Breast Pathology

Question 1

In which age group are fibroadenomas most common?

Answer 1

Younger women

Question 2

What is fibrocystic change characterised by?

Answer 2

Duct dilation +/- cyst formation

Fibrosis

Adenosis (proliferation of acini)

Apocrine metaplasia

Question 3

What are symptoms of Paget’s disease of the nipple?

Answer 3

Inflammation

Erythema

Exudate

Question 4

Is the stroma the same throughout the whole breast?

Answer 4

No, the intralobular stroma is different to the interlobular stroma

Question 4

What are possible symptoms of fibrocystic change?

Answer 4

Lumps

Discomfort

Question 5

What is an intervention for women who possess BRCA1 mutations?

Answer 5

Double mastectomy

Question 6

How does having a high level of oestrogen predispose one to breast cancer?

Answer 6

Oestrogen stimulates breast growth > increase risk of DNA mutations

Question 7

What are some clinical signs of breast pathology?

Answer 7

Lump/general lumpiness

Discomfort or pain

Nipple colour change/dischrage

Change in the shape of breast

Skin changes

Question 8

What is an in situ carcinomas?

Answer 8

Malignant population of cells confined to ducts and/or acini with no invasion through basement membrane

Question 9

Which the most common cause of cancer-related death in women?

Answer 9

Lung

Question 11

What is a lobule in the breast composed of?

Answer 11

A collection of acini

Question 12

Are fibroadenomas benign or malignant?

Answer 12

Benign

Question 13

What is Paget’s disease of the nipple?

Answer 13

When malignant cells from a ductal carcinoma in situ (DCIS) extend up duct to the nipple

Question 14

What happens if you have too many copies of HER2?

Answer 14

Cell proliferation due to increased sensitivity to growth factors

Question 14

What is the consequence of clearing all axillary lymph nodes?

Answer 14

Oedema of the upper limb

Question 15

What does the incidental findinng of hyperplasia predict?

Answer 15

Predicts the subsequent risk of cancer development

Question 16

What is the cell of origin in fibroadenomas?

Answer 16

Fibroblasts

Question 16

What is p53 involved in?

Answer 16

Cell cycle arrest

DNA repair

Question 17

What is the name of the cells that contract to eject milk from acini?

Answer 17

Myoepithelial cells

Question 19

What is the cellular function of the HER2 gene?

Answer 19

Epidermal growth factor receptor

Question 20

What is the primary predisposing factor for breast cancer?

Answer 20

Age - 70% diagnosed are over 50

Question 21

What is the average age of first diagnosis of breast cancer?

Answer 21

60 years

Question 22

What can looking at oestrogen and progestogen receptor number on excised tumour tissue tell you?

Answer 22

Predictive of prognosis

Determine whether tamoxifen therapy will be effective

Question 24

What pattern do malignant tumours exhibit on mammograms?

Answer 24

Stellate - spicules of tumour radiating out

Question 25

Do fibrous areas in the breast appear more or less dense on mammograms?

Answer 25

More

Question 27

What are the two types of invasive carcinomas?

Answer 27

Invasive ductal carcinoma: 70-80% Invasive lobular carcinoma

Question 27

What is the most common type of carcinoma?

Answer 27

Invasive ductal carcinoma

Question 28

In which part of the breast do invasive ductal carcinomas most commonly form?

Answer 28

Upper outer quadrant

Question 29

What function does BRCA1 and BRCA2 have?

Answer 29

Cell cycle arrest

Question 30

Is fibrocystic change physiological or pathological?

Answer 30

Physiological

Question 31

Which lymph nodes do invasive carcinomas spread to?

Answer 31

Axillary - most common Supraclavicular Internal mammary nodes