L3 – Breast Pathology Flashcards
What are the main histological components of the normal breast?
The breast consists of glandular tissue (including the ductal system and terminal duct lobular units) and supportive stroma.
How are the terminal duct lobular units (TDLUs) significant?
TDLUs represent the secretory portion of the breast and are the sites where many pathological changes begin.
What are the two cell types that line the ductal–lobular system?
The inner epithelial cells and the outer myoepithelial cells, each identifiable by distinct immunohistochemical markers.
Why is the structure of the ductal–lobular system clinically important?
It underpins the pathogenesis and diagnosis of both benign and malignant breast conditions.
What are common benign breast conditions?
Conditions such as fibrocystic change, fibroadenoma, papilloma, and fat necrosis.
How can fat necrosis mimic breast cancer radiologically?
Fat necrosis may display irregular borders and calcifications on mammograms, resembling malignancy.
What is the typical age range for fibroadenomas?
They commonly occur in women aged 20–35 years.
What is the significance of radial scars in breast pathology?
Although benign, radial scars can mimic carcinoma on imaging and are often categorised as B3 lesions requiring adequate sampling.
What is the prevalence of breast carcinoma in women?
Breast carcinoma accounts for 20% of all cancers in women, with a 1 in 8 lifetime risk in the UK.
How are breast carcinomas classified based on invasion?
They are classified as carcinoma in situ (non-invasive) or invasive carcinoma.
What distinguishes ductal carcinoma in situ (DCIS) from invasive carcinoma?
DCIS is confined within the ductal system with an intact myoepithelial layer, while invasive carcinoma breaches the basement membrane.
Why is the distinction between in situ and invasive carcinoma important for treatment?
In situ carcinomas generally have an excellent prognosis and may not require lymph node excision, whereas invasive carcinomas require more aggressive management.
List key risk factors for breast carcinoma.
Female sex, age, reproductive history (early menarche, late menopause, nulliparity), obesity, family history, and atypical hyperplasia.
What role does hormone receptor status play in breast cancer management?
Hormone receptor (ER/PR) positivity influences treatment decisions, including the use of anti-oestrogen therapies.
What are common treatment modalities for breast cancer?
Surgery (breast-conserving procedures or mastectomy), chemotherapy, radiotherapy, hormonal therapy, and immunotherapy.
How does the breast cancer screening programme impact prognosis?
Early detection via mammography screening significantly improves survival, as early-stage cancers have much higher 5‑year survival rates.
How do myoepithelial cells aid in differentiating invasive from in situ breast lesions?
Their presence in ducts typically indicates a benign or in situ process, while their absence suggests invasion.
What immunohistochemical markers are most useful for detecting myoepithelial cells?
Markers such as p63, SMM, and CK5/6 are routinely used to highlight the myoepithelial layer.
How can radiological imaging complement histological assessment in breast pathology?
Imaging can detect microcalcifications, architectural distortions, and density changes that correlate with histopathological findings.
How do proliferative benign conditions like atypical ductal hyperplasia influence breast cancer risk?
They increase the risk of developing subsequent carcinoma and require careful clinical surveillance.
What genetic alterations are commonly observed in breast carcinoma?
Mutations in BRCA1/2, alterations in HER2, and changes in genes regulating cell cycle and apoptosis are frequent.
How does breast density affect cancer risk and detection?
High breast density not only increases the risk of cancer but also can obscure lesions on mammographic imaging.
What is the role of sentinel lymph node biopsy in breast cancer management?
It provides crucial staging information with minimal morbidity compared to complete axillary dissection.
How do hormone receptor statuses guide therapeutic decisions in breast cancer?
They determine the use of anti-oestrogen agents, which can significantly impact patient outcomes.
What are the main histological components of the normal breast?
The breast consists of glandular tissue (including the ductal system and terminal duct lobular units) and supportive stroma.
How are the terminal duct lobular units (TDLUs) significant?
TDLUs represent the secretory portion of the breast and are the sites where many pathological changes begin.
What are the two cell types that line the ductal–lobular system?
The inner epithelial cells and the outer myoepithelial cells, each identifiable by distinct immunohistochemical markers.
Why is the structure of the ductal–lobular system clinically important?
It underpins the pathogenesis and diagnosis of both benign and malignant breast conditions.
What are common benign breast conditions?
Conditions such as fibrocystic change, fibroadenoma, papilloma, and fat necrosis.
How can fat necrosis mimic breast cancer radiologically?
Fat necrosis may display irregular borders and calcifications on mammograms, resembling malignancy.
What is the typical age range for fibroadenomas?
They commonly occur in women aged 20–35 years.
What is the significance of radial scars in breast pathology?
Although benign, radial scars can mimic carcinoma on imaging and are often categorised as B3 lesions requiring adequate sampling.
What is the prevalence of breast carcinoma in women?
Breast carcinoma accounts for 20% of all cancers in women, with a 1 in 8 lifetime risk in the UK.
How are breast carcinomas classified based on invasion?
They are classified as carcinoma in situ (non-invasive) or invasive carcinoma.
What distinguishes ductal carcinoma in situ (DCIS) from invasive carcinoma?
DCIS is confined within the ductal system with an intact myoepithelial layer, while invasive carcinoma breaches the basement membrane.
Why is the distinction between in situ and invasive carcinoma important for treatment?
In situ carcinomas generally have an excellent prognosis and may not require lymph node excision, whereas invasive carcinomas require more aggressive management.
List key risk factors for breast carcinoma.
Female sex, age, reproductive history (early menarche, late menopause, nulliparity), obesity, family history, and atypical hyperplasia.
What role does hormone receptor status play in breast cancer management?
Hormone receptor (ER/PR) positivity influences treatment decisions, including the use of anti-oestrogen therapies.
What are common treatment modalities for breast cancer?
Surgery (breast-conserving procedures or mastectomy), chemotherapy, radiotherapy, hormonal therapy, and immunotherapy.
How does the breast cancer screening programme impact prognosis?
Early detection via mammography screening significantly improves survival, as early-stage cancers have much higher 5‑year survival rates.
How do myoepithelial cells aid in differentiating invasive from in situ breast lesions?
Their presence in ducts typically indicates a benign or in situ process, while their absence suggests invasion.
What immunohistochemical markers are most useful for detecting myoepithelial cells?
Markers such as p63, SMM, and CK5/6 are routinely used to highlight the myoepithelial layer.
How can radiological imaging complement histological assessment in breast pathology?
Imaging can detect microcalcifications, architectural distortions, and density changes that correlate with histopathological findings.
How do proliferative benign conditions like atypical ductal hyperplasia influence breast cancer risk?
They increase the risk of developing subsequent carcinoma and require careful clinical surveillance.
What genetic alterations are commonly observed in breast carcinoma?
Mutations in BRCA1/2, alterations in HER2, and changes in genes regulating cell cycle and apoptosis are frequent.
How does breast density affect cancer risk and detection?
High breast density not only increases the risk of cancer but also can obscure lesions on mammographic imaging.
What is the role of sentinel lymph node biopsy in breast cancer management?
It provides crucial staging information with minimal morbidity compared to complete axillary dissection.
How do hormone receptor statuses guide therapeutic decisions in breast cancer?
They determine the use of anti-oestrogen agents, which can significantly impact patient outcomes.
