breast Flashcards
painful breast is suggestive of ___ lesion
benign/malignant
benign
would you suspect cancer of the breast when the nipple discharge is spontaneous and unilateral?
yes
most common bacteriologic cause of acute mastitis
S. aureus
[diagnosis]
mimic cancer, history of breast trauma
Histo: hemorrhagic, liquefactive fat necrosis with neutrophils and macrophages
fat necrosis
[benign or malignant?]
Benign ductal cells
Myoepithelial cells present
benign
[diagnosis]
malignant ductal cells
present myoepithelial cells
DCIS
[diagnosis]
malignant ductal cells
absent myoepithelial cells
negative p63
invasive CA
[diagnosis: proliferative disease without atypia]
> 2 layers of cells in aduct
distorted lumina at periphery
mimics DCIS
Epithelial hyperplasia
[diagnosis: proliferative disease without atypia]
solid cords or double strands of cells in a densely fibrotic stroma
closely mimics carcinoma; inner ducts are compressed
sclerosing adenosis
[diagnosis: proliferative disease without atypia]
papillary fronds with fibrovascular cores growing in a dilated duct
present myoepithelial layer
papilloma
[diagnosis: proliferative disease without atypia]
combination of epithelial hyperplasia, sclerosing adenosis and papilloma
central nidus of entrapped glands in a hyalinized stroma
mimics cancer
complex sclerosing lesion
[diagnosis: proliferative disease with atypia]
DCIS without full duct involvement cribiform pattern (cookie cutter appearance)
atypical ductal hyperplasia
[diagnosis: proliferative disease with atypia]
LCIS but less than 50% involvement of acini in a lobule; loss of E-cadherin
Atypical lobular hyperplasia
most common non-skin malignancy in women
breast CA
2nd to lung CA in causing deaths in women
breast CA
BRCA 1 is located in what chroomosome?
Ch 17
BRCA 2 is located in what chroomosome?
Ch 13
the duct system of that breast that is hormonally responsive
terminal duct-lobular unit
site in the breast where invasive breast CA arise
terminal duct-lobular unit
[diagnosis: cancer or not CA?]
small, irregular, numerous, clustered calcification
CA
[diagnosis: comedo vs non comedo DCIS]
high grade nuclei, central necrosis
comedo DCIS
[diagnosis: comedo vs non comedo DCIS]
variable nuclear grade and architectural pattern
non comedo DCIS
[diagnosis: comedo vs non comedo DCIS]
ducts filled with cells with high grade nuclear atypia, central necrosis
comedo
[diagnosis: comedo vs non comedo DCIS]
ducts completely filled with cell, appearing as solid nets
non-comedo, solid
[diagnosis: comedo vs non comedo DCIS]
ducts filled with cells with secondary lumina
non-comedo, cribiform
[diagnosis: comedo vs non comedo DCIS]
bulbous projections WITHOUT fibrovascular cores
non-comedo, micropapillary
[diagnosis: comedo vs non comedo DCIS]
papillary fronds WITH fibrovascular cores but NO myoepithelial layer in fronds
papillary
[diagnosis: CA]
monomorphic cellular appearance, distinct cytoplasmic borders, pale cytoplasm, round nuclei, absent streaming, CK5 (+), CK 6 (-), ER (+), diffuse
DCIS
[diagnosis: CA]
heterogenous appearance, indistinct borders, eosinophilic cytoplasm, oval nuclei, present streaming, CK5 (+) CK6 (+), ER (+), mosaic
epithelial hyperplasia
[diagnosis: CA]
unilateral eruption with a scale crust, pruritic, malignant cell reaches the ductal cell without violating the basement membrane
paget cells
[diagnosis: CA
intact basement membrane, no disruption of lobules, absent necrosis, nipple of the skin not involved, ER(+), PR(+), HER2(-)
LCIS
most common type of invasive carcinoma of the breast
invasive breast CA, no special type
[diagnosis: infiltrating carcinoma]
in situ with absence of myoepithelial layer, haphazarly disposed cells with desmoplasia
invasive breast CA, no special type
[diagnosis: infiltrating carcinoma]
E-cadherin loss, ER/PR (+), HER2 (-), little desmoplasia, indian file/ dyscohesive infiltrating tumor cells in single file
mucin (+)
invasive lobular carcinoma
[diagnosis: infiltrating carcinoma]
clusters of small islands of tumor cells floating in pools of extracellular mucin, low atypia
ER/PR(+), HER2 (-)
mucinous (colloid) carcinoma
[diagnosis: infiltrating carcinoma]
syncitium-like solid sheets of large cells with pleomorphic nuclei and prominent nucleoli, increased mitosis, lymphoplasmatic infiltrates, pushing borders
ER(-) HER2(-)
medullary carcinoma
[diagnosis: infiltrating carcinoma]
extensive invation and proliferation within lymphatic channels, presents as swelling that can mimics non-neoplastic inflammatory disorder
inflammatory CA
this test is done to confirm positivity to HER2 in cases of equivocal result
FISH
fluorescence in situ hybridization
[diagnosis: drug treatment for this subtype/molecular subtype]
ER(+)
Her2(-)
Ki67 low
Luminal A, tamoxifen
[diagnosis: drug treatment for this subtype/molecular subtype]
ER(+)
Her2(-)
Ki67 high
Luminal A, tamoxifen
[diagnosis: drug treatment for this subtype/molecular subtype]
ER(+/-)
PR(+/-)
Her2(+)
Ki67 high
Her 2 enriched, Trastuzumab
[diagnosis: drug treatment for this subtypemolecular subtype] in study ER(-) Her2(-) Ki67 high
Basal
most common benign tumor of the female breast
fibroadenoma
[diagnosis: stromal tumor]
older females, larger breast mass
stromal overgrowth, infiltrative boarders, high cellularity, high mitosis, nuclear pleomorphism, leaf-like projections
phyllodes tumor
[diagnosis: type of phyllodes tumor]
Well defined borders, fibroblastic appearance, little to mild atypia, <5 mitoses/10HPF, no stromal overgrowth
benign phyllodes tumor
[diagnosis: type of phyllodes tumor]
focally infiltrative borders, moderate cellularity, moderate atypia, 5-9 mitoses/10HPF, no stromal overgrowth or focal stroma
borderline phyllodes tumor
[diagnosis: type of phyllodes tumor]
infiltrative borders, high cellularity, marked atypia, >/10 mitoses/10HPF, with stromal overgrowth
malignant phyllodes
[diagnosis: type of phyllodes tumor]
metaplastic elements containing bone, skeletal, cartilage tissues
malignant phyllodes
[diagnosis: type of phyllodes tumor]
4 LPO field shows only stromal component
malignant phyllodes
[diagnosis: stromal tumors]
young female, relatively smaller breast mass
stromal proliferation = epithelial lesion, lesser stromal cellularity, not atypia, no mitosis
fibroadenoma
in gynecomastia, the duct lining undergoes ___ (hypertrophy/hyperplasia)
hyperplasia
