Breast Pathology 1

Question 1

What is triple breast assessment?

Answer 1

clinical; imaging and pathology

Question 2

What are the sampling methods for breast cytopatholgoy?

Answer 2

FNA; fluid; nipple discharge; nipple scrape

Question 3

What is C1 on breast FNA cytology?

Answer 3

unsatisfactory

Question 4

What is C2 on breast FNA cytology?

Answer 4

benign

Question 5

What is C3 on breast FNA cytology?

Answer 5

atypia; probably benign

Question 6

What is C4 on breast FNA cytology?

Answer 6

suspicious of malignancy

Question 7

What is C5 on breast FNA cytology?

Answer 7

malignant

Question 8

What are the diagnostic biopsies for breast histopathology?

Answer 8

needle core biopsy; vacuum assisted biopsy; skin biopsy; incisional biopsy of mass

Question 9

What are the option for B5 needle core biopsy?

Answer 9

B5a- carcinoma in situ

B5b- invasive carcinoma

Question 10

What developmental anomalies are seen in the breast?

Answer 10

hypoplasia; juvenile hypertrophy; accessory breast tissue; accessory nipple

Question 11

What is gynaecomastia?

Answer 11

breast devlopment in the male

Question 12

What seen pathologicall with gynaecomastia?

Answer 12

ductal growth without lobular devleopment

Question 13

What are the causes of gynaecomastia?

Answer 13

exogenous/endogenous hormones; cannabis; prescription drugs; liver disease

Question 14

What age group gets fibrocystic change of the breast?

Answer 14

20-50 years but mainly 40-50

Question 15

What is fibrocystic change in the breast associated with?

Answer 15

menstrual abnormalities–early menarche; late menopause

Question 16

When does fibrocystic change in the breast often resolve or diminish?

Answer 16

post-menopause

Question 17

What is the presentation of fibrocytic change of the breast?

Answer 17

smooth discrete lumps; sudden/cyclical pain; lumpiness

Question 18

What is seen on pathology with fibrocystic change?

Answer 18

usually multiple blue domed cysts with pale fluid with intervening fibrosis

Question 19

What is the seen microscopically on pathology with fibrocystic change?

Answer 19

thin walled cysts- may have fibrotic wall; lined by apocrine epithelium

Question 20

What is metaplasia?

Answer 20

change from one fully differentiated cell type to another fully differentiated cell type

Question 21

What is hamartoma?

Answer 21

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

Question 22

What race tends to get fibroadenoma?

Answer 22

African women

Question 23

When is the peak incidence of fibroadenoma?

Answer 23

3rd decade

Question 24

How do fibroadenomas present?

Answer 24

painless; firm; discrete; mobile mass

Question 25

What other name is given to fibroadenomas?

Answer 25

breast mosue

Question 26

What is the appearance of fibroadenomas on USS?

Answer 26

solid

Question 27

What is seen on pathology with fibroadenoma?

Answer 27

circumscribed; rubbery; grey-white; biphasic tumour- epithelium and stroma

Question 28

What are sclerosing lesions of the breast?

Answer 28

benign; disorderly proliferation of acini and stroma

Question 29

What makes diagnosis of sclerosing lesions of hte breast?

Answer 29

cause a mass or calcification so my mimic carcinoma

Question 30

What is the presentation of sclerosing adenosis?

Answer 30

pain; tenderness or lumpiness/thickening; may be asymptomatic

Question 31

What age group gets sclerosing adenosis?

Answer 31

20-70

Question 32

What is the prognossi for sclerosing adenosis?

Answer 32

benign with negligible risk of carcinoma

Question 33

What is the difference between radial scar and complex sclerosing lesion?

Answer 33

radial scar is between 1-9mm; complex sclerosing lesion is >10mm

Question 34

What are the gross features of a radial scar?

Answer 34

stellate architecture; central puckering; radiating fibrosis;

Question 35

What are the histological features of a radial scar?

Answer 35

fibroelastotic core; radiating fibrosis containind distored ductules; fibrocystic change; epithlelial proliferation

Question 36

What is the treatment for radial scar?

Answer 36

excise or sample extensively by vacuum biospy

Question 37

Why is a radial scar excised if it is benign?

Answer 37

in situ or invasive carcinoma may occur within the lesion

Question 38

What are the causes of fat necrosis?

Answer 38

local trauma- seat belt injury or surgery; warfarin therapy

Question 39

What is seen with fat necrosis of the breast?

Answer 39

damage and disruption of adipocytes; infiltration by acute inflammatory cells- "foamy" macrophages; subsequent fibrosis and scarring

Question 40

What are the clinical features of duct ectasia?

Answer 40

acute episodic inflammatory changes; bloodt and/or purulent discharge; fistulation and nipple retraction and distortion

Question 41

Which ducts does duct ectasia affect?

Answer 41

sub-areolar ducts

Question 42

What are the pathological changes with duct ectasia?

Answer 42

sub-areolar duct dilatation; periductal inflammation; periductal fibrosis ; scarring and distortion

Question 43

What is the main risk factor for developing duct ectasia?

Answer 43

smoking

Question 44

What is the management of duct ectasia?

Answer 44

treat acute infections; stop smoking; excise ducts

Question 45

What are the 2 main causes of acute mastitis/abscess?

Answer 45

duct ectasia; lactation

Question 46

What bugs are involved in acute mastitis caused by duct ectasia?

Answer 46

mixed organisms and anaerobes

Question 47

What bugs are invovled in acute mastitis caused by lactation?

Answer 47

staph. aureus; strep. pyogenes

Question 48

What is the management of acute mastitis/abscess?

Answer 48

antibiotics; percut drainage; infection and drainage; treat underlying cause

Question 49

What age group gets Phyllodes tumour?

Answer 49

40-50 years

Question 50

What is the clinical feature of phyllodes tumour?

Answer 50

slow growing unilateral breast mass

Question 51

What are the types of phyllodes tumour?

Answer 51

benign; bordelrine and sarcomatous

Question 52

What are the pathological features of a phyllodes tumour?

Answer 52

biphasic; stromal overgrowth

Question 53

What is the prognosis of phyllodes tumour?

Answer 53

prone to local reccurence if not adequately excised; rarely metastasise

Question 54

Who gets intraduct papilloma?

Answer 54

35-60 years

Question 55

What are the clinical features of intraduct papilloma?

Answer 55

nipple discharge +/- blood; nodules; calcification

Question 56

Which ducts does intraduct papilloma affect?

Answer 56

sub-areolar ducts

Question 57

What is seen pathologically with intraduct papilloma?

Answer 57

papillary fronds containing a fibrovascular core covered with myoepithelium and epithelium- may show proliferative activity

Question 58

What are the different types of epithelial proliferation seen with intraduct papilloma?

Answer 58

none; usual type hyperplasia; atypical ductal hyperplasia; ductal carcinoma in situ