Breast Flashcards

1
Q

What are the most important breast diseases in various age groups?

A

15-35: fibroadenoma

25-55: fibrocystic changes

> 45: breast cancer

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2
Q

What is acute mastitis, and when does it usually occur?

A

Typically occurs during lactation. It may present at diffuse swelling, multiple nodules, or large abcess.

staph and strep

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3
Q

How do hormones affect breasts in women and men?

A

Epithelial cells lining the ducts and acini, and intralobular connective tissue respond to sex hormones.

Lack of estrogen >> atrophy

Enlarge during puberty

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4
Q

What is gynecomastia?

A

Usually occurs due to excess estrogens

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5
Q

How common is fibrocystic change of the breast and how does it present clinically?

A

Affects 50% of women

Affects 10-15% clinically

*Usually affects both breasts, may have one-sided pain, nodularity, sensitivity. *

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6
Q

What are the pathologic features of fibrocystic breast change?

A

Fibrosis: loose intralobular connective tissue is replaced by dense connective tissu, rich in collagen but unresponsive to hormones.

Dilated ducts: entrapped in connective tissue strands and form cysts >> interruption of blood supply >> degenerative changes, necrosis, calcification

Proliferative breast disease: epithelium proliferates >> sclerosis adenosis

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7
Q

What is fibroadenoma, and how does it present clinically?

A

Most common benign tumor

  • 2-5 cm
  • encapsulated, round, lobulated
  • 2 components: fibrous stroma and glandular epithelium
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8
Q

What are the risk factors for breast cancer?

A
  • Female
  • >45
  • Whites (esp jews)
  • Mother/sister with breast cancer
  • early menarch
  • late menopause
  • no children
  • late age at 1st pregnancy
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9
Q

What is the most common microscopic type of breast cancer?

A

80% are invasive ductal carcinoma
Most occur in the upper lateral quadrant

Macro: tumor appears grayish white because of abundance of CT between tumor cells

Micro: strands of cancer cells surrounded by abundant collagenous connective tissue

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10
Q

Correlate the macroscopic and microsocopic pathology of infiltrating duct carcinoma.

A

Form a strong desmoplastic reaction = dense connective tissue

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11
Q

How does breast cancer metastasize?

A

Via lymphatics

most = axillary area

Common distant sites = lungs, liver, bones, brain, adrenals

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12
Q

How is breast cancer usually diagnosed?

A

Mammography = noninvasive, painless procedure with x-ray. FNA requires local anesthesia. Surgical biopsy is performed in OR under general anesthesia.

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13
Q

What are the diagnosis and survival rates of breast carcnoma diagnosed in various clinical stages of the disease?

A

Stage 0: 92%

Stage I: 87%

Stage II: 75%

Stage III: 45%

Stage IV: 13%

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