Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Path - Histopath > breast pathology > Flashcards

breast pathology Flashcards

1
Q

for which age groups would US/Mammogram/MRI be used to look at breasts?

A

Ultrasound – youngest girls – dense breast

MRI - more detailed images

Mammogram - is a low dose X-ray. older girls/women

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

when is cytopathology indicated in breast disease?

positives and cavaets?

A
  • Used in the investigation of nipple discharge and palpable lumps
  • Good cellular detail and quick to prepare but does NOT show the tissue architecture
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

list the meaning of the different coding of breast aspirate on cytology

A 
C1 = inadequate
C2 = benign
C3 = atypia, probably benign
C4 = suspicious of malignancy
C5 = malignant
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

how is breast histopathology conducted?

positives and cavaets?

A

Intact tissue removed, fixed in formalin, embedded in paraffin wax, thinly sliced, stained with H&E.

neg: Takes 24 hours to process.
pos: Architectural & cellular detail.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what is the gold standard for the diagnosis of breast cancer ?

A

histopathology

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

which cells must be present on cytology in normal breast tiissue?

their function?

A

Myoepithelial cells

help to pump breast milk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

which condition presents with

nipple discharge - often blood stained or green
Sometimes causes breast pain,
breast mass - subareolar
nipple retraction

what is this condition?

A

duct ectasia

when milk/mammary duct beneath the nipple widens, the duct walls thicken and the duct fills with fluid. affects peri-postmenopausal women

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what are the signs of duct ectasia on mammogram? and cytology?

A

Mammogram: Microcalcification

Cytology: proteinaceous material and inflammatory cells only inside the DUCT.

Foamy histiocytes/ Macrophages present

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

prognosis of duct ectasia?

what does this mimic?

A

Benign condition with no increased risk of malignancy.

can mimic invasive carcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

which condition presents with

breast: painful (tender), red, hot
breast lump/ hard area - wedge shape
nipple discharge; white
fever, fatigue, chills

A

acute mastitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is the aetiology and treatment of acute mastitis?

A

Seen in lactating women due to cracked skin (BREASTFEEDING!) and stasis of milk ->

bacteria invasion -> can cause pus/abscess formation

Staphylococci the usual organism.

Drainage & antibiotics usually curative.
- continue breast feeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is the prognosis of acute mastitis?

A

risk of chronic mastitis

risk of duct ectasia at same time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what inflammatory cells would cytology show on acute mastitis?

A

lots of neutrophils

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what inflammatory cells would cytology show on fat necrosis?

A

Histiocytes/ macrophages

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

which condition presents with

firm, round lump (or lumps) and is usually painless

The skin around the lump may look red, bruised or occasionally dimpled - tethering

inverted nipple sometimes

A

fat necrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

which condition presents with

benign (noncancerous) condition in which the breasts feel lumpy - firm, ropy or rubbery
cobblestone texture in breast

breast ache, itching

A

Fibrocystic disease

develop fluid-filled cysts along with areas of fibrosis in one or both breasts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what is the prognosis for Fibrocystic disease

A

No increased risk for subsequent breast carcinoma.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

The following signs are common on cytology in which condition?

Branching networks irregular - v peculiar
Biphasic – stromal and fibrous/glandular cells

A

Fibroadenoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

In the fibroepithelial neoplasms, name:

Benign
Malignant

A

Benign; fibroadenoma

Potentially Malignant: Phyllodes (most are benign)

20
Q

A typically large, fast-growing mass that in women aged over 50 should prompt which diagnosis ?

A

phyllodes

21
Q

origin of phyllodes tumours?

A

form from the periductal stromal cells of the breast.

22
Q

how is breast cell malignancy determined?

A

Based on the cellularity- number of cells and their clustering

take the stromal cells for example:

(high cellularity + stromal overgrowth –> malignant)

23
Q

how does intraductal papilloma present?

A

Central papillomas present with nipple discharge.

Peripheral papillomas may remain clinically silent if small.

24
Q

what is the origin of intraductal papilloma?

A

central papillomas - larger lactiferous ducts

peripheral papilloma - small terminal ductules

BENIGN

25
Q

What present as stellate/stellar masses on screening mammograms which may closely a carcinoma?

A

radial scar

26
Q

what is being described:

central fibroelastotic core
with radiating spokes of ducts and lobules - can show unusual changes such as cysts and epithelial hyperplasia

A

radial scar

27
Q

what is the risk of developing cancer with:

Usual epithelial hyperplasia

if any, what type of cancer?

