Breast Flashcards
(44 cards)
What is cytopatholgoy?
When you take a sample to show cells of change
E.g fluid, nipple discharge, needle scrape, fine needle aspiration
Classifying breast FNA, what category would implying malignancy?
C5 is malignant
C1 unsatisfactory C2 benign C3 atypical probs benign C4 suspicious malignant C5 malignant
What is histopathology?
Biopsy of a specimen
E.g needle core biopsy, vacuum assisted biopsy, skin biopsy, incisional biopsy of mass
What classification of needle core biopsy would define a malignant lesion?
B5 is malignant
B1 unsatisfactory/normal B2 benign B3 atypical probs benign B4 suspicious malignancy B5 malignant (b5a carcinoma insitu, b5b invasive carcinoma)
What is the significance in treatment approaches between B5a and B5b for needle core biopsy?
B5a carcinoma insitu so can leave axillary nodes alone
B5b invasive carcinoma so need a sentinal node biopsy as likely lymphatic spread
Who is most likely to get gynaecomastia?
Those who were exposed to exogenous or endoenous hormones in pregnancy
Cannabis users
Liver disease
What is fibrocystic change
Where multiple blue domed cysts with pale fluid accumulate in the breast tissue. With intervening fibrosis
Who is most likely to get fibrocystic change?
People with anovulatory cycles (long oestrogen stim)
Women 40-50
Early menarche
Late menopause
What is the treatment option for a fibroadenoma?
Surgical excision and reassurance as not malignant
What genetic mutations predispose you to getting a breast carcinoma?
BRCA1
BRCA2
HER2
Which precursor to breast carcinoma is most likely to progress to malignancy?
Ductal carcinoma in situ (DCIS)
Lobular in situ neoplasia
What risk does having atypical ductal hyperplasia give you to progress to breast carcinoma vs general population
4x population risk
What would the treatment for ductal carcinoma insitu be?
Surgery
Adjuvant radiotherapy
What does carcinoma in situ mean?
Malignancy is confined by the basement membrane so it is not yet invasive
What stain can you use to identify lobular in situ neoplasia
E-cadherin stain immunohistochemistry
What factors confer a high risk to developing breast cancer?
NON PARITY (childless)
Anything that increases your exposure to oestrogen
Obesity, early menarche, late menopause, not breast feeding
What are some of the symptoms of malignant breast cancer?
Dimpled or depressed skin Visible lump Nipple change (inversion) Bloody discharge Texture change Colour change
What is pagets disease of the nipple?
Where DCIS reaches the nipple epidermis but it is still an in situ carcinoma
Presenting with eczema of the breast and potentially discharge
Where does breast cancer metastasis to?
Liver Bone Brain Lungs Abdo viscera Female genital tract Local invasion
Breast cancer is oestrogen receptor positive what can you do to shrink it without physically removing the tumour?
Tamoxifen
Oophrectomy
Aromatase inhibitors (letrozole)
GnRH antagonists like goserilin
Breast cancer is HER2 receptor positive what can you do to shrink it without physically removing the tumour?
Trastuzamab (herceptin) which is a monoclonal antibody
What is the treatment for a fibroadenoma?
Reassurance not going to cause you any harm
Can remove if you want
Describe the physiology behind lactation
Mechanoreceptors stimulated from child sucking, goes to hypothalamus stimulates release of prolactin from anterior pituitary which causes milk secretion. Also stimulates oxytocin to be released from the posterior pituitary to cause smooth muscle contration and ejection of milk.
What are the benefits of breast feeding for the child?
Better growth Preventitive against childhood obesity Less diarrhoea, vomiting, constipation Less type 2 diabetes Less eczema
