Histopathology 3s - Breast Flashcards
What is triple assessment?
1) Clinical exam
2) Imaging (USS<35 or mammography >35)
3) Pathology (cytopathology and/or histopathology via FNA + biopsy)
Limitation of cytopathology
Does not show the tissue architecture unlike histopathology
What investigation is the gold standard for diagnosis of breast cancer?
histopathology (breast biopsy)
coding of cytology results
C1 = inadequate C2 = benign C3 = atypia, likely benign C4 = atypia, likely malignant C5 = malignant
Main clinical symptom of duct ectasia?
Nipple discharge +/- breast pain, breast mass, nipple retraction
duct ectasia cytology
proteinaceous material + NEUTROPHILS ONLY
Duct ectasia malignancy risk
no increased risk of malignancy
Painful red breast - Dx?
Cause?
Image on cytology?
Acute mastitis
Staphylococcus aureus infection (more common in pregnancy)
cytology: necrosis + neutrophils
What is fat necrosis?
An inflammatory reaction to damaged adipose tissue e.g. trauma, surgery
How does fat necrosis present?
Breast lump
Fat necrosis cytology
fat cells surrounded by macrophages
Most common benign proliferative breast disease? What causes it?
Fibrocystic disease/fibroadenosis
caused by an exaggerated normal response to hormones(no increased cancer risk)
Fibrocystic disease presentation
Lumpy breasts
20-30yo, well circumscribed mobile breast lump
Fibroadenoma
What is a fibroadenoma?
Benign fibroepithelial neoplasm of the breast
Treatment of fibroadenomas
“shell out”
Leaf like tumour
Phyllodes tumour
Phyllodes tumour - how doe they present and in whom?
> 50, enlarging mass, may arise within pre-existing fibroadenoma, majority benign but some aggressive and malignant
A benign tumour arising within the duct system of the breast = ?
Duct papilloma
How do central ductal papillomas present and how do peripheral ones present?
Central: bloody discharge (in the lactiferous ducts)
Peripheral: often clinically silent
USUALLY NO LUMP IN EITHER
Mx of an intraductal papilloma?
Excision (risk of malignancy if multiple)
Central fibrosis surrounded by proliferating glandular tissue in a stellate pattern - what is this?
Radial scar
How can DCIS present?
Lump, Paget’s disease of nipple
What does DCIS look like on mammography?
Areas of micro calcifications
