Breast Flashcards
Breast Anatomy
Alveoli + Myoepithelial cells
Lobules, Lactiferous Sinus, Duct
Fats
Are ducts radiolucent or radioopague
White - Radioopague - Radiodense
Diagnostic Triad
Clinical Presentation
Radiology
Pathology - Biopsy
Inflammation and what conditions
Give 3 diseases
Plus give AB
Acute Mastitis - Breast Abscess
- When lactation - cos milk for bacterial growth - staph aureus top
- MRSA: Vancomycin, 5th gen Ceftaroline;
Idiopathic Granulomatous Mastitis
Paraffinoma, inflammatory cells w MGC - Fibrosis is radioopague, white
Benign epithelial breast disease
- non-cancerous
+ Important Histological features
Fibrocystic change (possible hormone cause)
- Dilated ducts forming cysts
- Fibrosis as name suggests
- Apocrine change
- Epithelial hyperplasia
cells have apocrine phenotype - w abundant cytoplasm and prominent nucleolus ; cells lining the duct looks like apocrine secretory cells
Benign Breast Cancer
- pure epithelium
Papillary
very rare 1%
Breast Cancers
- mixed epithelium and mesenchymal [2 cancers]
- are they benign or malignant
Fibroadenoma
- fibrous stroma proliferation; from lobules - gland cells
- elongated ducts, COMPRESSED DUCTS
Phyllodes
- Massive STROMA PROLIFERATION - push into cystic space to give phyllodes appearance;
- Mets via blood
Both benign;
Malignant Breast Cancer, in situ
Origins
Clinical Presentation
Carcinoma
- can be Lobular CIS or Ductal CIS
- lobular is secretory cells;
Presentation:
Nipple discharge, mass; mammogram density, calcification
Whats a feature of Lobular Carcinoma
- histology?
(note distinction between LC and LCIS)
E-Cadherin mutation = ABSCENCEEEEEEEE // NEGATIVE
sheets of single cells, linear
characterized by enlargement and distension of acini
E-cadherin is a cell adhesion molecule that is expressed in normal breast tissue and is useful as a phenotypic marker in breast cancer, with absence of its expression frequently observed in lobular type tumors.
Is No Special Type prognosis better or worse than other types of breast carcinoma
Worse
Whats Paget’s Disease
DCIS in situ to nipple
- contained in epithelium
Gynacomastia
Causes [2]
Caused by either increase in estrogen
- like in cirrhosis
or decrease in testosterone
- testicular atrophy
Proliferation of ducts, glands, stroma
Whats the screening regimen in Sg
1/y 40-49
2/y 50 onwards
Prognosis Features + cancer genes lol
Type of tumor
Local extent, size, involvement - T staging, invasion of pectoralis, skin
Lymph Node Invasion - N
Mets
HER2, ER, PR (ER and PR + better response to therapy)
(prostaglandin and eostrogen)
HER2 is oncogene
– RTK family
BRCA1,2 are TSGs
– BRCA involved in DNA repair
Breast Cancer Risk
Family
Early Menarche, Late MP, Hormone RP, OCP
HORMONAL
No child (nullparous) or First Child born > 30 (no protective effect)
Obese, Alcohol, Radation