Breast Cancer Flashcards
Breast cancer most commonly occurs in what race?
Caucasian
Earliest sign of breast cancer seen on mammography?
microcalcifications
Three factors in risk of cancer in order:
- gender
- age (>50years)
- family history
Li-Fraumeni Syndrome
rare autosomal dominant disorder greatly increasing risk of developing several kinds of cancer
Atypical ductal hyperplasia (ADH)
identified on breast bx, increases risk for breast cancer
When is nipple discharge likely a benign finding?
whitish, greenish, or yellow, produced by several ducts
Benign changes in breast that may appear malignancy sonographically: (6)
- scar tissue
- diabetic mastopathy
- fat necrosis
- radial scar
- sclerosing adenosis
- granular cell tumors
Characteristics of spiculated carcinomas:
- mildly invasive
- low number of tumor cells
- water poor composition
- reduced sound transmission -shadowing
- not especially hypervascular
Characteristics of circumscribed carcinomas:
- highly invasive
- high number of tumor cells
- water rich composition
- increased sound transmission-enhancement
- hypervascular
The greater the peripheral vascularity, the _____ the cancer.
more agressive
Describe properties of multicentric tumor formation:
- multiple tumors in different quadrants
- tumor formation in both breasts
- tumors separated by more than 5cm
Describe properties of multifocal tumor formation:
- multiple tumors within same area, quadrant , or ductal system
- tumors separated by less than 5 cm
- more common than multicentric formations
- better prognosis than multicentric
What is ductal extension?
mass invasion of a single peripheral duct directed toward nipple
What is branch pattern?
mass invasion of multiple peripheral ducts directed away from nipple
Which carcinoma is actually not a cancer?
Lobular Carcinoma in Situ is actually a lobular neoplasm
Which carcinoma is most frequently missed on imaging?
Invasive Lobular Carcinoma, MRI best
Name the three Lobular Carcinomas
- Lobular Carcinoma in Situ
- Invasive Lobular Carcinoma
- Tubulolobular Carcinoma
Three Stromal Carcinomas:
- Cystosarcoma Phyllodes
- Lymphoma
- Metastatic Breast Cancer
What is the most common breast sarcoma?
cystosarcoma phyllodes
Which cancer is the malignant form of fibroadenoma?
cystosarcoma phyllodes
How does breast lymphoma present?
- RARE
- Palpable mass and/or diffuse thickening
- Rapid contrast uptake on MRI
Distant Mets
- once cancer cells extend to nodes outside of L1, L2, L3
- Cancer cells invading other organs
Breast Mets most commonly move to
#1 Bone #2 Liver #3 Lung
Stage 0 Carcinoma Stage:
In Situ Carcinomas
Stage 1 Carcinoma Stage:
<2 cm in size, no mets, no LN involvement
Stage 2 Carcinoma Stage:
- <2 cm in size, +nodes in axilla, no mets OR
- 2-5cm in size, +nodes in axilla, no mets OR
- > 5cm in size, no nodal involvement or mets
Stage 3 Carcinoma Stage:
> 5 cm AND ATLEAST ONE of the following:
- local/regional spread
- muscular attachment at chest wall
- fused axillary lymph nodes
Stage 4 Carcinoma Stage:
Any sized with muscular involvement at chest wall OR invasion to skin level AND mets to other breast spots AND significant node involvement
The Sentinel node is most often which level?
Level 1…lateral to pec minor
The most common route for mets to the breast is
bloodstream (hematogeneous)
Most common distant primaries:
- Melanoma (F)
- Prostate (M)
- lungs
- ovaries
- sarcoma
In mets to breast from distant primaries, where are these lesions most commonly found?
subcutaneous tissues, and often multiple mass formation
Most common type of mets occuring in the breast
from primary in opposite breast (occuring by direct infiltration)…usually solitary mass
Most common route for mets to bone
intercostal veins
Which drugs reduce estrogen and therefore tumor recurrence?
Tamoxifen and Raloxifine
