breast pathology Flashcards
(47 cards)
for which age groups would US/Mammogram/MRI be used to look at breasts?
Ultrasound – youngest girls – dense breast
MRI - more detailed images
Mammogram - is a low dose X-ray. older girls/women
when is cytopathology indicated in breast disease?
positives and cavaets?
- Used in the investigation of nipple discharge and palpable lumps
- Good cellular detail and quick to prepare but does NOT show the tissue architecture
list the meaning of the different coding of breast aspirate on cytology
C1 = inadequate C2 = benign C3 = atypia, probably benign C4 = suspicious of malignancy C5 = malignant
how is breast histopathology conducted?
positives and cavaets?
Intact tissue removed, fixed in formalin, embedded in paraffin wax, thinly sliced, stained with H&E.
neg: Takes 24 hours to process.
pos: Architectural & cellular detail.
what is the gold standard for the diagnosis of breast cancer ?
histopathology
which cells must be present on cytology in normal breast tiissue?
their function?
Myoepithelial cells
help to pump breast milk
which condition presents with
nipple discharge - often blood stained or green
Sometimes causes breast pain,
breast mass - subareolar
nipple retraction
what is this condition?
duct ectasia
when milk/mammary duct beneath the nipple widens, the duct walls thicken and the duct fills with fluid. affects peri-postmenopausal women
what are the signs of duct ectasia on mammogram? and cytology?
Mammogram: Microcalcification
Cytology: proteinaceous material and inflammatory cells only inside the DUCT.
Foamy histiocytes/ Macrophages present
prognosis of duct ectasia?
what does this mimic?
Benign condition with no increased risk of malignancy.
can mimic invasive carcinoma
which condition presents with
breast: painful (tender), red, hot
breast lump/ hard area - wedge shape
nipple discharge; white
fever, fatigue, chills
acute mastitis
what is the aetiology and treatment of acute mastitis?
Seen in lactating women due to cracked skin (BREASTFEEDING!) and stasis of milk ->
bacteria invasion -> can cause pus/abscess formation
Staphylococci the usual organism.
Drainage & antibiotics usually curative.
- continue breast feeding
what is the prognosis of acute mastitis?
risk of chronic mastitis
risk of duct ectasia at same time
what inflammatory cells would cytology show on acute mastitis?
lots of neutrophils
what inflammatory cells would cytology show on fat necrosis?
Histiocytes/ macrophages
which condition presents with
firm, round lump (or lumps) and is usually painless
The skin around the lump may look red, bruised or occasionally dimpled - tethering
inverted nipple sometimes
fat necrosis
which condition presents with
benign (noncancerous) condition in which the breasts feel lumpy - firm, ropy or rubbery
cobblestone texture in breast
breast ache, itching
Fibrocystic disease
develop fluid-filled cysts along with areas of fibrosis in one or both breasts
what is the prognosis for Fibrocystic disease
No increased risk for subsequent breast carcinoma.
The following signs are common on cytology in which condition?
Branching networks irregular - v peculiar
Biphasic – stromal and fibrous/glandular cells
Fibroadenoma
In the fibroepithelial neoplasms, name:
Benign
Malignant
Benign; fibroadenoma
Potentially Malignant: Phyllodes (most are benign)
A typically large, fast-growing mass that in women aged over 50 should prompt which diagnosis ?
phyllodes
origin of phyllodes tumours?
form from the periductal stromal cells of the breast.
how is breast cell malignancy determined?
Based on the cellularity- number of cells and their clustering
take the stromal cells for example:
(high cellularity + stromal overgrowth –> malignant)
how does intraductal papilloma present?
Central papillomas present with nipple discharge.
Peripheral papillomas may remain clinically silent if small.
what is the origin of intraductal papilloma?
central papillomas - larger lactiferous ducts
peripheral papilloma - small terminal ductules
BENIGN
