Breast Cancer Flashcards
indications for breast MR
high risk patients, evaluation of disease extent with newly diagnosed breast cancer, neoadjuvant chemotherapy response, assessment of residual disease with positive surgical margins, evaluation for tumor recurrence, evaluation for occult breast cancer in patient with axillary metastases
progression of invasive ductal breast cancer
normal –> flat epithelial atypia –> atypical ductal hyperplasia (ADH) –> DCIS –> IDC
intraductal proliferation with cytological atypia
atypical ductal hyperplasia
% of patients with core needle biopsy of FEA which will be upstaged to DCIS or invasive carcinoma upon surgical excision?
18%
most often occult cancer detected mammographically?
DCIS
is the basement membrane intact with DCIS?
yes
% of pts who will develop invasive carcinoma from DCIS?
30-50%
Risk factors for breast cancer
women
age
BRCA 1/2
first degree relative with breast cancer
prior chest radiation for HL/NHL
long term estrogen exposure (early menarche, late menopause, late first pregnancy, nulliparity, obesity)
prior biopsy result of high risk lesion in lobular neoplasia spectrum (ALH, LCIS)
most common subtype of breast cancer
invasive ductal carcinoma
classic mammo appearance of IDC
spiculated mass, architectural distortion, pelomorphic calcification
tubular carcinoma presentation, prognosis
small spiculated mass; may appear similar to radial scars/complex sclerosing lesions
prognosis better than IDC NOS
muscinous carcinoma alt names
colloid carcinoma, mucoid carcinoma, gelatinous carcinoma
mucinous carcinoma imaging appearance US, MR
US: low density circumscribed mass, similar to fibroadenoma
MR: hyperintense T2
medullary carcinoma, pt population, prognosis
young women; BRCA1 mutation
locally aggressive, better prognosis than IDC NOS
pappilary carcinoma
malignant form of intraductal papilloma
adenoid cystic carcinoma –presentation, prognosis
palpable firm mass; excellent prognosis with resection
5-10% of breast cancer cases?
invasive lobular carcinoma
does invasive lobular carcinoma form a discrete mass?
imaging characteristics?
not usually; spread through breast tissue
one view asymmetry to architectural distortion to spiculated mass
tumor invasion of ductal lymphatics
inflammatory carcinoma
breast erythema, edema, firmness…cancer type?
inflammatory carcinoma
mammo findings of inflammatory carcinoma
trabecular thickening and skin thickening, which may also look like abscess
paget disease, presentation
form of DCIS that infiltrates into the epidermis of the nipple with erythema, ulceration, eczematoid changes
most important prognositc factor in non metastatic breast cancer
axillary lymph node status
detection of axillary involvement is via?
surgical sentinel LN biopsy
