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Year 3 Repro (JK) > Pathology of the breast > Flashcards

Pathology of the breast Flashcards

1
Q

Epithelial components of the breast

A

ducts and lobules

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2
Q

Mesencymal components of the breast

A

fat and fibrous tissue

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3
Q

How many lobes does each breast have? how do lobes connect up to produce bulbs?

A

8-10

by forming lobules

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4
Q

Before puberty are there ducts in both sexes?

A

yes : 15-25

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5
Q

Before puberty are there lobules in both sexes?

A

no

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6
Q

Explain the branching in the breast following puberty

A

starts in nipple and branch into the terminal ductal lobular unit

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7
Q

Function of lymph ducts

A

drain fluid that carries WBC from the breast –> axillary/parasternal LN

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8
Q

LN function

A

filter bacteria (harmful) and play a key role in fighting infection

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9
Q

5 benign breast conditions

A 
fibrocystic change 
fibroadenoma 
intraduct papilloma 
fat necrosis 
duct ectasia
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10
Q

Who are fibroadenomas common in?

A

adolescent and young adult female

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11
Q

Pathology of fibroadenoma

A

proliferation of epithelial and stromal elements

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12
Q

symptoms and signs of fibroadenoma

A

well circumscribed, freely moveable, non painful - may regress

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13
Q

Ducts in fibroadenomas

A

elongated - intracanicular

not compressed - pericanicular

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14
Q

2 other adenomas

A

tubular and lactating

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15
Q

Intraduct papilloma

A
  • middle aged women
  • nipple discharge
  • epithelial hyperplasia
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16
Q

How can fat necrosis simulate carcinoma?

A

clinically and mammographically

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17
Q

IMPORTANT history in fat necrosis

A

history of trauma

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18
Q

appearance of fat necrosis histologically

A

histiocytes with foamy macrophages and lipid filled cysts

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19
Q

mammography appearance of fat necrosis

A

fibrosis, calcifications, egg shell

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20
Q

Appearance of phyllodes tumour

A

fleshy, leaf like pattern and cysts on cut surface

circumscribed, 1-15cm

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21
Q

types of phyllodes tumour

A

benign, borderline and malignant

22
Q

metastatic spread of phyllodes tumour

A

hematogenous

23
Q

How many women does breast cancer affect?

A

1 in 8

24
Q

How may men does breast cancer affect?

A

1 in 870

25
Q

Mammogram appearance of breast ca

A

soft tissue opacity and microcalcification

26
Q

Macroscopic appearance of breast ca

A

hard lump, fixed mass, tethering to the skin, peau d’orange dimpling of skin

27
Q

Risk factors for breast cancer

A 
genetic 
hormonal treatment 
personal history 
family history 
radiation 
age at 1st pregnancy 
menstrual history 
gender 
other eg obesity, alcohol
28
Q

Breast lesion and risk of ca

  1. Epithelial proliferation without atypia
  2. with atypia ductal or lobular
  3. LCIS/DCIS
A

1.5-2x
4-5x
8-10x

29
Q

What % of breast cancer attributed to hereditary factors?

A

5-10

30
Q

4 genes implicated in breast cancer

A

BRCA1, BRCA2, TP53, PTEN,

31
Q

Non invasive carcinoma

A

LCIS,DCIS

32
Q

invasive carcinoma types

A

IDC - 75%
ILC
special types = rest

33
Q

In situ carcinoma characteristics

A

preinvasive - non palpable
not detected clinically
LCIS is bilateral and multicentral
no met spread

34
Q

Risk of invasion of in situ carcinoma depends on?

A

grade

35
Q

Risk of progression

  1. LGDCIS
  2. HGDCIS
  3. LCIS
A

30% in 15 years
50% in 8 years
19% in 25 years

36
Q

special types

A
  1. tubular carcinoma
  2. mucinous carcinoma
  3. carcinoma with medullary features
  4. metaplastic carcinoma
37
Q

Diagnostic procedures

A 
mammogram/USS/MRI
clinical exam
FNAC
core biopsy 
wide local excision with adequate margins
38
Q

screening for breast cancer

A

30% reduction in mortality

mammogram every 3 years for 50-70 year olds

39
Q

Microcalcifications - what do they mean?

A

most harmless but can be a precancerous/cancerous indicator

40
Q

2 of the most important mammography indicators of breast cancer

A

masses

microcalcifications

41
Q

Histology report info

A 
invasive or non invasive 
tumour size 
grade 
nodal status
histological type 
margins
ER/PR receptor 
HER-2/neu
42
Q

3 spread of breast cancer

A

local eg skin, pectoral muscle
lymphatic - axillary and internal mammary
blood - bone, brain, lung, liver

43
Q

Prognosis of breast cancer

A 
patient and tumour related
node status
tumour size 
type 
grade 
age 
LVSI 
ER/PR/HER-2
gene expression profiling 
proliferative rate of tumour 
NPI
44
Q

Nottingham prognostic index

A

tumour size, grade, nodes

45
Q

5YS breast ca

A

64%

46
Q

ER/PR - useful for?

A

predictors of response to hormonal treatment

47
Q

HER-2 - what does it predict?

A

response to trastuzumab - Herceptin

48
Q

5 subtypes of molecular classification

A 
ER + luminal A 
Luminal B 
basal 
Her 2+
normal breast like
49
Q

Management for breast ca

A 
staging 
surgery - mastectomy, breast conserving +/- nodes
radiotherapy 
chemo 
anti-hormonal eg tamoxifen
50
Q

pagets disease of nipple

A

intraepithelial spread of intraductal carcinoma

large pale staining cells in epidermis of nipple

51
Q

gynaecomastia associated with…

A

hyperthyroidism - cirrhosis - Chronic renal failure - hypogonadism - hormone use

Year 3 Repro (JK) (33 decks)

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