What influences how Pathologies can be detected In the breast?
The density of breast tissue
Where are there more opportunities for superimposition?
The more dense the glandular tissue the more opportunities for superimposition of the breast tissue and lesson
What can be difficult to identify/sample/assess?
Small lesions, architectural distortion & calcifications
What can mask malignancy?
Benign hormonal changes postpartum
Whilst breastfeeding
During menstruation
During HRT (hormone replacement theraphy) or gender reassignment treatment
What are the common causes of increased glandular density?
Menstruation
Lactation
HRT
Poor technique
Post surgical scar tissue
How can malignant tumours be categorised?
Hormone receptor status
What is the Prevalence of breast cancer?
1% of all breast cancer occur In men
What are the risk factors of breast cancer?
Gender
Age 35 -70
Family history
HRT (hormone replacement therapy) - current/previous history
Not breast feeding
High oestrogen levels - early menarche, late menopause and no pregnancies
Lifestyle - fat in diet, BMI, alcohol
BRAC1 and BRAC2 gene mutation
What are the signs and symptoms of breast cancer?
A lump or thickening in an area of the breast
A change in the size or shape of the breast
Dimpling of the skin
A change in the shape of your nipple particularly if it turns in, sinks into the breast, or has an regular shape
A blood stained discharge from the nipple
A rash on a nipple or surrounding area
A swelling or lump in your armpit
What are the different types of nipple changes?
Nipple cleft which is benign, redness, Paget’s disease of the breast, peau d’orange, inversion, tethering, discharge, and thickening
Enlargement and asymmetry, circumferential retraction, paget disease (eczema like condition), dimpling, nodule, ulceration, and peau d’orange
What plane and axis does the breast gets image at?
Mediolateral oblique and craniocaudal
What are the radiographic Appearances of breast cancer?
Microcalcification
Dense
Margins: irregular or spiculated
Border: blurred, ill-defined or irregular
Size: smaller than palpable mass
Surrounding tissue: infiltrated
Calcification: few, isolated, uncountable, clustered or confined to the area of the lesion
What are the two different microcalcification?
Lobular calcification and intraductal calcification
What are lobular and intraductal calcification?
Lobular: are almost always benign round, punctate or sharply outlined
Intraductal: irregular, different sizes, linear and are suspicious of malignancy
What are the different staging of the tumour the nodule and metastasis abbreviation and meaning?
TX: the tumour cannot be assessed
T0: no evidence of a tumour is present
Tis: the Cancer maybe lcis dcis or target disease
T1: the tumour is 2 cm or smaller in diameter
T2: the tumour is 2-5 cm in diameter
T3: the tumour is more than 5 cm in diameter
T4: the tumour is any size, and it has attached itself to the chest wall and spread to the pectoral (chest) lymph nodes
In TNM what does the M numbers mean when referring to tumour types?
M1: normal
M2: probably benign
M3: indeterminate
M4: probably malignant
M5: malignant -definite
What are the different tumour classification staging?
Stage 1 cancer a very small tumour no spread
Stage 2 refers to a cancer that has grown but hasn’t spread
Stage 3 refers to a larger cancer which may have spread to the surrounding tissues and/or the lymph nodes and
Stage 4 refers to cancer which has spread from where it originally started to at least one other body organ; also known as “secondary” or “metastatic” cancer, e.g. bone
What are the treatment options of breast cancer?
It depends on the patients the tumour types/ location
Stage / progression
Hormone receptor status
Genetic predisposition
Surgery - localised tumour
Radiotherapy - localised surrounding tissue
Chemotherapy - systemic
Hormone - systemic (depends on receptor status)
Gene therapy - systemic (depends on genetic status)
What is a benign fibroadenoma?
Arise from terminal duct lobular unit it is lumps composed of fibrous and glandular tissue which are easy to remove as they have clearly defined edges and are highly mobile lump - breasts mice /mouse appearance
Signs and symptoms of benign fibroadenomas?
Mobile lump
Lump slowly growing
Painless
Solitary and firm
What are the radiographic Appearances of a benign tumour?
Smooth dense/ lucent clear defined edges
What are the radiographic Appearances of a malignant tumor?
Dense
Irregular
Spiculated
What are benign cysts?
Fluid-filled sac within the breast tissue, round or oval lump with defined edges can be painful
What is the prevalence of a benign cyst?
Most common in women 30 to 40 years of age
