Breast pathology

Question 1

what is the triple breast assessment?

Answer 1

it is a way to assess for breast pathologies it is made up of
1. clinical examination
2. radiological examination
3. pathological examination
all three assessments should correlate, an MDT discussion is involved.

Question 2

what age are screened for breast cancer and how often?

Answer 2

47-73 years old every 3 years

Question 3

what is the procedure if patient gets a positive screening of breast cancer?

Answer 3

this means the screening was abnormal and so a core biopsy is done

Question 4

what would be the procedure if a B2: Benign result is obtained?

Answer 4

IF benign reassure a patient and return to screening

Question 5

what would be the procedure if a B3: Uncertain malignant potential result is obtained?

Answer 5

the mass should be excised

Question 6

what would be the procedure if a B4: suspicion of malignancy result is obtained?

Answer 6

rebiopsy or excision of the mass.

Question 7

what would be the procedure if a B5: malignant result is obtained?

Answer 7

Surgical excision of the mass this may be WLE or Masetectomy.
if its B5a then its a DCIS
if its B5b then it’s invasive.
whether its B5a or B5b informs what procedure will be taken place.

Question 8

where is the glandular parenchyma found?

Answer 8

found near the areola.

Question 9

which group does fibrocystic change effect?

Answer 9

generally affects pre-menopausal women

Question 10

what does women with hypoestrogenism have an increased risk of

Answer 10

FCC

Question 11

what is fibrocystic disease?

Answer 11

A constellation of benign, hormonally mediated breast changes including cyst formation, stroll fibrosis and mild epithelial hyperplasia without atypia

Question 12

what is the presenting symptom of fibrocystic disease?

Answer 12

lumpy, premenstrually painful breasts

Question 13

what group is most likely to get fibroadenoma ?

Answer 13

20-30 years Afro-Caribbean women

Question 14

what is fibroadenoma?

Answer 14

Mobile, painless, well defined breast lump.

Question 15

what symptoms does those with fibroadenoma present with?

Answer 15

usually found as a lump- asymptomatic

Question 16

what radiology does fibroadenoma show?

Answer 16

well defined homogenous hypo echoic mass on ultrasound

Question 17

how do you treat fibroadenoma?

Answer 17

surgical excision, fibroadenoma may reoccur

Question 18

what is DCIS?

Answer 18

Ductal carcinoma in situ. Malignant clonal proliferation of cells within breast parenchymal structures, its a precursor of invasive carcinoma

Question 19

what are the risk factors of breast cancer?

Answer 19

linked to oestrogen.
increased with early menopause, late menopause, obesity in postmenopausal women, OCP’s and hormonal therapy for menopause and alcohol

Question 20

what are the main recognised types of breast carcinoma and %?

Answer 20

Ductal- 75%
lobular - 12%
tubular/Cribiform - 3%
medullary - 3% 
Mucoid - 2%
Metaplastic - 1%
others - 4%

Question 21

what are the key prognostic factors for breast carcinoma?

Answer 21

tumour grade
tumour size
nodal status

Question 22

what is the nottingham prognostic index?

Answer 22

(Grade + nodal status + 0.2 x tumour size)

3. 4 or less - good 80% + 16 year survival
4. 41- 5.4 - moderate 46%
5. 41+ - poor 10%