A

1.5-2.0x risk for subsequent

invasive carcinoma.

28
Q

what is the risk of developing cancer with:

Flat epithelial atypia
if any, what type of cancer?

A

4 times relative risk of developing

low grade ductal carcinoma in situ.

29
Q

what is the risk of developing cancer with:

In situ lobular neoplasia

if any, what type of cancer?

A

subsequent invasive breast carcinoma

7-12x risk

30
Q

list the prolefrative. breast diseases.

characteriisitics?

are they malignant?

A

Usual epithelial hyperplasia
Flat epithelial atypia
In situ lobular neoplasia

character: Microscopic lesions which usually produce no symptoms

all present an increased risk of invasive breast carcinoma.

31
Q

list the malignant breast diseases

A

Ductal carcinoma in situ (DCIS)

Basal-like carcinoma

-> high chance of malignancy (invasive breast carcinomas) BUT not an INEVITABLE progression

32
Q

which is the most COMMON breast tumour?

characteriisitics?

A

Invasive breast carcinomas

epithelial origin

33
Q

how does DCIS present?

A

85% are detected on MAMMOGRAM as areas of microcalcification.

10% produce clinical findings such as a lump, nipple discharge, or eczematous change of the nipple (Paget’s disease of the nipple).

34
Q

what is the treatment for DCIS?

A

Treatment is surgical excision -> of the tumour.

Complete excision with clear margins is curative

if it is very large or in multiple areas of breast THEN mastectomy

35
Q

cribriform DCIS is seen in which grade?

A

low grade DCIS

36
Q

BRCA mutations put you at risk of which breast cancer?

% risk?
which mutation most common?

A

Invasive breast carcinomas

85% lifetime risk

BRCA 2

37
Q

what are the risk factors for breast cancers, especially Invasive breast carcinomas
?

A

High lifetime oestrogens:

Early menarche, late menopause, increased weight, high alcohol consumption, oral contraceptive use, and a positive family history are all associated with increased risk.

BRCA mutations

38
Q

what are the genetic origins of low and high grade Invasive breast carcinomas?

A

“Low grade” breast carcinomas:

  • from low grade DCIS or in situ lobular neoplasia
  • 16q loss.

“High grade” breast carcinomas

  • high grade DCIS
  • much more complex genetics
39
Q

describe the histology of the following:

Invasive ductal carcinoma
Invasive lobular Carcinoma
Invasive TUBULAR Carcinoma
Invasive MUCINOUS Carcinoma

A

Invasive ductal carcinoma:
- large, pleomorphic, nucleates cells. have large nuclei

Invasive lobular Carcinoma

  • Trabecular pattern of growth
  • linear arrangement of cells: Indian File pattern
  • monomorphic; look like each other

Invasive TUBULAR Carcinoma

  • Low grade, low likelihood of mets
  • elongated tubules of cancer cells

Invasive MUCINOUS Carcinoma
- contain a lot of mucin

40
Q

what would ivx for Basal-like Carcinoma show?

A

Histopath:
Sheets of markedly atypical cells with a prominent lymphocytic infiltrate

Immunohistochem:
basal cytokeratins (CK5/6 and CK14)
○ Associated with BRCA mutations

41
Q

what are the parameters for breast tumour grading?

A

1) tubule formation 2) nuclear pleomorphism,, and 3)mitotic activity.

42
Q

what is the receptor status for the following tumours:

low grade
high grade
basal-like carcinoma

A

LG: ER/PR + and Her2-

HG: ER/PR- and Her2+

BLC: ER/PR- and Her2- (triple negative)

*estrogen receptor, progesterone receptor

43
Q

most important prognosstc indicator in breast cancere?

A

status of the axillary lymph nodes

44
Q

what is the purpose and characterisitcs of the NHS Breast Screening Programme?

A

to pick up DCIS or early invasive carcinomas.

Women aged 47-73

Screening every 3 years

Mammogram: looks for abnormal areas of calcification or a mass within the breast.

45
Q

Which core biopsy scores are representative of:

DCIS
Invasive carcinoma

A

B5a: DCIS

B5b: Invasive carcinoma

46
Q

woman attends NHS Breast Screening Programme and has an abnormal mammogram.

what are the next steps?

A

further ivx: another mammogram or Ultrasound

+ core biopsy - > for B grade

47
Q

male gynaecomastia of histology is similar to ___ ?

A

§ Similar to fibroadenoma

Path - Histopath (21 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions