Breast Pathology Flashcards
What is a breast?
Large sweat gland modified to produce milk instead of sweat.
What is the composition of a breast and what is the pathway for milk?
- 15-25 lobes, each made of groups of lobules.
- Functional unit is the Terminal Duct Lobular Unit (TDLU) composed of acini glands - milk produced here
- Milk drains via terminal ducts into main duct system, eventually opens into nipple.
What is the histology of breast tissue?
Epithelium surrounded by a basement membrane.
What is the most likely cause of a breast lump in young vs older women?
- Young - fibroadenoma and fibrocystic change
2. Older - cancer, but fibroadenoma and fibrocystic change can also occur
What should all breast lumps undergo in terms of investigation?
Triple assessment
What are the components of a tripe assessment of a breast lump?
- Clinical - history and exam
- Radiological - mammography (if >35), USS (if <35 as breast is too dense for mammogram)
- Pathological - FNA and/or core biopsy, C2/B2 is benign, C5/B5 is malignant (including DCIS)
- Discussed in MDT
What is the most common benign tumour of the breast and at what age does it occur?
- Fibroadenoma
2. Under the age of 30
What is this a presentation of and how is it managed?
Firm, mobile, painless breast lump. May be multiple.
- Fibroadenoma
2. Reassurance and excision
What is the pathophysiology of fibrocystic changes in the breast and at what age is it commonly seen?
- Variety of benign, non-neoplastic changes.
- Result of minor aberrations in the normal response to cyclical hormonal changes.
- Between 25-45 years of age.
What is the histology of fibrocystic change in the breast?
- Affect terminal ductal lobular unit
2. Fibrosis (scarring) and cyst formation
What is this a presentation of and how is it managed?
Breast pain/tenderness, lumps/cysts (especially during 2nd half of menstrual cycle).
- Fibrocystic change
2. Reassurance, analgesia, cyst aspiration, rarely excision.
