Breast pathology Flashcards
what is the triple breast assessment?
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.
what age are screened for breast cancer and how often?
47-73 years old every 3 years
what is the procedure if patient gets a positive screening of breast cancer?
this means the screening was abnormal and so a core biopsy is done
what would be the procedure if a B2: Benign result is obtained?
IF benign reassure a patient and return to screening
what would be the procedure if a B3: Uncertain malignant potential result is obtained?
the mass should be excised
what would be the procedure if a B4: suspicion of malignancy result is obtained?
rebiopsy or excision of the mass.
what would be the procedure if a B5: malignant result is obtained?
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.
where is the glandular parenchyma found?
found near the areola.
which group does fibrocystic change effect?
generally affects pre-menopausal women
what does women with hypoestrogenism have an increased risk of
FCC
what is fibrocystic disease?
A constellation of benign, hormonally mediated breast changes including cyst formation, stroll fibrosis and mild epithelial hyperplasia without atypia
what is the presenting symptom of fibrocystic disease?
lumpy, premenstrually painful breasts
what group is most likely to get fibroadenoma ?
20-30 years Afro-Caribbean women
what is fibroadenoma?
Mobile, painless, well defined breast lump.
what symptoms does those with fibroadenoma present with?
usually found as a lump- asymptomatic
what radiology does fibroadenoma show?
well defined homogenous hypo echoic mass on ultrasound
how do you treat fibroadenoma?
surgical excision, fibroadenoma may reoccur
what is DCIS?
Ductal carcinoma in situ. Malignant clonal proliferation of cells within breast parenchymal structures, its a precursor of invasive carcinoma
what are the risk factors of breast cancer?
linked to oestrogen.
increased with early menopause, late menopause, obesity in postmenopausal women, OCP’s and hormonal therapy for menopause and alcohol
what are the main recognised types of breast carcinoma and %?
Ductal- 75% lobular - 12% tubular/Cribiform - 3% medullary - 3% Mucoid - 2% Metaplastic - 1% others - 4%
what are the key prognostic factors for breast carcinoma?
tumour grade
tumour size
nodal status
what is the nottingham prognostic index?
(Grade + nodal status + 0.2 x tumour size)
- 4 or less - good 80% + 16 year survival
- 41- 5.4 - moderate 46%
- 41+ - poor 10%
