Week 11.1 - Breast disease Flashcards Preview

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Flashcards in Week 11.1 - Breast disease Deck (38):
1

How would pain present in breast disease?

-Non-cyclical
-Focal

2

How would a malignant lump present in breast disease?

-Hard
-Craggy
-Fixed

3

Give 3 differential diagnoses for palpable masses

-Invasive carcinomas
-Cysts
-Fibroadenoma

4

What is the most common benign palpable mass?

-Fibroadenoma

5

Give 2 differential diagnoses for milky discharge

-Pituitary adenoma
-OCP

6

Give 3 differential diagnoses for bloody/serous nipple discharge

-Benign lesion eg papilloma
-Duct ectasia
-Malignancy

7

Why are mammographic abnormalities easier to detect in older people?

-High adipose content in breasts

8

What does calcification suggest on a mammograph?

-DCIS
-benign mass

9

What is polyethelia?

-Additional nipple

10

What is acute mastitis?

-Inflammatory condition of the breast from Infection from staph. aureus during lactation due to nipple cracks as can track up the lactiferous duct

11

What is fat necrosis?

-Inflammatory condition of the breast which presents as a mass of skin changes as a history of trauma or surgery

12

What is fibrocystic change?

-The most common breast lesion which presents as a mass or on mammograph
-Histology shows cyst formation, fibrosis and apocrine metaplasia

13

State 3 benign epithelial lesions of the breast

-Fibrocystic change
-Stromal tumour eg fibroadenoma or phyllodes
-Gynacomastia

14

Name 2 benign stromal tumours

-Fibroadenoma
-Phyllodes

15

Describe how fibroadenoma would be on presentation

-Highly mobile mass (breast mouse)
-Well circumscribed
-Can be multiple, bilateral and large

16

In what age group does phyllodes most oftn occur?

-Over 40 years

17

Describe the behaviour of malignant phyllodes

-Aggressive
-Recur
-Metastasise by blood

18

What is the histiological difference between phyllodes and fibroadenoma?

-Phyllodes withh have more atypical stroma

19

When excising phyllodes, what is the difference between that and fibroadenoma? why?

-Wide excision margin as can recur

20

What is gynaecomastia? In who does it most often occur?

-Enlargement of the male breast due to decreased androgens or increased oestrogens
-Young or elderly

21

give 3 causes of gynaecomastia

-Liver disease
-Klinefelters
-Testicular tumour

22

What is the most common type of breast malignancy?

-Adenocarcinoma

23

Describe some riskfactors for breast malignancy

-Uninteruppted menses
-Early menarche
-Late menapause
-Obesity
-OCP/HRT

24

What is mean by in situ carcinoma?

-Neoplastic cells are limited to ducts and lobules by BM and thus cannot metastasise

25

What is distinctive about DCIS histiologically?

-Central comedo necrosis

26

What is pagets disease of the breast?

-DCIS which has extended up to the nipple skin as does not have to cross BM to get here
-Red crusting nipple

27

How does DCIS most often present?

-Mammographihc calcification

28

By the time a breast malignancy is palpable, what % have mets?

-50%

29

Where does invasive carcinoma commonly metastasise first?

-Axillary LNs

30

What is the cause of peau d'orange?

-Blockage of the lymphatics causing odematous breast -> Hair follicles are firmly attched to dermis and pull down

31

What are the two types of invasive carcinoma? Which is most common?

-IDC-No special type (most common)
-Invasive lobular carcinoma

32

How does invasive lobular carcinoma look histologically?

-Discohesive single file infiltrating cells

33

How does breast cancer commonly metastasise?

-Using lymphatics
-(distant mets usually by bloodstream)

34

Where does breast malignancy commonly metastasise?

-ipsilateral LNs, bone, lung, liver, brain

35

Describe the triple approach to investigation and diagnosis

-Clinical history and examination
-Radiographic imaging
-FNA

36

Describe breast cancer screening

-47-73
-2 view mammograms every 3 years
-Aims to detect small impalpable cancers

37

When would a breast malignancy get treated with tamoxifen?

-If it was oestrogen receptor positive

38

When would a breast malignancy get treated with herceptin?

-If it was HER2 receptor positive