7.1.1 Breast Disease Pathology Flashcards
What is the normal histological appearance of breast tissue?
Modified sweat glands
Lobules and lactiferous ducts
Lobules contain acini and intralobular stroma
Describe the acini ducts in breast tissue
Cuboidal epithelia lining the lumen
Myoepithelial cells act as basement membrane on outside of the lumen
What physiological changes occur in breast tissue in these phases?
- Prepubertal
- Menarche
Prepubertal
Few lobules- identical to male breasts
Mencharce
Increase in number of lubules
Increased volume of interlobular stroma
What physiological changes occur in breast tissue during pregnancy?
- Increase in size and number of lobules
- Decrease in stroma
- Secretory changes
- Cessation of lactation, atrophy of lobules but not back to former levls
What physiological changes occur during the menstrual cycle?
Follicular phase lobules quiescent
After ovulation proliferation and stromal oedema
Menstruation leads to decrease in lobules
What physiological changes occur to breast tissue as women age?
Terminal duct lobular units decrease in number and size
Stroma replaced with adipose tissue
What does breast tissue look like in pregnancy?
Loss of stroma
Glands produce milk so are filled with colostrum initially, then milk - large dilated white filled acini
Stop producing milk when baby feeding stops
How can breast conditions present?
Pain
Palpable mass
Nipple discharge
Mammographic abnormalities
Skin changes
Lumpiness
What breast conditions cause pain?
May be cyclical and diffuse
Non-cyclical and focal- ruptured cysts, injury, inflammation
Breast cancer (sometimes)
What breast conditions cause a palpable mass?
Normal nodularity
Invasive carcinomas
Fibroadenomas
Cysts
Worrying if hard, craggy and fixed
What breast conditions cause mammographic abnormalities?
Densities
Invasive carcinomas
Fibroadenomas
Cysts
Calcifications
Ductal carcinoma in situ (DCIS)
Benign changes
What age group are invited to mammographic screening ?
Women between 47-73 years old every 3 years
Easier to detect lesions in breasts of older women
What is the most common benign tumour of the breasts?
Fibroadenoma
How common is breast cancer?
Most common non-skin malignancy in women
What does mammographic screening increase detection of?
Small invasive tumours and in situ carcinomas
What is fat necrosis of the breast?
Presents as a mass, skin changes or mammographic abnormality
Hx of trauma or surgery
Can mimic carcinoma clinically and mammographyically
Fat cells break down and surrounded by macrophages and inflammatory cells
What is fibrocystic change?
- Commonest breast lesion
- Can present as a mass or mammographic abnormality
- Histology- cyst formation, fibrosis and apocrine metaplasia
- Can mimic carcinoma clinically and mammographically
