
  • Hard lump/mass in breast
  • tethering to skin / dimpling of skin
  • discharge / bleeding
  • change in size /shape of breast
  • change in colour of areola
  • redness over breast skin
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15
Q

risk factors of Breast carcinoma?

A
  • Increased age
  • FH
  • BRCA1/2

increased exposoure to oestrogen:

  • age at menstruation and menarche
  • age at 1st pregnancy
  • hormonal therapies ie HRT /OCP

lifestyle:

  • obesity
  • alcohol

radiation

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16
Q

histological classification of Breast carcinoma ?

A

Non-Invasive

  • Ductal Carcinoma In Situ
  • Lobular Carcinoma In Situ

Invasive

  • Invasive Ductal Carcinoma (85%)
  • Invasive Lobular Carcinoma
  • other types:
    • mucinous carcinoma
    • tubular carcinoma
    • medullary carcinoma
17
Q

what are the features of in-situ carcinoma?

A
  • pre-invasive
  • no metastatic spread
  • not detected clincially
    • apart from DCIS on X-Ray
  • risk of invasion depending on grade
  • multicentricity and bilaterality in LCIS
18
Q

what is Paget’s Disease of the Nipple and where does it affect?

A

result of intraepithelial spread of intraductal carcinoma

  • affects nipple or areola
19
Q

what are symptoms of Paget’s disease?

A

pain/ itching / discharge / ulceration/ crusting / scaling and redness

20
Q

what are diagnostic procedures for Breast carcinoma and outline their sensitivities

A
  • clinical examination 88%
  • Mammography 93%
  • US 88%
  • MRI
  • Fine Needle Aspiration cytology 94%
  • Needle Core Biopsy
  • wide local excision with adequate margins
21
Q

outline the breast screening process

A

mammogram every 3 years for women aged 50-70

22
Q

what are the 2 most important mammographic indicators of breast cancer?

A
  • mass
  • microcalcifications
    • tiny specks of calcium in the soft tissue of the breast
    • in majority of cases, this is normal
    • however in a few cases it can be cancerous / pre-cancerous tissue
23
Q

outline the spread of breast cancer?

A
  • Local
    • skin / pectoral muscles
  • Lymphatic
    • axillary lymph nodes / internal mammary
  • Blood
    • bone, lung, liver, brain
24
Q

what are the factors that influence someone’s prognosis regarding Breast carcinoma?

A
  • LYMPH SPREAD–> best prognostic indicator
  • age
  • presence of ER/PR/HER-2
  • type / size and grade of cancer
25
Q

what does the presence of the HER-2 receptor predict?

A

response to Trastuzumab (Herceptin)

Reproductive System (32 decks)

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