Breast Pathology Flashcards Preview

Yr3 Reproductive > Breast Pathology > Flashcards

Flashcards in Breast Pathology Deck (24):
1

First off list 5 benign breast conditions

1) Fibrocystic change
2) Fibroadenoma
3) Intraductal papilloma
4) Fat necrosis
5) Duct Ectasia

2

What is a fibroadenoma and who gets it?

Proliferation of the epithelial and stromal elements leads to a circumscribed mobile & non-painfulnodule.

Occurs in women of reproductive age, peaking at 3rd decade

3

When would we suspect fat necrosis?

If it looks clinically and on mammogram like a carcinoma

PLUS they have a h/o trauma or surgery

4

What benign conditions commonly cause nipple discharge?

Intraduct Papillomas & Duct Ectasia

5

Name a breast condition that can be benign and malignant?

Phyllodes tumour

6

What is a Phyllodes tumour?

A fibroepithelial tumour that shows a leaf like pattern and cysts on its cut surface

7

How many women get and die from breast carcinoma?

1 in 8 women (22% of all female cancers)

1 in 3 affected women die of it

8

How does a carcinoma of the breast look clinically?

A hard fixed mass that tethers to the skin
With "orange peel" skin dimpling

9

Where does breast carcinoma spread to?

1) Locally to skin & pecs
2) Lymphatically to axillary & internal mammary nodes
3) By blood to bones, lungs, liver and brain

10

What tests can we do to identify a breast carcinoma?

Exam
Mammogram
US
MRI
FNA or Core Biopsy
Wide Local Excision

11

We histologically classify breast carcinoma into Non-invasive (in situ) and Invasive. What are the subtypes of carcinoma in-situ?

Ductal Carcinoma in-situ (DCIS)
Lobular Carcinoma in-situ (LCIS)

12

Carcinoma in-situ is pre-invasive so non-palpable and can't be detected clinically, how do we find it then?

On breast cancer screening

13

How do we determine the risk a non-invasive carcinoma will become invasive?

By its grade, which requires biopsy.

Low grade DCIS - 30% in 15yrs
High Grade DCIS - 50% in 8yrs
LCIS - 19% in 25yrs

14

What are the subtypes of invasive carcinoma of breast and which is the most common?

- Invasive Ductal Carcinoma 85%
- Invasive Lobular Carcinoma 10%
- Special 5% (tubular, mucinous and medullary)

15

What do we use to estimate prognosis for breast carcinoma, and what factors is it based on?

the Nottingham Prognostic Index (NRI)
Uses size, grade and nodal status

16

Whats the 5yr survival for breast cancer?

64% mean 5yr survival

17

How do we determine if a breast carcinoma will respond to hormonal therapies?

Check if its Oestrogen receptor or Progesterone receptor +VE (ER/PR)

18

What are the risk factors for breast carcinoma?

1) Gender
2) Age
3) Early Menarche
4) Older age of first pregnancy
5) F/h & H/o
6) Radiation
7) Hormonal treatment
8) Obesity
9) Alcohol
10) Genetic Factors

19

What are the major genetic risk factors for breast carcinoma?

BRCA1 or BRCA2

20

What options do we have for managing breast cancer?

Surgery - Radical mastectomy or breast conserving surgery +/- lymph node removal

RT & Chemo

Hormonal therapy e.g. tamoxifen

21

What is Paget's disease of the nipple?

An Intraepithelial spread of intraductal carcinoma

It leads to large pale-staining cells in the epidermis of the nipple

22

How does Paget's disease of nipple present?

Pain & itching
Scaling
Redness

It's easily mistaken for eczema

You may see ulcers, crusting and serous or bloody discharge

23

What are the major male pathologies of the breast?

Carcinoma (very rare)

Gynaecosmastia (actually quite common)

24

What can cause gynaecomastia?

- Hyperthyroidism
- Cirrhosis
- Chronic renal or pulm disease
- Hypogonadism
- Certain medications e.g. hormone therapies, spironolactone, Tricyclic Antidepressants and the dank erb