Breast Flashcards
greatest density of breast tissue in a female
upper, outer
most common physiologic cause of galactorrhea
nipple stimulation
most common pathologic cause of galactorrhea
prolactinoma
type of tumor that can cause gynecomastia
testicular choriocarcinoma
most common pathogenic cause of acute mastitis
S. aureus
cellular change responsible for predicate mastitis
keratinizing squamous metaplasia of the lactiferous ducts
characteristic d/c for mammary duct ectasia
green-brown nipple discharge
typical presentation of breast fat necrosis
incidental finding of micro calcifications on mammogram
what biopsy findings in fibrocystic change are associated with increased risk of cancer?
ductal hyperplasia- 2x
sclerosing adenosis- 2x
atypical hyperplasia- 5x
how is a papilloma differentiated from a papillary carcinoma?
papilloma has luminal epithelium and myoepithelial cells; carcinoma only has luminal epithelium
which medication is known to cause the development of multiple, bilateral fibroadenomas?
cyclosporin A
what is the characteristic biopsy finding for fibroadenoma?
“cave paintings’- glands become compressed due to abundant stroma
what is the characteristic biopsy finding for phyllodes tumor?
“leaf-like projections”- overgrowth of fibrous portion
what is the difference between fibroadenoma and phyllodes tumor? (2)
- fibroadenoma is always being, phyllodes can be malignant
- fibroadenoma is more common in premenopausal, phyllodes is more common in postmenopausal
most common breast cancer presentation
asymptomatic with abnormal mammogram
most common site for a breast cancer in females? males?
females- upper/outer
males- subareolar
precursor lesion to DCIS
ductal hyperplasia
most common DCIS subtype
comedo (necrosis and calcifications)
what is Paget’s disease of the breast?
extension of malignancy from the duct to the skin
what malignancy is usually associated with Paget’s disease of the breast? exception?
usually DCIS, except if there is a palpable mass, then it is usually invasive carcinoma
4 types of invasive ductal carcinoma
tubular
mucinous
medullary
inflammatory
which type of invasive ductal carcinoma is associated with BRCA1?
medullary
which type of invasive ductal carcinoma is associated with older women?
mucinous
which type of invasive ductal carcinoma is associated with the poorest prognosis?
inflammatory
what is the typical “pattern” of LCIS?
multifocal and bilateral
what “cellular defect” is associated with LCIS and invasive lobular carcinoma?
loss of E-cadherin (gene CDH)
2 unique biopsy findings for invasive lobular carcinoma
- single file pattern of cells
- signet ring cells
unique mets of invasive lobular carcinoma
carcinomatous meningitis
most important prognostic factor in breast CA
mets
most useful prognostic factor in breast CA
spread to LN
which LNs are involved in spread of breast CA?
outer- axillary LN
inner- internal mammary LN
treatment for ER/PR+
antiestrogenic - tamoxifen
treatment for Her2/Neu
trastuzumab
locus of BRCA1
17q21
locus of BRCA2
13q12.3
BRCA1 mutation cancers
breast and ovarian
BRCA2 mutation cancers
breast (males and females)
most common type of breast CA in males
invasive ductal carcinoma
genetic abnormalities associated with male breast CA
BRCA2, Klinefelters
fibroadenomas may grow under the influence of —
estrogen (during pregnancy, menstrual cycle)
characteristic cells in medullary carcinoma
lymphocytes
male breast cancers are mainly in the —
elderly
4 “fibrocystic changes”
duct proliferation, duct dilation, apocrine metaplasia, fibrosis
histologic appearance of gynecomastia
proliferation of ducts in fibrous stroma
