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Flashcards in Breast pathology 1 Deck (51)
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1

what is the triple assessment of a patient

clinical - history and exam
imaging - mammography, USS, MRI
pathology - cytopathology, histopathology

2

how is breast cytopathology taken

fluid needle aspiration
fluid
nipple discharge
nipple scrape

3

how is FNA staged from C1-5

C1 unsatisfactory
C2 benign
C3 atypia, probs benign
C4 suspicious of malignancy
C5 malignancy

4

what are the two types of breast histopathology and how is each one done

diagnostic - needle core biopsy, vacuum assisted biopsy, skin biopsy, incisional biopsy

therapeutic - excision biopsy of mass, resection of cancer (wide local excision of mastectomy)

5

how is a needle core biopsy graded from B1-5

B1A unstisfactory/normal
B2 benign
B3 atypia, probs benign
B4 suspicious of malignancy
B5 malignant
B5a carcinoma in situ
B5b invasive carcinoma

6

what are some developmental anomalies of breasts

hypoplasia
juvenile hypertrophy - usually one but can be both
accessory breast tissue - commonly at the axilla and becomes evident when hormonal state changes
accessory nipple

7

inflammatory benign breast disease (3)

fat necrosis
duct ectasia
acute mastitis/abscess

8

what is gynaecomastia
what kind of growth

breast develop,emt in the male
ductal growth without lobular development

9

what are some causes of gynaecomastia

exogenous/endogenous hormone
cannabis
prescription drugs
liver disease

10

who does fibrocystic change occur in

women aged 20-50 but commonest in women aged 40-50

11

risk factors for fibrocystic change

menstrual abnormalities
early menarche
late menopause
often resolve or diminish after menopause

12

link between breast cancer and fibrocystic change

same risk factors
can have co existing breast cancer

13

fibrocystic change presentation

smooth discrete lumps
sudden pain form rupture of cysts
cyclic pain which changes with menstrual cycle
lumpiness
incidental finding
screening

14

gross pathology of fibrocystic change of the cysts

1mm- several cm
blue domes with pale fluid
usually multiple
associated with other benign changes

15

microscopic pathology of cysts with fibrocystic change

thin walled but may have fibrotic wall
lined by apocrine epithelium

16

management of fibrocystic change

exclude malignancy
reassure
excise if necessary

17

what is hamartoma

circumscribed lesion composed of cell types normal to the breast but present in an abnormal proportion or distribution

18

treatment of hamartoma

left alone as it does not cause issues

19

how common is fibroadenoma

common
commoner in african women
usually solitary (10% multiple)

doesn't invade the tissue like cancer does

20

fibroadenoma age
presentation

peak incidence in 30s
can be picked up on screening
painless, firm, discrete mobile mass
"breast mouse"

21

US of fibroadenoma

solid on USS

22

description of a fibroadenoma

circumscribed
rubbery
grey-white colour
biphasic tumour/lesion - epithelium, stroma

23

treatment of fibroadenoma

diagnose
reassure
excise

24

when can a fibroadenoma grow rapidly

during pregnancy

25

what are the types of scelrosing lesions

sclerosis adenomas
radial scar/complex sceloring lesion (CSL)

26

what are sclerosising lesions
what can they cause
what can they mimic

benign
disorderly proliferation of acini and stroma

mass or calcification

carcinoma

27

sclerosising adenosis presentation

pain, tenderness, lumpiness/thickening
often asymp
age 20-70

28

risk of carcinoma + sclerosising adenosis

its benign and there is no risk of subsequent carcinoma

29

radial scar age
is it common
how is it found
ix

wide age range
common - 67% multi centric, 43% bilateral
incidental finding
mamographically detected

30

different between a radial scar and CSL

RS 1-9mm
CSL >10mm