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ICA > Breast Pathology + Disease > Flashcards

Breast Pathology + Disease Flashcards

1
Q

?

A

Multiple stroma + terminal duct lobular unit > major duct > lactiferous duct > nipple

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2
Q

What makes up the terminal ductal lobular unit?

A

Terminal duct + multiple acini

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3
Q

Where do epithelial cancers of the breast arise?

A

Terminal ductal lobular unit

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4
Q

What epithelium line the ducts and acini of the breast?

A

Low columnar or cuboidal epithelium
Surrounding myoepithelial cells

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5
Q

What are the three steps of breast cancer assessment

A

History + assessment
USS or mammogram
Biopsy

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6
Q

What does bloody nipple discharge suggest?

A

Intraductal papilloma

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7
Q

What does clear nipple discharge suggest?

A

Mammary duct ectasia

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8
Q

What does milky nipple discharge suggest?

A

Breastfeeding
Hormone-related causes
Galactorrhea

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9
Q

What does yellow nipple discharge suggest?

A

Infection

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10
Q

What does green nipple discharge suggest?

A

Fibrocystic disease

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11
Q

What does brown nipple discharge suggest?

A

Fibrocystic disease
Mammary duct ectasia

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12
Q

What is mammary duct ectasia?

A

Benign disorder of extralobular ducts causing stasis of secretions > dilated ducts + inflammation

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13
Q

Who is mammary duct ectasia common?

A

Peri-menopausal women

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14
Q

Risk factor for mammary duct ectasia?

A

Smoking

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15
Q

Managment of mammary duct ectasia

A

Observation
+/- antibiotics
+/- excision

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16
Q

What is the most common breast tumour in young patients?

A

Fibroadenoma

17
Q

What is a fibroadenoma?

A

Benign neoplasm of glands + stromal elements

18
Q

Management of breast friboadenoma

A

No treatment vs conservative surgical excision

19
Q

What is gynaecomastia due to?

A

Oestrogen testosterone imbalance

20
Q

Physiological causes of gynaecomastia

A

Oestrogen production peaks before testosterone during puberty

21
Q

Pathological causes of gynaecomastia

A
  • lack of testosterone: klinefelter’s, testicular atrophy
  • excess oestrogen: liver disease, testicular tumours, obesity
  • medication: spironolactone, anabolic steroids
22
Q

What is breast ductal carinoma in situ?

A

Neoplastic epithelial cells confined to ductolobular system with no invasion beyond basement membrane

23
Q

What testing can be done to see if there has been invasion through basement membrane?

A

Immunohistochemistry showing intact myoepithelial cells = no invasion

24
Q

Management of ductal lobular carinoma in situ

A
  • Surgery: breast conserving vs mastectomy
  • consider radiotherapy
  • consider endocrine therapy if ER positive
25
Q

What is the most common subtype of breast adenocarcinoma?

A

Invasion ductal carcinoma

26
Q

Types of breast adenocarcinoma

A
  • invasive ductal (most common)
  • lobular
  • tubular
  • mucinous
  • micropapilary
27
Q

What parameters are looked at in breast cancer grading?

A

Tubule formation
Nuclear pleomorphism
Mitotic count

28
Q

What is used to stage breast cancer?

A

TNM

29
Q

Managment of breast cancer

A
  • surgery
  • sentinel lymph node biopsy
  • chemotherapy
  • radiotherapy
30
Q

Systemic therapies of breast cancer

A

Tamoxifen
Herceptin

31
Q

How does tamoxifen work in breast cancer treatment

A

Selective oestrogen receptor modulator
Blocks receptor and prevents over production of oestrogen driving proliferation

32
Q

How does Herceptin work as a treatment in breast cancer?

A

Blocks HER2 receptor and prevents over production of HER2 driving proliferation

33
Q

What is peau d’orange?

A

Orange skin appearance of breast

34
Q

What is Paget’s disease of the nipple?
What is it assocaited with?

A
  • Unilateral red, bleeding eczematous lesion > erosion
  • Associated with ductal carcinoma in situ or invasive carcinoma
35
Q

Risk factors of breast cancer

A
  • increasing age
  • previous breast cancer
  • BRCA1+2
  • dense breast tissue
  • benign breast diseases
  • hormonal factors e.g. HRT, COCP, early menarche/late menopause + nulliparity
  • obesity
  • alcohol
  • smoking
36
Q

Presentaion of breast cancer

A
  • Breast lump - often tethered + painless
  • nipple symptoms
  • skin changes
37
Q

What is intra ductal papiloma?

A

Being tumour inside milk duct > bloody nipple discharge

ICA (13 decks)

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