Breast Pathology 1: Benign Breast Disease Flashcards Preview

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Flashcards in Breast Pathology 1: Benign Breast Disease Deck (43)
1

Describe the part of the triple assessment

Clinical = history and examination
Imaging= Ultrasound, mammography or MRI
Pathology = cytopathology or histopathology

2

What specimens can be sent for cytopathology

Fine needle aspiration
Fluid
Nipple discharge
Nipple scrape

3

Describe the results that can come back on FNA cytology

C1- unsatisfactory
C2- benign
C3- atypia, probably benign
C4- suspicious of malignancy
C5 - malignant

4

Describe the results that can come back for a needle core biopsy

B1 - Unsatisfactory / normal
B2 - Benign
B3 - Atypia, probably benign
B4 - Suspicious of malignancy
B5 - Malignant
B5a - carcinoma in situ
B5b - invasive carcinoma

5

Define cynaecomastia

Breast development in the male
Ductal growth without lobular development

6

Causes of gynaecomastia

Exogenous/endogenous hormones
Cannabis
Prescription drugs e.g.rispiredone, spironolactone
Liver disease

7

What age group does fibrocystic change usually occur in

woman aged 40-50 most commonly

(can occur in 20-50s group though)

8

What usually causes fibrocystic change

menstrual changes/abnormalities
early menarche
late menopause

usually resolves after menopause

9

How does fibrocystic change present

Smooth discrete lumps
Sudden pain
Cyclical pain
Lumpiness
Incidental finding
Can be detected at screening

10

What is a hamartoma

A circumscribed lesion of cell types normal to the breast but present in abnormal proportion or distribution.
It is benign.

11

In what race are fibroadenomas more common

African

12

How common is it to have multiple fibroadenomas

only 10 percent have multiple
usually solitary

13

What are the clinical features of a fibroadenoma

Peak incidence in 3rd decade
Screening
Painless, firm, discrete, mobile mass
“Breast mouse”
Solid on ultrasound

14

What is a fibroadenoma

localised hyperplasia
Proliferation of intralobular stroma

15

what are the features of a fibroadenoma

Circumscribed
Rubbery
Grey-white colour
Biphasic tumour/lesion
Epithelium
Stroma

16

How are fibroadenomas treated

Rule out malignancy
Reassure
Exise

17

What are sclerosing breast lesions

benign, disorderly proliferation of acini and stroma causing a mass or calcification which may mimic carcinoma

18

What are the main causes of breast sclerosinf lesions

radial scar
sclerosing adenosis

19

When does sclerosis adenosis usually present and how does it usually present

any age between 20-70
pain, tenderness, lump/thickening
asymptomatic sometimes

20

Is there a risk of carcinoma developing from a sclerosing adenosis

yes but it is negligible

21

WHat is a radial scar

is a benign breast lesion that can radiologically mimic malignancy

22

how common are bilateral radial scars

in about 43 percent of cases they are bilateral

23

what is the difference between a radial scar and complex sclerosing lesion

RS is 1-9mm
CSL- more than 10mm

24

what are the histological features of a radial scar

Fibroelastotic core
Radiating fibrosis containing distorted ductules
Fibrocystic change
Epithelial proliferation

25

Is a radial scar pre malignant

No but often show epithelial proliferation
In situ or invasic carcino may occur within these lesions

26

What is fat necrosis of the breast

damage and disruption of adipocytes usually following trauma to the breast
infiltration of acute inflammatory cells
subsqequent fibrosis and scarring

27

what are the usual causes for fat necrosis

local trauma such as seat belt injury
can occur with no history or history of very insignificant/minor trauma
warfarin therapy

28

what are the symptoms of duct ectasia

Pain
Acute episodic inflammatory changes
Bloody and/or purulent D/C
Fistulation
Nipple retraction and distortion

29

Where does duct ectasia affect

sub areolar ducts

30

What is the risk factor for duct ectasia

smoking

31

what are the pathological features of duct ectasia

Sub-areolar duct dilatation
Periductal inflammation
Periductal fibrosis
Scarring and distortion

32

What are the two main aetiologies of mastitis or abscess in the breast

duct ectasia
lactation

33

What is usually the causal organism of mastitis/abscess in lactation

Staph aureus
Step pyogenes

34

What usually causes an infection in duct ectasia

mixed organisms
anaerobes

35

How is mastitis/abscesses managed

Antibiotics
Percutaneous drainage
Incision & drainage
Treat underlying cause

36

what is a phyllodes tumour

A tumour of the breast characterised by peri ductal stromal overgrowth. can be benign, borderline or malignant.

37

how do phyllodes tumours behave

they are prone to local recurrence if not excised adequately
rarely metastasize

38

What papillary lesions can occur in the breast

intraductal papilloma
nipple adenoma
encysted papillary carcinoma

39

what age range do intraductal papillomas usually occur in

35-60

40

What is a common symptom of intraduct papillomas

nipple discharge +/- blood

41

What may be seen on screening with an intraductal papilloma

nodules
calcification

42

what are the features of an intraductal papilloma

Sub-areolar ducts
2-20 mm diameter
Papillary fronds containing a fibrovascular core
covered by myoepithelium and epithelium
Epithelium may show proliferative activity

43

What epithelial proliferation may be seen in intraductal papillomas

None
Usual type hyperplasia
Atypical ductal hyperplasia
Ductal carcinoma in situ