48 - Breast Pathology

Question 1

breast screening programme - frequency and age

Answer 1

Every 3 years

All women aged 50+

Question 2

Breast cancer - clinical presentation

Answer 2

Lumps
Puckered nipple/indrawn nipple
Pain
Inflammation/infection
Nipple discharge
Abnormal/sore nipple
Radiology/screening

Question 3

Triple assessment of breast lumps involve:

Answer 3

Clinical - examination and palpation
Radiological
Pathological - cytology or histopathology

Question 4

Fibrocystic changes

Answer 4

So common it is often thought of as physiological

Can mimic cancer - clinically and pathologically. Some links with breast cancer

Question 5

What grading is given for core biopsies?

Answer 5

B grading

Question 6

B1

Answer 6

Unsatisfactory/normal breast lesion

Question 7

B2

Answer 7

Benign lesion

Question 8

B3

Answer 8

Atypical probably benign

Question 9

B4

Answer 9

Atypical probably malignant

Question 10

B5

Answer 10

Malignant (B5a = in situ, b invasive)

Question 11

Fibroadenoma

Answer 11

Common - mobile lumps or radiological masses
Cause concern but biopsy
Coordinated growth of glandular and connective tissue (stromal) element

Question 12

Phyllodes tumours

Answer 12

Rare fibroepithelial neoplasm which forms spectrum of lesions

Question 13

Fibrocystic change

Answer 13

Ductal hyperplasia, apocrine metaplasia and cysts

May present as lump w/ microcalcifications
Shares risk factors with breast cancer but probably not precursor
Can be tricky for the histopathologist to interpret correctly in rare cases

Question 14

Puckered nipple

Answer 14

Fat necrosis

Carcinoma, puckering and peau d’orange

Question 15

Pain present in breast cancer?

Answer 15

Rare

Question 16

Nottingham prognostic index

Answer 16

Grade and nodal status and tumour size taken into account to predict survival