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YR5 Histopathology > Histopathology 3 - Breast pathology > Flashcards

Histopathology 3 - Breast pathology Flashcards

1
Q

In which type of breast cancer is MRI most useful?

A

Lobular

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2
Q

What guage needle is used for biopsy in breast cancer investigiation?

A

Core: 14/16 guage
Vacuum: 8-11 gauge gives more tissue

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3
Q

Recall the C1-C5 code that is used to grade fine needle aspirate in breast cancer investigation

A 
C1 - Inadequate sample
C2 - Benign
C3 - Atypia, probably benign
C4 - Suspicious of malignancy
C5 - Malignant
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4
Q

Recall 4 symptoms of duct ectasia

A

Discharge

Sometimes: Pain, Mass, Nipple inversion

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5
Q

What would be seen upon cytological analysis of nipple discharge in duct ectasia?

A

Proteinaceous material + inflammatory cells only

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6
Q

What is the most common pathogen identified in acute mastitis?

A

Staphylococcus aureus

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7
Q

3 causes of fat necrosis of the breast?

A

Trauma
Surgery
Radiotherapy

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8
Q

What is the cause of fibrocystic disease of the breast?

A

Normal, but exaggerated, response to hormonal influences

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9
Q

How can fibroadenoma be cured?

A

‘Shelling out’

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10
Q

Which breast tumours can be described as ‘leaf like’?

A

Phyllodes tumours

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11
Q

What is a phyllodes tumour?

A

Potentially aggressive fibroepithelial neoplasm of the breast
Usually benign

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12
Q

How do phyllodes tumours tend to present?

A

Enlarging breast mass in women >50

Often in pre-existing fibroadenomas

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13
Q

In what ways are intraductal papillomas comparable to polyps?

A

They have a fibrovascular core

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14
Q

How can radial scars of the breast be cured?

A

Excision

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15
Q

What is the key histopathological feature of usual epithelial hyperplasia of the breast?

A

Irregular lumens

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16
Q

What is another name for flat epithelial atypia?

A

Atypical ductal carcinoma

17
Q

How much is risk of malignancy increased by flat epithelial atypia?

A

4 times

18
Q

What is the main histopathological features of flat epithelial atypia?

A

Cribiform spaces

19
Q

How much is risk of malignancy increased by in situ lobar neoplasia?

A

7-12 times increased risk

20
Q

How will the lumens often appear in DCIS?

A

Calcified

21
Q

How should DCIS be managed?

A

Complete excision with surgical margins

22
Q

What is the biggest risk factor for invasive breast carcinoma?

A

Osetrogen exposure

23
Q

Which genetic change is seen in low grade invasive ductal carcinoma of the breast?

A

16q loss

24
Q

What is the histological appearance of invasive ductal carcinoma vs lobular carcinoma?

A

Ductal: Large pleiomorphic cells with huge nuclei
Lobular: Linear, MONOmorphic cells

25
Q

Which type of breast pathology would show an “Indian file pattern” of cells under the microscope?

A

Invasive lobular carcinoma

26
Q

Which type of breast carcinoma has the worst prognosis?

A

Basal-like carcinoma

27
Q

How can basal-like breast carcinomas be identified using immunohistocheistry?

A

Positive for ‘basal’ cytokeratins eg CK5/6/14

28
Q

What 3 features of a breast malignancy are examined to decide its histological grading?

A

Tubule formation
Nuclear pleiomorphism
Mitotic activity

29
Q

Which receptors are tested for in breast cancer diagnosis, and why?

A

ER
PR
HER2
Gives therapeutic and prognostic value

30
Q

What age group is invited to breast cancer screening in the UK?

A

50-73

31
Q

Recall the B1-B5 code used for core biopsies of breast masses

A 
B1 = normal/ inadequate sample
B2 = benign
B3 = uncertain malignant potential
B4 = suspicious of malignancy
B5 = malignant
32
Q

The normal breast is characterised by the rule of 2s what is this?

A

2 main structures: Large ducts + Terminal ductal lobular unit
2 types epithelial cells: luminal + myoepithelial
2 types of storm: interlobular + intralobular

33
Q

Most common breast lesion presenting with discharge

A

Papilloma

34
Q

Nipple discharge difference between physiological and pathological

A

Phys: bilateral + from multiple ducts.
Path: unilateral, from a single duct, spontaneous + persistent

YR5 Histopathology (27 decks)

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