Breast pathology Flashcards Preview

Clinical Pathology > Breast pathology > Flashcards

Flashcards in Breast pathology Deck (32):
1

Where do the majority of malignancies arise in the breast?

Epithelial cells - therefore, CARCINOMAS

2

Where do the majority of malignancies arise in the breast?

Epithelial cells - therefore, CARCINOMAS

3

What is the breast comprise?

Mammary glands (lobes) - where epithelium are

Lactiferous ducts

Fat (adipose tissue)

Epithelial tissue - fibrous bis of breast

4

Why are breast in younger people more lumpy?

More glandular and fibrous - therefore mammograms = less useful in young people

5

What age of people are more likely to get breast CARCINOMAS?

Peri/post menopausal - below 35yrs lumps = benign mostly!

6

What do mobile lumps of the breast indicate in different age groups

Fibroadenoma in 55 yrs

7

What do ill defined lumps/lump areas indicate in different age groupo?

Fibrocycstic changes in perimenopausal women

8

What do firm lump +/- tethering indicate in different age groups?

Carcinoma (>25yrs)

9

What does clear nipple discharge indicate in different age groups?

Duct ectasia

10

What does bloody nipple discharge indicate in different age groups?

Duct papiloma
Duct carcinoma (in situ)

11

What are the risk factors for breast cancer?

- Genetic - first degree relative (BRCA1/2)
- Obesity
- Oestrogenic environment e.g. oestrogen-progesterone contraceptive, HRT (oestrogen
- obesity
- Radiation

12

What are the risk factors for breast cancer?

- Obesity
- Oestrogenic environment e.g. oestrogen-progesterone contraceptive, HRT (oestrogen
- obesity
- Radiation

13

What is protective for breast cancer?

Breast feeding

14

What is the breast comprise?

Mammary glands (lobes) - where epithelium are

Lactiferous ducts

Fat (adipose tissue)

Epithelial tissue - fibrous bis of breast

15

Why are breast in younger people more lumpy?

More glandular and fibrous - therefore mammograms = less useful in young people

16

What are duct papillomas? How do they present and what population do they mostly effect?

-Middle aged women
- Nipple discharge (bloody)
- Solitary lesion in large breast duct
- Papillary structures, with fibrovascular core covered by
benign epithelium
- Benign

17

What are phyllodes tumours?

-Occur at any age

-Discrete lump with firm and soft areas

- rare fibroepithelial neoplasm - stroma can become aggressive

18

How are great biopsies graded?

B grade

19

Name so presentations for breast disease

- puckered skin/withdrawn nipple fibroblasts pull structures inwards

Peau d'orange - inflammatory breast cancer - lots of tumour blocking lymphatics - lumpy

Inflammation e.g. TB, carcinoma, mastitis following breast feeding

Nipple discharge

Pain (rare though!)

20

What gene is overexpressed with paget's disease/invasive breast carcinoma? How is it characterised in the nipple?

HER2

Eczema like irritation of nipple - associated with underlying carcinoma

21

What is protective for breast cancer?

Breast feeding

22

What is the nickname for fibroadenomas?

Breast mouse

23

Where do fibroadenomas arise from?

Lobules - involve proliferation of connective tissue stroma and glands

24

What are the characteristics of fibroadenomas?

-Non-malignant
-Untethered (therefore, mobile)
- compression of overlying breast tissue

25

What are duct papillomas? How do they present and what population do they mostly effect?

-Middle aged women

- Nipple discharge (bloody)

- Solitary lesion in large breast duct

- Non-malignant

26

What are phyllodes tumours?

-Occur at any age
-Discrete lump with firm and soft areas
- stroma and epithelial parts - stroma can become aggressive and reoccurrence

27

If a breast lump is found, what 3 investigative parameters should be performed? (triple assessment)

Clinical - exam and palpation

Radiological

Pathological - cytological/histopathology

28

What investigations can be performed to diagnose breast malignancies?

- imaging – mammography and ultrasonography

- fine-needle aspiration cytology

- core biopsy or vacuum-assisted biopsy

29

How are great biopsies graded?

B grades
B1 - normal
B2 - benign
B3 - Atypical, prob benign
B4 - atypical, prob malignant
B5 - malignant a) in situ; b) invasive

30

What characterised fibrocystic changes?

Physiological changes
- ductal hyperplasia
- cysts
-apocrine metaplasia
- micro calcifications
- oestrogenic environment

31

Name so presentations for breast disease

- puckered skin/withdrawn nipple fibroblasts pull structures inwards

Peau d'orange - inflammatory breast cancer - lots of tumour blocking lymphatics - lumpy

Inflammation e.g. TB, carcinoma, mastitis following breast feeding

Nipple discharge

32

What gene is overexpressed with pages disease?

HER2

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