Breast Flashcards
- adaptive response of breast to cancer
- forms a palpable mass
desmoplasia
- cuboidal and myoepithelial cells lining vascular connective tissue that anchors it to duct
- nipple discharge (bloody or serous)
- benign tumor in lactiferous ducts
**no increased risk for cancer and is not a precursor**
intraductal papilloma
- ill defined, stellate density
- malignant ductal epithelial cells
- useful to determine ER status before tx
Invasive ductal carcinoma of breast
- cystic dilation of terminal ducts
- increase in fibrous stroma
- ductal epithelial hyperplasia without atypia
- nodular breasts on palpation
- commonly in women of reproductive age
- apocrine metaplasia may be present
fibrocytsic change
- breastfeeding mother
- fever
- swollen and painful breast
- usually caused by staph aureus
Acute Mastitis
- painful swelling of breasts with menstrual cycle
- irregular nodularity of breasts with tenderness
- exuberant form of proliferative fibrocystic change that forms papollary structures in the distended ductule
Papillomatosis
(proliferative fibrocystic changes DO increase the risk for cancer)
- intake of excess estrogens
- presence of hormone secreting adrenal or testicular tumors
- paraneoplastic production of gonadotropins
- metabolic disorders (liver disease, hyperthyroidism) that cause an increased conversion of androstenedione into estrogens
These are all causes of…..
Gynecomastia in males
-potential cause of galactorrhea in male or nulliparous female
Pituitary adenoma
(most common endrocinopathy from this is hyperprolactinemia)
- painless, rubbery breast nodule, sharply demarcated from surrounding tissue
- micture of fibrous connective tissue and elongated epithelial ducts (elongated because fibrous CT compresses them)
- Usually women ages 20-35
- Hormonally responsive (enlarge suring pregnancy)
- Risk fo breast cancer is DOUBLED
Firboadenoma
- mutations in this gene place a women at a 60-85% lifetime risk of for breast cancer
- also increases risk for ovarian cancer
BRCA1
Most Important prognostic factor for breast cancer diagnsois?
Status of axillary lymph nodes
- calcifications on mammogram
- no lymph node enlargement
- ductal atypia, fills duct lumen
- 30% risk of developing into invasive carcinoma
Ductal Carcinoma In Situ
Comedo type- large pleomorphic cells w/ abundant eosinophilic cytoplasm and irregular nuclei
Noncomedo type- smaller and more regular cells and nuclei
Stongest association with an increased risk of breast cancer is…..?
family history
- malignant cells in solid clusters that pack and distend the terminal ducts (not to the same extent as DCIS)
- less likely to have a detectable mass b/s it does not incite dense fibrosis and chronic inflammation like DCIS
- usually and incidental finding on biopsy
- 30% risk of invasive cancer without tx (in either breast!!)
Lobular Carcinoma In situ
- second most common form of invasive breast cancer
- varies from discrete mass to diffuse indurated area
- “indian filing” of malignant cells between stromal fibers
Invasive lobular carcinoma
- mass without calcifications on mammography
- solid nests and sheets of highly pleomorphic cells with many mitotic figures
- surrounded by dense infiltrate of lymphocytes
- better prognosis than other breast carcinomas
Medullary Carcinoma
- well circumscribed mass
- loose fibroconnective tissue with sarcomatous stroma, hypercellular with abundant mitoses
- usually in women ages 30-70
- usually poorly circumscribed with invasion into surrounding breast tissue
Phyllodes Tumor
- soft, jelly like tumor
- commonly in older women
- tumor has glistening surface and mucoid consistency
- small clustes of epithelial cells (may form glands) floating in pools of mucin
- often admixed with invasive ductal carcinoma
Colloid Carcinoma
- Fibrous, rock hard mass
- sharp margins
- small, glandular, duct-like cells, STELLATE infiltrate
- Worst and most invasive breast cancer
- 76% of all breast cancers
- Most common type of breast cancer in males (may invade chest wall muscles b/c less fat in males)
- Risk increased with BRCA2 mutation
Invasive Ductal Carcinoma
