Breast

Question 1

What percent of breast lumps are cancer?

Answer 1

10%

Question 2

What is the triple assessment?

Answer 2

1. Physical exam
2. Imaging (sonography, mammogrpahy, mri)
3. Pathology (cyopathology, histopathology)

Question 3

Most common lesion causing nipple discharge?

Answer 3

papilloma (within large duct)

Question 4

When is papilloma more associated with cancer?

Answer 4

bloody discharge and a mass

Question 5

Pros and cons of FNA?

Answer 5

• safe, reliable, fast, accurate, cheap
• can’t differentiate ductal hyperplasia from low grade, or cancer from advanced cancer

Question 6

Reporting system of UK NHS screening service

Answer 6

B1: normal tissue/poor sample
B2: benign lesions
B3: uncertain malignant potential
B4: suspicion of malignancy
B5: malignancy

Question 7

What is acute mastitis?

Answer 7

• acute inflammation in the breast often seen in lactating women with cracked skin and stasis
• usually one side

Question 8

Most common cause of acute mastitis?

Answer 8

staphylococci

Question 9

Cells seen in acute mastitis

Answer 9

neutrophils

Question 10

What is duct ectasia

Answer 10

inflammation and dilation of large breast ducts

• usually 50-60 yr old

Question 11

how does duct ectasia usually present?

Answer 11

nipple discharge
lump
can get retracted nipple

Question 12

What is fat necrosis and how does it present?

Answer 12

• inflammatory reaction to adipose tissue
• presents as a lump
• after trauma

Question 13

What is a radial scar?

Answer 13

benign sclerosing lesions with a central zone of scarring surrounded by zone or glandular tissue

• stellate masses on screening mammograms
• excision needed
• thought to be reparative phenomenon in response to areas of tissue damage
• gives a star-like appearance

Question 14

What is flat epithelial atypia?

Answer 14

• may be earliest morphological precursor to low grade ductal carcinoma in situ
• relative risk of 1.5 of developing cancer

Question 15

In situ lobular neoplasia

Answer 15

• risk factor for invasive breast cancer
• affects whole lobule
• 8-10 times relative risk of cancer

Question 16

What is Paget’s disease of nipple?

Answer 16

• uncommon proliferation of malignant glandular epithelial cells in the areolar epidermis (in situ carcinoma)
• ## 60 - 70s

Question 17

Modified blood-richardson score

Answer 17

3-5 = well differentiated
6-7 = moderately differentiated
8-9 = poorly differentiated

Question 18

What is oncotype DX

Answer 18

• looks at oestrogen positive low-grade cancer
• tells us if added chemo or radio would help

Question 19

high Ki67 proliferation index

Answer 19

above 67 suggests greater risk of reocurrence