breast Flashcards
name the most common disorder of the breast?
fibrocystic disease
what are the 3 forms of fibrocystic disease of the breast?
non-proliferative
proliferative
sclerosing adenosis
what are some special lab findings of non-proliferative fibrocystic breast tissue
dilation of ducts with no epithelial hyperplasia.
&
Increase in collagen
what is the color of a fibrocystic cyst (non-proliferative) when removed ?
blue/brown
what are some special lab findings of proliferative fibrocystic breast tissue?
epithelial hyperplasia
ductal papillomatosis
fenestrations
increase risk of carcinoma
what are the findings of ductal papillomatosis?
multilayered with papillary folding
what are the findings with fenestration of breast tissue?
filling of the ductal lumen
what form of fibrocystic breast disease can you find papillomatosis and fenestrations?
proliferating form
what is special about sclerosing adenosis?
*looks like carcinoma of the breast* adenosis intralobular sclerosis enlarged and deformed lobular units proliferation of acini
what does adenosis mean?
the number of acini per duct is increasing
is which form of fibrocystic disease of the breast can you find an increase of acini per duct and intralobular fibrosis?
sclerosing adenosis
what is the most common benign tumor of the breast?
fibroadenoma
what is special about a fibroadenoma?
it is hormone dependent.
responds to increase of estrogen
multiple and bilateral
if a women comes to the clinic with a free moveable mass on her breast what should be on the top of your differential dx.?
fibroadenoma
after taking a biopsy of a free moveable mass of a woman’s breast what should you expect to see?
intact BM
loose fibroblastic stroma
can either appear:
periductal or intraductal
in a lab finding you see a periductal mass meaning it is what shape
round or oval
in a lab finding you see a slit like mass what shape is it?
slit like
in a lab finding you see a slit like mass with loose stroma and an intact BM what tumor of the breast is it?
intraductal fibroadenoma
what is the name of a epithelial tumor of the breast
intraductal papilloma
what are the two main locations of a intraductal papilloma?
lactiferous ducts and the aerola
what are some special findings of a intraductal papilloma?
mostly solitary
branching papillae covered with cubical epithelium
neoplastic papillary growth
are intraductal papilloma benign or mets?
benign
what are some clinical findings of a intraductal papilloma?
bloody nipple discharge
unilateral
subaerolar mass
what is the second leading cancer in america
carcinoma of the breast
a lady comes into the clinic an immoveable mass in breast
early menarche
late menopause
and used birth control for several years
what is she most likely to have?
carcinoma of the breast
what are some classical findings of breast carcinoma?
ductal or lobular epithelium
left breast involved
upper outer quadrants
where can non-invasive carcinomas be found?
in the basement membrane
out of the non-invasive carcinomas;
is intraductal or intralobular carcinoma of the breast most common?
intraductal is most common
what are some classic lab findings of intralobular carcinoma?
- plugged and filled ducts
- confined to BM
- comedocarcinoma = central necrosis of ducts
- rapid proliferation
you find central necrosis of ducts
plugging and filling of ducts
and rapid proliferation of cells (mitotic figures) in tissues what carcinoma of the breast is it most likely?
intraductal carcinoma of the breast
during a mammogram you incidentally find clusters of acini that are monomorphic what kind of carcinoma of the breast is it?
lobular
what is the treatment for both the intralobular or intraductal forms of non-invasive carcinoma?
lumpectomy
the majority of invasive breast carcinomas are
ductal
pt. comes into the clinic with a hard immoveable mass on the outer quadrant of the left breast with an ‘orange’ look with dimpling and a retracted nipple…. what should be on the top of your differential?
invasive ductal carcinoma
in the lab biopsy of a invasive ductal carcinoma what would likely be seen?
nests and cords of malignant cells in stroma
replacement of breast fat with fibrosis
what are the variants of ductal carcinoma?
medullary
colloid
tubular
microscopically the dr. finds large fleshy groups of cells separated by scant fibrous tissue and infiltration of lymphocytes what type of ductal carcinoma is it?
medullary
out the 3 types of ductal carcinoma which one has the best prognosis?
medullary
microscopically the dr. finds mucin intracellularlly and extracellulary with a blue/gray bulky mass…
what kind of ductal carcinoma is this?
medullary
microscopically you find well formed tubules… what kind of ductal carcinoma of the breast is this?
tubular ductal
pt. comes into office with nipple lesion and the lab finds it extending into the ductal system and does not cross the BM
they also note a ‘halo’ look?
what kind of disease of the breast is this?
paget’s disease
due to an existing tumor of the breast (non-invasive or invasive)
what are some special lab findings of pagets disease?
- clear halo– mucopolysaccharide
- DOES NOT cross BM
- invades the ductal system
what is a special lab finding of invasive lobular carcinoma?
indian file line
you find mitotic cells invading ‘individually’ into the stroma –> looking like a (———–) (——-) indian file line; what type of carcinoma of the breast is this?
invasive lobular carcinoma
Peau d’orange is due to?
localized lymphedema due to a tumor of the breast
carcinome of the breast will spread fast/slow during pregnancy due to an increase of estrogen…
fast
of carcinoma of the breast is to spread by blood where will it go?
lung, bone, liver, adrenals
