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Path year 5 > Histopath - Breast > Flashcards

Histopath - Breast Flashcards

1
Q

What are the 3 conditions that fall under inflammatory breast disease?

A
  1. Duct ectasia
  2. Acute mastitis
  3. Fat necrosis
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2
Q

What is duct ectasia?

A

Inflammation and dilatation of large breast ducts

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3
Q

Duct ectasia presentation

A

Nipple discharge ± may cause breast pain, breast mass and nipple retraction

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4
Q

Biggest RF for duct ectasia

A

Smoking

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5
Q

Histopathology of duct ectasia

A

Dipple d/c cytology: proteinaceous material and
inflammatory cells

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6
Q

Is duct ectasia malignant?

A

Benign w/ NO incr risk malig

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7
Q

What is acute mastitis?

A

Acute inflammation in the breast

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8
Q

What population is acute mastitis usually seen in?

A

lactating women due to milk stasis and cracked skin

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9
Q

Which organism usually causes acute mastitis?

A

Staphylococcus

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10
Q

How does acute mastitis present?

A

Painful, red breast and fever

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11
Q

Mx of acute mastitis

A

continued milk expression, drainage (if abscess), and antibiotics

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12
Q

What is fat necrosis?

A

Inflammatory reaction to damaged adipose tissue (benign)

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13
Q

What is fat necrosis caused by?

A

trauma, surgery or radiotherapy

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14
Q

How does fat necrosis present?

A

Painless breast mass in obese, middle-aged women

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15
Q

What are 5 benign breast diseases?

A
  1. Fibrocystic disease
  2. Fibroadenoma (breast mouse)
  3. Phyllodes tumour
  4. Intraductal papilloma
  5. Radial scar
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16
Q

What is fibrocystic disease?

A

Breast lumpiness due to normal responses to hormonal influences

(aspirate brown fluid, cysts)

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17
Q

What is fibroadenoma?

A

Common, benign fibroepithelial neoplasm of the breast

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18
Q

*How does breast fibroadenoma often present?

A

Circumscribed mobile breast lump in young women aged 20-30

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19
Q

What is phyllodes tumour?

A

Uncommon potentially aggressive fibroepithelial neoplasm of breast w/ stromal elements

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20
Q

What can phyllodes tumours form from?

A

Fibroadenomas

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21
Q

What presentation would you see with Phyllodes tumour?

A

Enlarging masses in women >50y/o

22
Q

Phyllodes tumour Mx

A

Local excision/ mastectomy

23
Q

*What is an intraductal papilloma?

A

Benign papillary tumour

24
Q

*Presentation of intraductal papilloma

A

Bloody discharge

25
Q

What is a radial scar?

A

Benign central scarring surrounded by proliferating glandular tissue

26
Q

What are 3 malignant breast diseases?

A
  1. Ductal carcinoma in situ
  2. Invasive breast carcinoma
  3. Basal-like carcinoma
27
Q

What is ductal carcinoma in situ?

A

Neoplastic intraductal epithelial proliferation in breast with an increased risk of progression to invasive breast carcinoma

28
Q

What do screening programmes for ductal carcinoma in situ look for?

A

Areas of microcalcification

  • aiming to detect breast ca at duct carcinoma in situ (DCIS) stage
29
Q

What are invasive breast carcinomas?

A

Group of malignant epithelial tumours which infiltrate within the breast and can metastasise

30
Q

What are the 4 subtypes of invasive breast carcinoma?

A
  • Invasive ductal
    • Most common
  • Invasive lobular
  • Tubular
  • Mucinous
31
Q

Histopathology of invasive ductal breast carcinoma

A

Big, pleomorphic cells that move into the stroma

32
Q

Histopathology of invasive lobular breast carcinoma

A

Cells in single file chains + E cadherin related

33
Q

Histopathology of tubular breast carcinoma

A

Well-formed tubules with low grade nuclei

34
Q

Histopathology of invasive mucinous breast carcinoma

A

Lots of extraceullular mucin which goes into surrounding stroma

35
Q

What are the RFs of developing invasive breast carcinoma?

A
  • Early menarche
  • Late menopause
  • +ve FHx
  • Increased weight
  • BRCA mutation
  • Oral contraceptive use
  • High alcohol consumption
36
Q

What method is used for screening of invasive breast carcinoma?

A

USS in younger pts (30s and below ish)

Mammogram in older pts

37
Q

Malignant breast disease Ix

A

Triple assessment

  • Examination
  • Radiology
  • Core needle biopsy
38
Q

Which receptors are assessed for in malignant breast disease?

A
  • Oestrogen receptors
  • Progesterone receptors
  • HER2 receptors
39
Q

What is the prognosis like for invasive breast carcinoma?

A

If responsive to

  • ER/PR = good prognosis (as responds to Tamoxifen)
  • HER2 = poor prognosis
40
Q

Histology for basal-like carcinoma

A
  • Sheets of atypical cells with lymphocytic infiltrate
  • Immunohistochemically stain positive for CK 5/6 and 14
41
Q

Basal-like carcinoma receptor response

A

ER/PR/Her2 negative

42
Q

What are 2 male breast conditions?

A

Gynaecomastia and male breast ca

43
Q

What is the cause of gynaecomastia?

A

Idiopathic or associated with drugs

44
Q

How does male breast ca present?

A

Most commonly presents with a palpable lump

45
Q

Which stage(s) is male breast ca often at?

A

Stage 3 or 4

(+ associated with BRCA 2 carriers)

46
Q

*Woman with known breast cancer has a red and rough nipple

A

Paget’s disease of the nipple

47
Q

*Woman with breast lump, FNA shows C5 grading

A

DCIS or other invasive breast ca

(C5=malignant)

48
Q

*Most common breast malignancy

A

Invasive ductal carcinoma

49
Q

*Which/What cancer is also known as non-specific type?

A

Invasive ductal carcinoma

50
Q

*Which/What cancer is associated with presence of E cadherins

A

Invasive ductal carcinoma

(inv lobular if E cad neg)

51
Q

*histopath of phyllodes tumour

A

Fibro-epithelial tumour with abundant stromal elements

52
Q

Periductal mastitis

A

keritanising squamous epithelium in smokers breast

Path year 5 (48 decks)

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