Breast Flashcards
Most common ____ of female cancer Second highest ____ rate
Incidence Mortality
___x more common in women than men Incident _____ with age 80% new cases in women >50 due to ______
100x rises screening (1988)
anatomy
Alveolar Structure
lobules - multiple s______ units
epithelial cells - be c______ or columnar
myoepithelial cells - situated between the e______ cells and b_______ membrane.
lobules - multiple secretory units
epithelial cells may be cuboidal or columnar
myoepithelial cells are situated between the epithelial clls and basement membrane.
Ducts
Myoepithelial cells
lined with layer of epithelial cells
contractile, sensitive to oxytocin
Mammary Gland Development
BIRTH - almost entirely ducts, few alveoli
BIRTH-PUBERTY - branching of ducts
PUBERTY:
oestrogen - branching of ducts and alveolar development
cyclic oestrogen/progesterone - additional duct/lobule + deposition of adipose and connective tissue
During Pregnancy
- lobules enlarge
- less intralobular tissue
- alveoli enlarge
- cuboidal epithelial cells
Lactation
- decrease oestrogen & progesterone
- increase prolactin, oxytocin
- copious milk secretion
DURING Lactation
- mammary tissue almost entirely alveoli distended with milk
- intralobular tissue consists only of thin septa
- epithelial flattened
NON NEOPLASTIC breast conditions
Inflammatory (3)
Non-Neoplastic (1)
Benign Neoplasms (1)
Inflamatory
- acute mastitis and abscess
- fat necrosis
- silicone mastitis
Non-Neoplastic
- cysts
Benign Neoplasms
- fibroadenoma
Malignant Neoplasms (BREAST CANCER) Risks
- relatives with breast cancer
- length of reproductive age
- age of first pregnancy
- ethnicity
- BRCA 1+2
- alcohol
- previous cancer (bar cervical)
TDLU?
TUBULAR DUCTAL LOBULAR UNIT
Non-Invasive Carcinomas - DCIS
DUCTAL CARINCOMA IN SITU
- terminal ducts enlarge - proliferation of tumour cells
- spread throughout duct system
- NOT palpable
- becomes invasive if untreated (30%)
Non-Invasive Carcinoma - LCIS
LOBULAR CARCINOMA IN SITU
- NOT palpable
- mammograms not useful in detection
- coincidental finding in biopsies
- 30% chance of becoming invasive within 20 yrs
- 50% likely to arise in other breast
INVASIVE CARCINOMAS
- invasive ductal carcinoma (worst prognosis)
- invasive lobular carincoma (worst prog)
- medullary carcinoma (interm. prog)
- colloid carcinoma
- tubular carcinoma (favourable prog)
