Female Repro Pathology 1 Flashcards
What are benign breast diseases?
A heterogenous group of lesions including developmental abnormalities, inflammatory lesions, epithelial and stromal proliferations and neoplasms
How are the majority of benign breast diseases diagnosed?
With use of mammography, ultrasound, magnetic resonance imaging of the breast and needle biopsys therefore most diagnoses don’t require surgery.
What is a core biopsy (tru-cut) used for and what is a complication?
It provides a specimen for histology and it can lead to fat necrosis
What is fibrocystic change?
A benign breast disease which is a nonproliferative change that includes microscopic cysts, apocrine metaplasia, mild epithelial hyperplasia, adenosis and increase in fibrous stroma
Describe features of proliferative breast disease?
Without atypia - 2 fold increase of developing a carcinoma over 5-15 years.
With atypia - 5 fold increase
What is the most common benign breast condition in men and its features
Gynaecomastia which is hyperplasia of male breast stromal and ductal tissue. Caused by increase in oestrogen to androgen ratio
Name some benign breast tumours
- Fibroadenoma,
- Duct papilloma,
- Adenoma,
- Connective tissue tumours
Describe some features of fibroadenomas
- Arising from breast lobules, they are well circumscribed and highly mobile. They can be difficult to differentiate from Phyllodes tumours (sarcomas)
Describe the differences between fibrocystic change vs fibroadenoma
FCC - Most common benign breast condition, it may be painful and when aspirated there is straw/green coloured fluid.
Fibroadenoma - Typically painless, well circumscribed mobile mass.
What are some risk factors for breast cancer?
- alcoholic beverages,
- Oestrogen-progestogen contraceptives/menopausal therapy,
- X-ray/gamma radiation,
- Obesity,
- adult attained height
What are the two forms of non-invasive precursors?
- Ductal carcinoma in situ.
- Lobular carcinoma in situ
What is Paget’s disease of the nipple?
Associated with underlying in situ or invasive carcinoma. Leads too erosion of the nipple that resembles eczema
What are prognostic factors for breast cancer?
- Tumour type,
- Tumour grade,
- Tumour stage,
- Oestrogen receptors,
- HER-2 amplification
What are some screening strategies for breast cancer?
- Self examination,
- Clinical breast examination,
- Mammography,
- Ultrasonography,
- MRI
These are been very effective in saving lives
What are some breast changes that would make you suspect breast cancer?
- Lump,
- Pilled in nipple,
- Dimpling,
- Nipple discharge,
- Redness/rash,
- Skin changes
What is the commonest cervical cancer?
Invasive tumour of epithelial origin with squamous differentiation
What is the main aetiological factor for cervical cancer?
Human papillomavirus as host’s tumour suppressor genes can be inactivated and therefore damaged DNA is replicated without being checked.
What part of the cervix is prone to tumours?
The transformation zone since there is a high cell turnover here.
What are precursors for invasive cervical cancer?
Squamous intraepithelial lesions
What are some screening and intervention strategies for cervical cancer
- Cytology,
- HPV detection,
- Visual inspection with acetic acid or iodine,
- Vaccination against HPV
Name some examples of invasive cervical cancers and the classic symptoms
Majority are squamous cell carcinomas and a minority are adenocarcinomads. Present with post coital bleeding and intermenstrual bleeding
What is the treatment for invasive squamous cell carcinomas of the cervix
radicle hysterectomy (removal of uterus)
What are the differences between breast cancer and cervical cancer
BC - Pre-malignant phase less obvious and may not be invariable present and difficult to detect by screening .
CC - Well understood pathway from PHV infection through CIN (cervical intraepithelial neoplasia) to invasive cancer and there is readily accessible screening
