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Charis & Ellie VS Breast > Breast Pathology/Benign Breast Conditions > Flashcards

Breast Pathology/Benign Breast Conditions Flashcards

1
Q

Assessment of patient with breast disease?

A

Triple assessment

  • Clinical
  • Imaging
  • Pathology (cytopathology, histopathology)
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2
Q

Breast cytopathology?

A

(Rarely undertaken these days)

  • Fine needle aspiration
  • Fluid
  • Nipple discharge
  • Nipple scrape
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3
Q

Grades of breast FNA cytology?

A 
C1: Unsatisfactory 
C2: Benign 
C3: Atypia, probably benign 
C4: Suspicious of malignancy 
C5: Malignant
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4
Q

Grading of needle core biopsy?

A 
B1: Unsatisfactory/normal 
B2: Benign 
B3: Atypia, probably benign 
B4: Sus of malignancy 
B5: Malignant
   a= Carcinoma in situ 
   b= Invasive carcinoma
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5
Q

What is WLE?

A

Wide local excision

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6
Q

Types of developmental abnormalities?

A

Hyperplasia
Juvenile hypertrophy
Accessory breast tissue
Accessory nipple

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7
Q

Non-neoplastic pathology of benign breast disease?

A 
Gynaecomastia 
Fibrocystic change 
Hamartoma 
Fibroadenoma 
Sclerosing lesions
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8
Q

Inflammatory pathology of benign breast disease?

A

Fat necrosis
Duct ectasia
Acute mastitis/abscess

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9
Q

Benign tumours of breast?

A

Phyllodes tumour

Intraduct papilloma

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10
Q

What is gynaecomastia?

A

Breast development in males

-Ductal growth without lobular development

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11
Q

Causes of gynaecomastia?

A
  • Exogenous/endogenous hormones
  • Cannabis
  • Prescription drugs
  • Liver disease
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12
Q

What is cause of fibrocystic change?

A

Abnormal and exaggerated responses of breast tissue to cyclical physiological menstrual hormonal stimuli

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13
Q

What age group does fibrocystic change occur in?

A

Pre-menopausal women age 20-50

Very common

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14
Q

Resolution of fibrocystic change?

A

Often resolves or diminishes after menopause

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15
Q

Presnetation of fibrocystic change?

A

Lump or lumpiness of breast in pre-menopausal women

  • Smooth discrete lumps
  • Sudden pain
  • Cyclical pain
  • Lumpiness
  • Incidental finding (asymptomatic)
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16
Q

Microscopic and macroscopic appearance of fibrocystic change?

A

Cysts with intervening fibrosis

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17
Q

Management of fibrocystic change?

A

Exclude malignancy, reassure, excise if necessary

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18
Q

What is hamartoma?

A

Circumscribed lesion composed of cell types normal to breast but present in an abnormal proportion or distribution

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19
Q

What is the commonest benign tumour of the breast?

A

Fibroadenoma

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20
Q

Presentation of fibroadenoma?

A

Usually solitary single lump which is small, firm and mobile.
Usually painless

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21
Q

Who do fibroadenomas usually occur in?

A

Young women

Afro-carribean

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22
Q

How does a fibroadenoma appear on US?

A

Solid

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23
Q

Gross appearance of fibroadenoma?

A
  • Well circumscribed
  • Rounded
  • Elastic
  • Greyish cut surface
24
Q

Clinical description of fibroadenoma?

A

Painless, discrete, mobile mass

25
Q

Microscopic fibroadenoma?

A

Composed of connective tissue (stroma) and epithelium

26
Q

Management of fibroadenoma?

A
  • Reassure that it is benign

- Excise if causing symptoms

27
Q

Difference between fibrocystic change and fibroadenoma?

A

Fibrocystic= Painful, irregular lumpiness

Fibroadenoma= Painless, solid single lump

28
Q

What are sclerosing lesions?

A

Benign, disorderly proliferation of acini and stroma

29
Q

What mimics carcinoma?

A

Sclerosing lesions

30
Q

Presentation of scleroing adenosis?

A
  • Pain, tenderness or lumpiness/thickening

- Asymptomatic

31
Q

Age for presentation of scleroising adenosis?

A

20-70 years old

32
Q

What is a radial scar?

A

Small firm lesion with dense fibrous core with radiating fingers of fibrosis entrapping and distorting glandular elements

33
Q

What may occur in radial scars?

A

In situ or invasive carcinoma

34
Q

Management of radial scars?

A

Excised or vacuumed

35
Q

Radial scars can be confused with?

A

Carcinoma

36
Q

Cause of fat necrosis?

A

Local trauma

  • Seat belt injury
  • Surgery

OR
Warfarin therapy

37
Q

What is fat necrosis?

A

Necrotic fat with lipid rich macrophages, giant cells and later, fibrosis

38
Q

What can fat necrosis present as?

A

Mass mimicking carcinoma

39
Q

Management of fat necrosis?

A

Exclude malignancy and reassure
-Lumps generally go away
Surgery can be done if they become big/uncomfy

40
Q

What is duct ectasia?

A

Chronic inflammatory condition assoc with ectasia of ducts/cystic dilation

41
Q

What is duct ectasia associated with?

A

Ageing and smoking

42
Q

Clinical features of duct ectasia?

A
  • Affects sub-areolar ducts
  • Pain
  • Acute episodic inflammatory changes
  • Blood/purulent discharge
  • Fistulation
  • Nipple retraction and distortion
43
Q

Management of duct ectasia?

A
  • Treat acute infections
  • Exclude malignancy
  • Smoking cessation
  • If bad can do surgery
44
Q

2 main aetiologies of acute mastitis and breast abscess?

A

Duct ectasia > involves organisms and anaerobes

Lactation > staph A, strep pyogenes

45
Q

Clinical presentation of acute mastitis/abscess?

A

Signs of infection and painful swollen breast

46
Q

Management of acute mastitis/abscess?

A
  • AB’s
  • Percutaneous drainage
  • Incision and drainage
47
Q

Age range for phyllodes tumour?

A

40-50

48
Q

Cut surface of phyllodes tumour looks like?

A

Leaves- Phyllodes= (greek for leaf)

-Biphasic growth

49
Q

Where can duct papilloma develop?

A

Most common in lacteal sinuses at nipple, but can be anywhere in duct system

Sub areolar duct

50
Q

Age for intraduct papilloma?

A

Age 35-60

51
Q

Presnetation of intraduct papilloma?

A

Nipple discharge +/- blood

52
Q

Management of duct papilloma?

A

Surgical removal and histology examined as small risk of cancer

53
Q

Developmental anomalies?

A

Hypoplasia
Juvenile hypertrophy
Accessory breast tissue
Accessory nipple

54
Q

Non-noeplastic pathology of benign breast disease?

A 
Gynaecomastia 
Fibrocystic change 
Hamartoma 
Fibroadenoma 
Sclerosing lesions
55
Q

Inflammatory benign breast disease?

A

Fat necrosis

Acute mastitis/abscess Duct ectasia

56
Q

Tumours of benign breast?

A

Phyllodes tumour

Intraduct papilloma

57
Q

Causes of gynaecomastia?

A

Exogenous/endogenous hormones
Cannabis
Prescription drugs
Liver diseas

Charis & Ellie VS Breast (10 decks)

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