Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Reproductive > Pathology of Breast Disease > Flashcards

Pathology of Breast Disease Flashcards

1
Q

What is contained in the normal structure of breasts?

A
  • Epithelial: ducts and lobules (glandular)
  • Mesenchymal: fat and fibrous tissue
  • Hormone dependent
  • Physiological changes with age and pregnancy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the basic structure of a breast?

A
  • Made up of 8 to 10 lobes that are arranges like petals of a daisy
  • Inside each lobe are smaller structures called lobules
  • At the end of each lobule and tiny sacs (bulbs) that can produce milk
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Where does branching of lobules start and what is it dependent on?

A
  • Branching of the lobules starts from the nipple and it is hormonally responsive
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the role of the lymph ducts of the breasts?

A
  • Drain fluid that carries WBCs from the breast tissues to the lymph nodes in the axilla and behind the sternum
  • [they filter harmful bacteria and play key role in fighting infection]
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are some benign breast conditions?

A

Fibrocystic change: fibrosis, adenosis, apocrine metaplasia

Fibroadenoma: circumsised mobile nodule of reproductive age

Intraduct papilloma: lactiferous ducts, nipple discharge

Fat necrosis: traumatic

Duct ectasia: nipple discharge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the features of fibroadenoma?

A
  • Proliferation of epithelial and stromal elements
  • MOST COMMON breast tumour in adolescent and young adult women
  • Well circumscribed, freely mobile, non painful mass
  • May regress with age
  • Ducts distorted elongated slit-like structures intracanalicular pattern, ducts not compressed

pericanalicular growth pattern

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Two other types of adenoma?

A
  • Tubular adenoma: far less common, discrete freely moveable mass, young women
  • Lactating adenoma: enlarging masses during lactation/pregnancy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Features of intraduct papilloma?

A
  • Usually middle aged women
  • Nipple discharge
  • [can show epithelial hyperplasia, which may be atypical]
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What effect can fat necrosis have on breast tissue? And its features?

A
  • Can simulate carcinoma clinically and

mammographically

  • History of antecedent trauma, prior surgical

intervention

  • Histiocytes with foamy cytoplasm
  • Lipid–filled cysts
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Epidemiology of breast carcinoma

A
  • Affects 1 in 8 females
  • 1 in 870 males
  • Commonest cause of female cancer death (1/3

of affected women will die from disease)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What can be seen on mammogram for breast carcinoma?

A
  • Soft tissue opacity
  • Microcalcification
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What can be seen macroscopically of breast cancer?

A
  • Hard lump, fixed mass, tethering to skin, peau d’orange dimpling of skin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

RF for breast carcinoma?

A
  • Gender
  • Age
  • Menstrual history
  • Age at first pregnancy
  • Radiation
  • Family history
  • Personal history
  • Hormonal treatment
  • Genetic factors
  • Other: obesity, lack of exercise, alcohol
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How can some breast lesions effect risk of breast cancer ?

A
  • Epith proliferation without atypia: RF 1.5/2x
  • With atypia ductal or lubular: RF 4/5x
  • Lobar carcinoma in situ (LCIS): 8-10x
  • Ductal carcinoma in situ (DCIS): 8-10x
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

List the genes related to inherited breast cancer disease and their relative contributions to hereditary carcinoma.

A
  • BRCA1: 20-40%
  • BRCA2: 10-30%
  • TP53: <1%
  • PTEN: <1%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Name the histological classifications of invasive and non-invasive breast cancers.

A

Non-invasive

  • Ductal carcinoma in situ (DCIS)
  • Lobular carcinoma in situ (LCIS)

Invasive

  • Invasive ductal carcinoma (75%)
  • Invasive lobular carcinoma and its variants (5-15%)
17
Q

What are the features of the in situ carcinomas?

A
  • preinvasive - does not form a palpable tumor 
  • not detected clinically (only X-ray in DCIS–screening)
  • multicentricity and bilaterality (LCIS)
  • no metastatic spread (basement membrane)
  • risk of invasion depending on grade
18
Q

What are the risks of progression in situ cancer?

