Breast Flashcards
Acute mastitis
S. aureus –> cracked nipple
redness, pain, fever - cellulitis -abx
Can lead to abscess
-mass fluctuant –> u/s, drain/surgical drainage
Keep breast feeding or pump during mastitis to clear it, not harmful to baby
Gynecomastia
infancy elderly puberty-transient testicular tumors cirrhosis Klinefelters Syn
Drugs "STACKED" Spirolactone THC (marijuana) Alcohol - chronic Cimetidine Ketoconazole Estrogens Digoxin
Non-proliferative breast (fibrocystic) changes
MC - breast lumps in 25-50 yo
fluctuate w/ hormones
Just before period w/ breast pain and multiple b/l breast lesions
-regress after period - 1 week after period smallest
Increase benign fluid filled cysts and fibrous tissues
Fibrosis: hyperplasia of breast stroma
Cysts: fluid filled cavities - “blue dome cysts”
-worse w/ caffeine, dietary fat
Proliferative breast disease w/o atypia
Sclerosing adenosis - increased glandular tissue/acini (compressed and distorted in lobule) –> intralobular fibrosis, calcifications
Epithelial hyperplasia - increased epithelial cell layers in terminal duct of lobule
Complex sclerosing lesion (radial scar) - scar w/ irregular shape, looks like fat necrosis
-like invasive cancer on mammo
Fibroadenoma
Fibroadenoma
MC under 25 yo
cellular tumor
small firm mass, regular edges - mobile
Increase size w/ estrogen exposure - pregnancy and menses
Intraductal papilloma
Small tumor inside lactierous ducts under areola
serous or bloody nipple discharge
small risk of cancer
phyllodes tumor
large, bulky tumor
leaf-like projections on histo
50s
occasionally become malignant
Ductal carcinoma in situ (DCIS, intraductal carcinoma)
duct epithelium, ductal hyperplasia
comedocarcinoma - central necrosis Solid cribriform papillary micropapillary
Lobular carcinoma in situ (LCIS)
arise in lobules
signet ring cell - filled w/ mucus, nucleus pushed to edge
always ER and PR positive - target for tx
risk factor for invasive carcinoma
mastectomy or tamoxifen tx
Breast cancer
MC cancer in women 2d MC cuase of death MC after menopause MC lcoation - tail of spence Prognostic - LN involvement
Risk factors: estrogen exposure -early menarche /late menopause -fewer pregnancies -less time breast feeding -older age at 1st live birth -obesity FHx BRCA mutaiton HNPCC
Paget disease of breast
eczema like patches on nipple and areola
underlying carcinoma - DCIS
cancer cells surrounded by clear halo
Invasive ductal carcinoma
75-80%
firm “rock hard” mass, sharp margins, immobile
histo: stellate border - star like
Invasive lobular carcinoma
multiple and b/l inactivation of e-cadherin genes Chr 16 ER/PR + signet ring cells Single file rows
Medullary carcinoma
fleshy, cellular mass w/ lymphocytic infiltrations
Invasive breast cancer
Non-detailed invasive breast cancers list
tubular/cribriform carcinoma
mucinous carcinoma
papillary carcinoma
metaplastic carcinoma
