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Flashcards in Breast week Deck (115)
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1

Describe the surface anatomy of the breast

Between ribs 2 and 6

T4 dermatome

2

Describe the anatomy of the breast briefly

Sits infant of deep fascia and the pectorals major muscle

Made up of 15-25 lobes, each containing ducts leading to the nipple

Fibrous and adipose tissue between lobes

3

Where do the suspensory ligaments attach and what is their function

Suspensory ligaments attach between skin and the pec major/ deep fascia

They support the breast tissue

4

What kinds of epithelium lined the lactiferous duct?

Stratified squamous epithelium

Stratified cuboidal epithelium

5

What kinds of epithelium lines the acini?

Secretory epithelial cells (varies from cuboidal to columnar)

Outer layer of myoepithelial cells

6

What type of epithelium covers the nipple?

Keratinised squamous epithelium

7

What changes to breast tissue occur in pregnancy?

Reduced connective tissue and adipose tissue

Proliferation of secretory tissue

8

What changes to breast tissue occur with the menopause?

Secretory tissue degenerates, leaving only ducts

Reduced connective tissue

9

Describe what is meant by apocrine secretions

Lipid droplets are surrounded by a membrane which carry a small amount of cytoplasm with it

10

Describe what is meant by merocrine secretions

EXOCYTOSIS

11

Mastalgia is usually cyclical. When does the pain tend to be most intense?

During the immediate premenstrual phase of the cycle

12

What is the usual management for mastalgia?

Reassure

Well fitting bra and exercise

Tamoxifen/ NSAIDs

13

What is the most common cause of spontaneous nipple discharge?

Intraductal papilloma

14

What is the main advantage of breast histopathology over breast cytopathology?

Allows for the identification of invasive cancers vs carcinoma in situ

(rather than just identifying something as cytologically malignant)

15

What are 4 examples of developmental anomalies of the breast?

Hypoplasia

Juvenile hypertrophy

Accessory breast tissue

Accessory nipple

16

What are some inflammatory examples of benign breast disease?

Mastitis/ abscess

Fat necrosis

Duct ectasia

17

List some benign breast tumours

Phyllodes tumour

intraduct tumour

Lipoma

Adenolipoma

18

What is a galactocele?

How is it managed?

Palpable milk-filled cyst most commonly associated with pregnancy or lactation

Diagnosed and drained by FNA

19

What is gynaecomastia?

Breast development in the male

(ductal growth without lobular involvement)

20

What can cause gynaecomastia in males?

Exogenous or endogenous hormones

Cannabis

Prescription drugs

Liver disease

21

Fibrocystic change is very common in women. How does it present?

Smooth lumps

Sudden pain / cyclical pain

22

How is fibrocystic change managed?

Exclude malignancy

Reassure that they usually resolve after the menopause

Excise if necessary

23

What kind of epithelium lines cysts?

Apocrine epithelium

24

Describe the gross pathological appearance of cysts associated with fibrocystic change

Blue domed cysts with pale fluid

Intervening fibrosis

Usually multiple

25

What is a hamartoma?

Lesions composed of normal breast cell types but present in an abnormal proportion or distribution

26

What is the most common benign breast condition?

Fibroadenoma

27

Describe how fibroadenoma presents

Painless, firm, mobile mass

28

Which breast condition is described as the "breast mouse"

Fibroadenoma

Because the mass is small firm and mobile like a little mouse

29

Fibroadenomas are described as "biphasic", what does this mean?

Contain both epithelium and stromal elements

30

How are fibroadenomas managed?

Ultrasound core biopsy to confirm diagnosis

Reassure

Excise if the woman wishes (usually decrease in size with the menopause)