Breast Flashcards
Dx of Breast
- Fibrocystic Breast Condition
- Fibroadenoma
- cyst
- intraductal papilloma
- blocked milk duct
- mastitis
- phyllodes tumor
- atypical hyperplasia
fibrocystic breast condition CP
s/s- lumpiness, thickening, swelling, pain, tenderness
cp- menstruation, lactation
what is most common benign breast mass
fibroadenoma
adenoma means
mass, does not mean CA
intraductal papilloma CP
- grows in milk ducts of breast
- bengin
- cp- often w/ nipple discharge
mastitis
infection of fatty tissue of breast
- caused by bacteria
- s/s warm, tender, painful
- cp- lactating, fevers, chills, warmth, pain
phyllodes tumor
- 1% breast tumors
- can be benign, intermediate, malignant
location of phyllodes tumor
- connective tissue of breast (sarcoma)
- tumor not in ducts or lobules
atypical hyperplasia
accumulation of abnormal cells in ducts or lobules of breast
- can lead to BC
hyperplasia means
proliferation
screening tools
- mammography
- tomosynthesis
- US
- MRI
- fast MRI
- CBE
mammography
low energy x-ray
- screening or dx
what is suspicious for malignancy on mammography
microcalcificaitons
US
- aids in detection of hard to see tumors
- differentiates between solid or fluid filled masses
- often after mammogram and before bx
tomosynthesis
3D imaging
- earlier detection of small BC than 2D
- greater accuracy
MRI indications
- F with BC gene, BRCA1 or BRCA2
- F w/ 1st deg relative w/ BC gene
- F w/ lifetime risk of 20-25% based on BC predicition model
- radiation to chest between 10-30 yrs
- various rare syndromes that have higher incidence of BC
fast MRI
- self pay
- ideal for candidates that have dense breast tissue or other high risk factors that do not meet qualifications for traditional MRI screening
- does not detect spectrum of dx that can be detected by conventional MRI
- not intended to replace mammogram
Risks for BC
1 FEMALE
- aging
- FH
- risk doubles if 1st deg relative w/ BC
- age at menarche
- age of 1st live birth
- age of menopause
- obesity
- ETOH
- BRCA 1, BRCA2
- male BRCA II Mutation
non invasive BC
- ductal carcinoma in situ
- most common noninvasive BC
DCIS recurrance risk of DCIS or invasive
30%
DCIS
presence of abnormal cells inside milk duct of breast
- considered earliest form of BC
tx DCIS
- lumpectomy followed by radiation will decrease recurrance rate to 15%
- sometimes masectomy
invasive c
- inflammatory BC
- invasive ductal carcinoma
- metaplastic BC
- medullary carcinoma
- Paget’s dx of nipple
- tubular carcionma
- paget’s dx of nipple
- invasive lobular carcinoma
- angiosarcoma
- mucinous carcinoma
inflammatory BC (IBC)
- Advance, invasive, aggressive
- Starts in milk ducts
- Invades skin and lymph system
- No breast lump or mass
- Not painful
- Subcutaneous change of skin
invasive ductal carcinoma (IDC)
- most common, 8/10 CA
- male breast CA
metaplastic BC
- “changed form” – looks like cells from other parts of body; squamous or osseous
- Treated aggressively
- Prognosis uncertain
- Metaplastic = metamorphosis
medullary carcinoma
- resembles medulla tissue
- better prognosis
tubular carcinoma
- rare, 2%
- good prognosis
- cells resemble small tubes
Paget’s dx of nipple
- Rare
- CA under skin
- Redness, scaly, flaky skin
- CA cells move through ducts to nipple
i. Nipple skin cells spontaneously change to CA cells
papillary carcinoma
- Type of DCIS
- Cells resemble fingers or threads
- Rarely invasive, stays contained in ducts
invasive lobular carcinoma (ILC)
- 10% of all invasive BC
- Leaves lobules and spreads to fatty tissue and other breast tissues
- Ability to metastasize
angiosarcoma
- Rare, aggressive
- Forms in cells that line blood vessels within breast or axilla
- Can be caused by radiation
mucinous carcinoma
- produces mucous
- good prognosis
- rare
breast pathology
- invasive or non-invasive
- tumor size
- cell grade [not stage]
- tumor necrosis
- vascular or lymphatic invasion
- hormone receptor status
- HER2 status
- surgical margins
BC tx
- systemic therapy- chemo
- local therapy- surgery or radiation
- immunotherapy
- hormonal therapy
- targeted therapy
- biotherapy
adjuvant
- chemo given after CA is tx to get rid of what tx didnt get
neoadjuvant
shrink and debulk tumor before surgery
lifestyle changes
- diet- plant based, low fat, high ca
- limit ETOH
- exercise
- maintain ideal wt
- ASA
CI to BC pills
- History of DVT/PE
- Hypertension
- Those with tobacco use who are over 35 years old
- Migraines with aura
- Liver dysfunction
- Breast cancer [hormones]
