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Leila's Yr 5 Pathology > Histopathology 3s - Breast > Flashcards

Histopathology 3s - Breast Flashcards

1
Q

What is triple assessment?

A

1) Clinical exam
2) Imaging (USS<35 or mammography >35)
3) Pathology (cytopathology and/or histopathology via FNA + biopsy)

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2
Q

Limitation of cytopathology

A

Does not show the tissue architecture unlike histopathology

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3
Q

What investigation is the gold standard for diagnosis of breast cancer?

A

histopathology (breast biopsy)

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4
Q

coding of cytology results

A 
C1 = inadequate
C2 = benign
C3 = atypia, likely benign
C4 = atypia, likely malignant
C5 = malignant
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5
Q

Main clinical symptom of duct ectasia?

A

Nipple discharge +/- breast pain, breast mass, nipple retraction

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6
Q

duct ectasia cytology

A

proteinaceous material + NEUTROPHILS ONLY

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7
Q

Duct ectasia malignancy risk

A

no increased risk of malignancy

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8
Q

Painful red breast - Dx?
Cause?
Image on cytology?

A

Acute mastitis
Staphylococcus aureus infection (more common in pregnancy)
cytology: necrosis + neutrophils

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9
Q

What is fat necrosis?

A

An inflammatory reaction to damaged adipose tissue e.g. trauma, surgery

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10
Q

How does fat necrosis present?

A

Breast lump

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11
Q

Fat necrosis cytology

A

fat cells surrounded by macrophages

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12
Q

Most common benign proliferative breast disease? What causes it?

A

Fibrocystic disease/fibroadenosis

caused by an exaggerated normal response to hormones(no increased cancer risk)

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13
Q

Fibrocystic disease presentation

A

Lumpy breasts

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14
Q

20-30yo, well circumscribed mobile breast lump

A

Fibroadenoma

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15
Q

What is a fibroadenoma?

A

Benign fibroepithelial neoplasm of the breast

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16
Q

Treatment of fibroadenomas

A

“shell out”

17
Q

Leaf like tumour

A

Phyllodes tumour

18
Q

Phyllodes tumour - how doe they present and in whom?

A

> 50, enlarging mass, may arise within pre-existing fibroadenoma, majority benign but some aggressive and malignant

19
Q

A benign tumour arising within the duct system of the breast = ?

A

Duct papilloma

20
Q

How do central ductal papillomas present and how do peripheral ones present?

A

Central: bloody discharge (in the lactiferous ducts)
Peripheral: often clinically silent
USUALLY NO LUMP IN EITHER

21
Q

Mx of an intraductal papilloma?

A

Excision (risk of malignancy if multiple)

22
Q

Central fibrosis surrounded by proliferating glandular tissue in a stellate pattern - what is this?

A

Radial scar

23
Q

How can DCIS present?

A

Lump, Paget’s disease of nipple

24
Q

What does DCIS look like on mammography?

A

Areas of micro calcifications

25
Q

What are the two types of breast carcinoma in situ and how can they be differentiated?

A

Ductal - E-cadherin +ve

Lobular - E-cadherin -ve

26
Q

How is DCIS treated?

A

Surgical excision

27
Q

Types of invasive breast carcinoma?

A

Ductal
Lobular
Tubular
Mucinous

28
Q

Invasive breast carcinoma which has linear cells in strands?/ “Indian file” , monomorphic

A

Invasive lobular carcinoma

29
Q

E-cadherin +ve invasive breast carcinoma

A

Invasive ductal carcinoma

30
Q

Elongated tubules invading the stroma

A

Invasive tubular carcinoma

31
Q

Immunohistochemistry of basal like carcinomas

A

+ve for basal cytokeratins, CK5/6 + CK14

32
Q

whAT IS breast cancer grading dependent on?

A

Tubule formation
Nuclear pleomorphism
Mitotic activity

33
Q

Alongside grading, what else is looked at on core needle biopsy?

A

Receptor status: Her2, ER/PR

34
Q

The receptor status of someone with a low grade phenotype?

A

ER/PR+ve, HER2 -ve

35
Q

The receptor status of someone with a high grade phenotype?

A

ER/PR-ve, HER2 +VE

36
Q

Receptor status of basal like carcinomas

A

Her2/ER/PR -ve (triple negative)

37
Q

Most important prognostic factor in breast factor

A

status of the axillary LN

38
Q

NHS Breast screening programme

A

47-73 every 3 years

39
Q

How is lobular carcinoma in situ always identified?

A

ALWAYS AN INCIDENTAL FINDING ON BIOPSY AS MICROCALCIFICATIONS NOT SEEN

Leila's Yr 5 Pathology (100 decks)

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