48 Breast pathology Flashcards

1
Q

What are the majority of breast cell malignancies?

A

Carcinomas.

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2
Q

How are breasts of younger people different to older people?

Clinical significance?

A

More glandular and fibrous - more lumpy.

Mammograms and palpation less good at finding tumours in younger people.

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3
Q

Name three factors that decrease the risk of breast cancer:

A

Breast feeding.
Physical activity.
Body fatness (pre-menopausal only).

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4
Q

What are the risk factors of breast cancer? (12).

A
Alcohol.
Oestrogen-Progesterone medication.
Diethylstilbestrol.
Radiation.
Body fatness (post-menopausal only).
Shiftwork.
Height.
Baby birth weight. (pre-menopausal only).
Digoxin.
Tobacco.
Female.
Long interval between menarche + menopause.
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5
Q

Who is eligible for breast screening?

Frequency of screening?

A

Women aged 43 to 73.

Every 3 years.

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6
Q

What is the triple assessment for breast screening?

A

Clinical: exam + palpation.
Radiological.
Pathology: histopathology or cytology.

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7
Q

How are breast biopsies graded? (5)

A
  1. normal.
  2. benign lesion.
  3. atypical probably benign.
  4. atypical probably malignant.
  5. malignant.
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8
Q

What is a fibroadenoma?

How do they present?

A

Benign fibroepithelial neoplasms with coordinated growth of glandular and connective tissue.
Mobile lumps.

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9
Q

What is a phyllodes tumour?

How do they present?

A

Rare fibroepithelial neoplasm.
Spectrum from fibroadenoma to overgrowth of stomal element which may be sarcomatous.
Discrete lump.

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10
Q

What is fibrocystic change of the breast? (3).

A

Constellation of:
Ductal hyperplasia
Apocrine metaplasia
Cysts

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11
Q

How does fibrocystic change present? (2).

A

Lump.

Micro calcifications.

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12
Q

How is fibrocystic change related to breast cancer?

A

Very common - almost physiological.
Oestrogen is shared exposure.
Probably not a precursor.

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13
Q

What is peau d’orange and why does it occur with breast cancer? (2).

A

Puckered appearance of the skin.

Fat necrosis. Tumour cells interact with fibroblasts causing contraction.

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14
Q

What are the causes of breast inflammation? (4).

A

Mastitis during breast feeding.
Breast abscesses and fistula.
TB.
Sarcomas/carcinomas.

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15
Q

What are the causes of nipple duct discharge? (4)

A

Duct ectasia.
Intraductal papilloma.
In situ papillary carcinoma.
Intracystic papillary carcinoma.

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16
Q

Which prognostic score is used for breast cancer?

A

Nottingham prognostic index.

17
Q

What is a duct papilloma of the breast?

Presentation?

A

Benign solitary lesion occurring in large ducts.

Blood stained nipple discharge.

18
Q

What is the aetiology of breast cancer?

A

Overexposure to oestrogen.

Underexposure to progesterone.