Breast pathology Flashcards
why is mammography offered to patients over 40
less glandular tissue, more fat
how do you collect pathological sample for breast cancer
fine needle aspiration OR core biopsy
What is duct ectasia
inflammation and dilatation of large breast ducts
what shows up in cytology. of duct ectasia
Dilated ducts
Periductal inflammation with secretions (inflammatory cells, proteinaceous material ).
Foamy macrophages
WHAT IS ACUTE MASTITIS
ACUTE INFLAMMATION OF THE BREAST
Often presents in lactating women with cracked skin, stasis of milk, painful red breast
what organism causes acute mastitis
staphylococci
What is fat necrosis
inflammatory reaction to damaged adipose tissue
what can cause fat necrosis
trauma
surgery
radiotherapy
how does fat necrosis present
breast mass
fat necrosis on cytology
fat cells surrounded by macrophages
acute mastitis on cytology
lots of neutrophils
What are the three inflammatory breast diseases
duct ectasia
acute mastitis
fat necrosis
What are benign breast conditions
fibrocystic disease fibroadenoma phyllodes tumour intraductal papilloma radial scar
what is fibrocystic disease
normal but exaggerated response to hormonal influence
what is presentation of fibrocystic disease
breast lumpiness and change with period
what is histology of fibrocystic disease
dilated and calcified ducts
what is a fibroadenoma
benign neoplasm of breast
what is presentation of fibroadenoma
circumcised, mobile breast lump (BREAST MOUSE) in young women
What is fibroadenoma histology
branching structure
glandular + stromal cells, compressed slit like ducts
what is a philloides tumour
potentially aggressive fibroepithelial neoplasm
what age group does philloides tumour present
elderly >50
what is phyllodes tumour histology
overlapping cells, LEAF LIKE
what is an intraductal papilloma
benign papillary tumour
arises within the duct system of the breast
what does a central papilloma present as
nipple disscharge
what does a peripheral papilloma present with
clinically silent
How do you treat papilloma q
excision
what does histology show for papilloma
finger like papillary lesion
Fibrovascular core to nourish the papilloma
clustered cells
what does a radial scar look like on histology
stellate
describe histology of ductal carcinoma in situ
cribriform
calcification (detected on mammogram)
atypical epithelial cells
what is histology of high grade ductal carcinoma
large cells
pleomorphic, occlude duct
treat with surgical excision
what is an invasive breast carcinoma
malignant epithelial tumour which infiltrates the breast
spreads to distant site
what does low grade invasive breast carcinoma derive from
low grade DCIS / in situ lobular neoplasia
what does low grade invasive breast carcinoma show on chromosome
16q loss
what does high grade invasive breast carcinoma derive from
from high grade DCIS
explain cytology of invasive DUCTAL carcinoma
pleomorphic, large nuclei
what is cytology of invasive LOBULAR carcinoma
linear arrangement - INDIAN FILE
MONOMORPHIC
what are invasive breast cancers assessed for
oestrogen receptor
progesterone receptor
Her2 receptor
what is the most important prognostic factor for breast cancer
v axillary lymph nodes
What is cytology of invasive tubular carcinoma
elongated tubules of cancer cells
what is cytology of invasive mucinous carcinoma
lots of empty spaces containing mucin
What is a low grade phenotype of breast cancer (in terms of receptors)
ER/PR +
Her2 -
What is a high grade phenotype of breast cancer (in terms of receptors)
ER/PR-
HEr2+
What is a basal like carcinoma in terms of receptors
ER, PR, Her2 NEGATIVE
How can you tell apart ductal from lobular in situ carcinoma
Ductal:
- unilateral, unifocal
- on mammogram: microcalcification with central necrosis.
- pleomorphic nuclei
Lobular:
- pre-menopausal women
- bilateral and multifocal.
- No calcification occurs > no detection on mammogram.
- Histologically no necrosis and uniform nuclei are present.