A
  • Low grade DCIS - 30% in 15 years
  • High grade DCIS - 50% in 8 years
  • LCIS - 19% in 25 years and bilaterality
19
Q

What are the ‘special’ types of breast cancer?

A
  • Tubular carcinoma
  • Mucinous carcinoma
  • Carcinoma with medullary features  (This is the type you get with BRCA1 mutations)
  • Metaplastic carcinoma
20
Q

What are the diagnostic procedures for finding breast cancer?

A
  • Clinical examination
  • Radiology (Mammogram, ultrasound, MRI)
  • Fine needle aspiration cytology FNA
  • Needle core biopsy
  • Wide local excision with adequate margins
21
Q

How is breast cancer screening carried out and what are the benefits?

A
  • Mammogram every 3 years for women between the age of 50 and 70
  • 30% reduction of mortality
  • Over 80% (1,406 cases) of cancers detected were invasive, of which over half were less than 15mm in size
22
Q

Explain microcalcifications

A
  • Tiny deposits of calcium can appear anywhere in the breast and often show up on a mammogram
  • Most women have one or more areas of microcalcifications of various sizes
  • Majority of calcium deposits are harmless
  • A small percentage may be in precancerous or cancerous tissue
23
Q

On mammography, what are the two most important mammographic indicators of breast cancer?

A
  • Masses
  • Microcalcifications
24
Q

What info will be gained from a histology report?

A
  • Invasive vs non-invasive
  • Histological type: ductal (85%) or lobular
  • Grade (estimate of how aggressive the cancer is)
  • Size
  • Margins
  • Lymph nodes
  • Eostrogen/progesterone receptor
  • HER2 gene
25
Q

Where can breast cancer spread and via what route?

A
  • Local: skin and pectoral muscles
  • Lymphatic: axilla and internal mammary nodes
  • Blood: bone, lungs, brain, liver
26
Q

What factors have an effect on the prognosis of breast cancer?

A
  • Patient + tumour related
  • Node status
  • Tumour size
  • Type
  • Grade
  • Age
  • Lymphovascular invasion
  • Oestrogen/progestrogen receptors
  • HER-2
  • Proliferative rate of tumour
  • Overall there is a 64% 5 year survival
27
Q

What molecular markers can we use?

A
  • ER /PR strong predictors of response to hormonal therapies
  • ER/PR negative tumours do not respond
  • HER-2 : about 20-30% positive- predicts response to trastuzumab ( Herceptin )
28
Q

Theres some stuff on molecular classification in the lectures although I’m unsure if we need to know it: it’s on this card anyway if you’re feeling keen

A

Molecular Classification

  • Gene expression technology
  •  5 subtypes : ER + luminal A, luminal B, Basal, Her 2+ and normal breast-like
  • Biologically diverse disease
  • Predictive gene signatures/ potential to improve therapy
  • Complement current clinicopathological features
29
Q

What is the management of breast cancer?

A
  • Staging
  • Surgery: mastectomy, breast conserving surgery ± lymphnodes
  • Radiotherapy
  • Antihormonal therapy (tamoxifen)
  • Chemotherapy
30
Q

What is pagets disease of the nipple? Signs and symptoms?

A
  • Results from intraepithelial spread of intraductal carcinoma
  • Large pale staining cells within the epidermis of the nipple
  • Limited to the nipple or extend to the areola
  • Pain or itching, scaling and redness, mistaken for eczema
  • Ulceration, crusting, and serous or bloody discharge
31
Q

Most common pathology of the male breast?

A

Gynecomastia

  • increase in subareolar tissue
  • in 30 to 40 percent of adult males, both breasts are affected in many cases
  • Associated with hyperthyroidism, cirrhosis of the liver, chronic renal failure, chronic pulmonary disease and hypogonadism

Reproductive (34 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions