Female reproductive and breast Flashcards
CIN
Cervical Intraepithelial neoplasia. CIN I is equivalent to low grade dysplasia. CIN II and CIN III are regarded as equivalent to high grade dysplasia.
Cervical polyp
A benign overgrowth of connective tissue and epithelium of the cervix.
Pap test
Cervical cytology.
Cytology
Modern method of processing cervical cytology specimens from a liquid fixative.
Fallopian tube
Ovarian tube connecting ovary with the endometrial cavity.
PID
Pelvic Inflammatory Disease
Ectopic pregnancy
Gestation occurring outside endometrial cavity. Most often within fallopian tube; may lead to rupture and bleeding.
Dermoid cyst
A benign cystic teratoma-usually benign.
Cystadenoma
A benign cystic neoplasm of epithelial origin.
Cystadenocarcinoma
A malignant cystic neoplasm of epithelial origin.
Torsion
Twisting of the tube and ovary on their pedicle, may cause venous infarction.
Fibrocystic change
Benign changes including fibrosis, cyst formation, and epithelial hyperplasia. Hyperplasia of ‘usual type’ is low risk for later cancer.
Atypical ductal hyperplasia
Epithelial hyperplasia with features overlapping with ductal carcinoma in situ, but not bad enough to call DCIS.
Atypical lobular hyperplasia
Epithelial hyperplasia with features overlapping with lobular carcinoma in situ, but not bad enough to call LCIS.
DCIS
Ductal carcinoma in situ. Abnormal proliferation of breast epithelium resembling ductal invasive breast cancer not yet invasive (may accompany invasive cancers).
LCIS
Lobular carcinoma in situ. Abnormal proliferation of breast epithelium resembling lobular invasive breast cancer but not yet invasive (may accompany invasive cancers).
Invasive ductal carcinoma
The commonest kind of invasive breast cancer. Sometimes referred to as being of ‘no special type’.
Invasive lobular carcinoma
The second commonest kind of invasive breast cancer. Typically its cells are non-cohesive and lack E-cadherin.
ER/PR status
Whether or not the carcinoma cells express oestrogen receptor (ER) or progesterone receptor (PR).
HER2 status
Whether or not the carcinoma cells EITHER over-express Her protein OR have Her2 gene amplification. Without one of these the cancer is not a target for Herceptin.
Grade
Bloom and Richardson grade as modified by Elston and Ellis. Grade III carcinomas are the most aggressive.
Sentinel node
A node or noes in the axilla into which a tracer molecule first drains from the breast. If it is free of cancer cells involvement of other nodes in the axilla is unlikely.
What is a radial scar?
Complex sclerosing lesions >10mm. Benign lesions characterised by fibrotic and elastotic core, trapped glands and a pseudo-infiltrative appearance.
PASH
Pseudo-angiomatous stromal hyperplasia. A proliferation of myofibroblasts may cause a mass and may require biopsy to exclude malignancy.
Diabetic fibrous mastopathy
Stromal fibrosis with infiltrating lymphocytes. it is associated with T1DM and may be clinically suspicious of carcinoma. It usually occurs in women but sometimes men.
What is Poland’s syndrome?
A combination of chest wall deformity and absent or hypoplastic pectoralis muscle and breast associated with shortening and brachysyndactylyl of upper limb.
Acute (peurperal, lactational) mastitis
A cellulitis associated with breastfeeding. Skin fissures may let bacteria in, milk stasis, leading to infection. Sometimes causes abscesses that need to be drained.
Plasma cell mastitis
Calcification of inspissated secretions in or immediately adjacent to ectatic beign ducts. Normally women over 60 y.o.
Duct ectasia
Dilation of central lactiferous ducts, periductal chronic inflammation and scarring.
Fibroadenoma
Characteristic outgrowth of epithelium and stroma resembling a giant lobule. Usually regarded as a benign neoplasm, hormone sensitive and regress after the menopause.
Intraduct papilloma
Benign tumour of the epithelium lining of the mammary ducts. Solitary central papillomas are thought to be innocuous if no epithelial atypia. Multiple papillomas more likely to be associated with malignancy.
What are the 2 layers of epithelium in glandular and duct tissue of the breast?
Inner layer is luminal, outer layer is myoepithelal.
What conditions is breast hypoplasia associated with?
Ulnar-mammary syndrome, Poland’s syndrome, Turner’s syndrome and congenital adrenal hyperplasia.
Idiopathic granulomatous mastitis
Lobule-centred non-necrotising granulomatous inflammatory process with a tendency to recurrence after excision.
What type of epithelium lines the fallopian tube?
Ciliated columnar epithelium.
What is salpingitis?
Inflammation of the fallopian tubes. Most commonly infective, mainly bacterial eg. chlamydia trachomatis. Usually considered an ascending infection.
Complications of salpingitis
Adherence of tube to ovary; tubo-ovarian abscess. Adhesions increase risk of ectopic pregnancy. Ruptured tubal ectopic pregnancy can be potentially life-threatening. Damage to lumen may cause infertility.
STIC
Serous Tubal Intraepithelial Carcinoma. Abnormal epithelium distal fallopian tube. Limited by BM so in situ. lIkely precursor for high grade serous carcinoma.
What is Meig’s syndrome?
Combination of ovarian fibroma, with ascites and pleural effusion. Removal of the tumour clears the problem.
What are Brenner tumours?
These are uncommon mixed surface epithelial-stromal tumours. Usually benign, unilateral, size variable, solid, circumscribed, yellowish. Histologically, nests of transitional epithelial cells with longitudinal nuclear grooves and abundant fibrous stroma.
What are some of the risk factors for breast cancer?
Early menarche, later menopause, OC use, HRT, obesity, denser breast tissue on mammography, alcohol, positive family history.
Carcinoma in situ.
Ductal carcinoma in situ or lobular carcinoma in situ.:
- Malignant looking proliferation of epithelial cells within the basement membrane.
- No extension into breast stroma
- No communication with blood vessels or lymphatics.
- No possibility of metastates
Basal-like carcinomas
Express genes associated with the basal/myoepithelial cells of the breast. They tend to be aggressive, and there is overlap with the cancers which occur in BRCA1 mutation carriers.
What are the main classes of cancer chemotherapy drugs?
- Alkylating agents
- Antimetabolites
- Cytotoxic antibiotics
- Microtubule inhibitors
- Steroid hormones and antagonists
