breast Flashcards
infection of breast due to S aureus
associated with breastfeeding →cracking of nipples → cellulitis → breast abscess
red, pain, fever
acute mastitis
treatment of acute mastitis
antibiotics
if feel mass:
continue breastfeeding during mastitis (bacteria in milk not dangerous to infant)
if refuse to breastfeed: pump to clear infected fluid
breast tissue in men
gynecomastia
due to ↑ estrogen levels
conditions that cause gynecomastia
hyperestrogenism: testicular tumors (release estrogen), cirrhosis, Klinefelter syndrome (testicular atrophy), puberty
drugs that cause gynecomastia
STACKED Spironolactone THC (marijuana) Alcohol (chronic) Cimetidine Ketoconazole Estrogens Digoxin
most common cause of breast lumps in women 25-50 yo
fluctuate in size with hormone levels
breast pain (just before period), regresses after period (check again 1 week after period)
multiple bilateral breast lesions
non-proliferative breast changes (fibrocystic)
breast tumors don’t change size with
menstrual cycle
“blue dome” cysts
fibrocystic changes of breast
food causes of nonproliferative breast changes
caffeine
dietary fat
tx: stop intake
most common breast TUMOR in women under 25 yo
fibroadenoma
looks like fat necrosis but no history of trauma or breast surgery
complex sclerosing lesion
calcifications present
sclerosing adenosis
radial scar
complex sclerosing lesion
small, firm mass with regular edges
MOBILE
↑ size with estrogen exposure: pregnancy, menstruation
no risk of cancer
fibroadenoma
small tumor inside lactiferous ducts beneath the aerola
intraductal papilloma
serous “straw-colored” or bloody nipple discharge
small increase in cancer risk
intraductal papilloma
LARGE, bulky tumor
“leaf-like” projections
50 yo
small increase in cancer risk
phyllodes tumor
“leaf-like” projections
phyllodes tumor
most common cancer in women
breast cancer
most common age of breast cancer
menopause
most important prognostic indicator for breast cancer
axillary lymph node involvement at time of diagnosis
risk factors for breast cancer
estrogen exposure - main one: early menarche, late menopause, fewer pregnancy, less time breastfeeding, older age at 1st live birth, obesity
family history
BRCA mutation
HNPCC (lynch syndrome)
overexpressed estrogen + progesterone receptors or HER2/neu receptor (ErbB2 gene)
in breast cancer tissue
targets for chemotherapy
triple negative: ER-, PR-, Her2/neu- prognosis
more aggressive
breast cancer that arises from ductal hyperplasia → fill lumen of duct
no penetration of BM
ductal carcinoma in situ (DCIS)
eczema-like patches on nipple and areola suggesting underlying carcinoma
paget disease of breast
the underlying carcinoma = DCIS
large cancer cells in epidermis with clear halo
Paget cells
caseous necrosis
comedocarcinoma: subtype of DCIS
signet ring cells
lobular carcinoma in situ (LCIS)
mucinous material in cell pushes nucleus out to periphery
*also seen in kruckenburg tumor (gastroadenocarcinoma with mets to ovary)
firm, “rock-hard” mass with sharp margins
FIXED, immobile (feels like fibroadenoma, need bx)
invasive ductal carcinoma
breast cancer is:
small glandular, duct-like cells with a stellate pattern
invasive ductal carcinoma
most common breast MASS in postmenopausal woman
invasive ductal carcinoma
breast cancer with worst prognosis and most invasive
invasive ductal carcinoma
breast cancer is:
multiple, BILATERAL
ER+, PR+, signet ring cells
invasive lobular carcinoma
associated with inactivation of e-cadherin genes
invasive lobular carcinoma
breast cancer with fleshy, cellular mass with lymphocytic infiltrates
medullary carcinoma
inflammatory carcinoma signs
peau d’ orange: lymph obstruction + edema
dimpling of breast
nipple retraction: duct pulling on nipple
treatment of breast cancer
SERMs: tamoxifen, raloxifene
aromatase inhibitor: anastrozole
most common breast mass in premenopausal women
fibrocystic change
multiple bilateral fluid-filled lesions with diffuse breast pain
fibrocystic change of breast
firm fibrous mass in 55 yo woman
invasive ductal carcinoma
