Breast Flashcards
Acute Mastitis
breast-feeding -> Staphylococcus aureus infection -> intramammary abscess
Periductal Mastitis
Smoker, reproductive age, painful mass, Squamous Metaplasia from nipple into ducts, keratin blocks ducts -> Granulomatous inflammatory reaction
Mammary Duct Ectasia Clinical Presenation
50-60 y/o, non-smoker, multiparous, cheesy nipple discharge, painless mass
Mammary Duct Ectasia Histological Presentation
Mucin-plug causing dilation of ducts filled with lipid-laden macrophages + granulomatous inflammation w/ infiltrate of lymphocytes, macrophages and plasma cells
Fat Necrosis
Trauma, lipid-laden macrophages, granulomatous inflammation, calcifications + crystallized lipid
Granulomatous Mastitis
Secondary to disease, infection, foreign body
Cyst Formation
PURE fibrocystic change; blue dome cysts, calcification, apocrine metaplasia
Fibrosis
PURE fibrocystic change; Cyst rupture -> overproduction of collagen -> fibrosis
Adenosis
PURE fibrocystic change; Fibrosis + aggregated glands w/ increased acini -> calcifications
Usual Ductal Epithelium Hyperplasia
Proliferation of ductal epithelium w/ no cytological changes, 2 cell types present
Atypical Ductal Epithelium Hyperplasia
Proliferation of ductal epithelium w/ cytological changes: mitotic figures, hyperchromia; Microcalcifications lining ducts (much like DCIS); Increased risk for cancer
Non-Complex Sclerosing Adenosis
Swirling fibrous tissue + increased acini + duct compression into cords
Complex Sclerosing Adenosis
Abundant central fibrosis / elastosis, Few, tiny glands separated by extensive bands of collagen
Atypical Lobular Epithelium Hyperplasia:
Proliferation of lobular epithelium w/ cytological changes: mitotic figures, hyperchromia
Sclerosing Papillomas
Typical sclerosing adenosis features + Papillary projections into lumen
Small Duct Papillomas
Occur deep w/in breast; Papilloma (arise from epithelium) in small ducts
Fibroadenoma
Most common neoplasm
Phyllodes
>60 y/o, large, low-grade tumor, less-defined, more cellular w/ few mitotic figures, SCALLOPED clefts
Cystosarcoma phyllodes
Highly CELLULAR, a lot of ATYPIA, less stromal tissue
Stewart-Trevis Syndrome
Lymphangiosarcoma may develop outside the breast in patients who have had mastectomy - lymphedema in unilateral UE
Large Duct Papilloma
Serous or bloody nipple discharge; ductal papilloma in a large duct
Ductal Carcinoma In Situ – Comedo
High-grade, high risk for IDC, solid sheets of tumor cells + central area of necrosis and microcalcifications
Ductal Carcinoma In Situ – Comedo on mammogram
microcalcifications lining ducts
Ductal Carcinoma In Situ – Non-Comedo
Low-grade, less atypia, characterized by the way cells grow in ducts (cribriform, papillary, etc)
Paget Disease of the Nipple
Nipple is fissures, ulcerating, oozing; DCIS extends from nipple ducts into contiguous epithelium of nipple and areola
Lobular Carcinoma In Situ
does not calcify or show up on mammogram, hard to detect, high incidence of BILATERALITY
Invasive Ductal Carcinoma
Hard, gritty, chalky-like mass; • Cords, solid nests, anastomosing sheets of malignant cells
African Americans tend to have
Triple negative IDC
Medullary Carcinoma
IDC, 20-30y/o, BRCA1 mutation, HIGH-GRADE w/ LOW-GRADE BEHAVIOR; circumscribed, marked anaplasia + lymphocytic infiltrate
Colloid/Mucinous Carcinoma
IDC, Elderly, well-circumscribed, mucin-lakes w/ malignant cell islands (PALE BLUE, gelatinous)
Tubular Carcinoma
IDC, Low-grade, well-formed tubules, but lack myoepithelial cell layer, appears similar to Sclerosing Adenosis
Invasive Papillary Carcinoma
IDC, rare, DCIS + papillary architecture
Invasive Lobular Carcinoma
BILATERAL 20%, RUBBERY/scorrhous stroma, SINGLE-FILE Invasion; no tubules w/ rings about normal ducts
cheesy discharge
Mammary Duct Ectasia
blue dome cysts
Cyst Formation - fibrocystic change
fibrous area b/w cysts that shows an aggregation of glands w/ enlarged lumens
Adenosis
Proliferation of ductal epithelium + cytological changes
Atypical Ductal Epithelium Hyperplasia (DCIS)
Swirling fibrous tissue, compression of ducts into cords + aggravated small glands
Sclerosing Adenosis
Most COMMON neoplasm
Fibroadenoma
glands forming flattened elongated /cleft-like spaces
Fibroadenoma
GLAND spaces are more scalloped and may have breakdown of the epithelia
Phyllodes
Serous or bloody nipple discharge
Large Duct Papilloma
Nipple is fissured, ulcerating or oozing
Paget’s
Hard, gritty, chalky-like mass
Invasive Ductal Carcinoma
solid sheets of cancer cells
Invasive Ductal Carcinoma
High-grade features w/ LOW-GRADE BEHAVIOR
Medullary Carcinoma
Mucin lakes with malignant cell islands.
Colloid Carcinoma
similar to Sclerosing Adenosis, tubules w/o myoepithelial cell
Tubular Carcinoma
Rubbery, single-file
Invasive Lobular Carcinoma
BILATERAL
Invasive Lobular Carcinoma