Breast pathology Flashcards by Laura Lazzari

why is mammography offered to patients over 40

less glandular tissue, more fat

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how do you collect pathological sample for breast cancer

fine needle aspiration OR core biopsy

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What is duct ectasia

inflammation and dilatation of large breast ducts

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what shows up in cytology. of duct ectasia

Dilated ducts
Periductal inflammation with secretions (inflammatory cells, proteinaceous material ).
Foamy macrophages

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WHAT IS ACUTE MASTITIS

ACUTE INFLAMMATION OF THE BREAST

Often presents in lactating women with cracked skin, stasis of milk, painful red breast

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what organism causes acute mastitis

staphylococci

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What is fat necrosis

inflammatory reaction to damaged adipose tissue

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what can cause fat necrosis

trauma
surgery
radiotherapy

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how does fat necrosis present

breast mass

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fat necrosis on cytology

fat cells surrounded by macrophages

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acute mastitis on cytology

lots of neutrophils

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What are the three inflammatory breast diseases

duct ectasia
acute mastitis
fat necrosis

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What are benign breast conditions

fibrocystic disease
fibroadenoma 
phyllodes tumour 
intraductal papilloma 
radial scar

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what is fibrocystic disease

normal but exaggerated response to hormonal influence

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what is presentation of fibrocystic disease

breast lumpiness and change with period

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what is histology of fibrocystic disease

dilated and calcified ducts

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what is a fibroadenoma

benign neoplasm of breast

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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.