Breast Flashcards
What is the embryology of breast tissue?
The breast develops from the skin- it is a modified sweat gland
Where do third nipples develop?
Along the milk line (in both men and women)
What are the two layers of epithelial cells in the breast?
Luminal cells
Myoepithelial cells
Both layers must be present in order for the breast tissue to be normal (non-cancerous)
What are the two most likely causative agents of acute mastitis?
Staph
Strep
What is the clinical relevance of fat necrosis?
Fat necrosis can appear as calcification, which is an ominous sign for potential cancer. A biopsy is required to differentiate the two
Fat necrosis can appear as a palpable mass, or calcification on mammography
What is the single most common breast disorder?
Non-proliferative fibrocystic change
Why are fibrocystic changes clinically relevant?
They can give you a mass, calcifications, or even nipple discharge (which could indicate cancer)
What is the increase in cancer risk associated with fibrocystic changes with apocrine metaplasia?
No increased risk
What is adenosis?
Increase in the number of acini/lobule
Lots of glands with little intervening stroma
What are the three main features of fibrocystic change?
Fibrosis
Adenosis
Cystic change with apocrine metaplasia
When is adenosis a normal physiologic process?
Pregnancy
A fibroadenoma is a benign tumor of what part of the breast?
Stroma
Are fibroadenomas hormone sensitive?
Yes- to estrogen
Describe the appearance of a fibroadenoma
well demarcated, smooth, mobile mass
Phyllodes tumors are an overgrowth of what part of the breast?
Stroma
Describe the growth of phyllodes tumors
They are leaf-like, large overgrowths of stroma
Who generally gets phyllodes tumors?
Post-menopausal women
Are phyllodes tumors benign or malignant?
Most are benign, a few can be malignant
What is the most common cause of bloody nipple discharge in younger women?
Intraductal papilloma
Must rule out papillary carcinoma
What is the relative risk of developing carcinoma with intraductal papilloma?
1.5-2x
What is the relative increased risk of cancer in the presence of atypical hyperplasia?
Atypical hyperplasia
Atypical hyperplasia can advance to which carcinoma?
Lobular carcinoma in situ (LCIS)
What is the etiology of Paget’s Disease?
DCIS in the ductal system works its way up to the nipple skin without crossing the basement membrane.
Paget’s disease indicates there is DCIS below it.
What is the role of BRCA1 and BRCA2?
They are both tumor suppressors
What are the markers for luminal A breast cancer?
ER+, PR+, HER2/Nu -
What are the markers for luminal B breast cancer?
ER+
PR+
Her2/Nu +
What are the markers for Basal like breast cancer?
Triple negative
WHat causes gynecomastia?
Hyperestrogenism
Which gene mutation is associated with male breast cancer?
BRCA2
