Breast Cancer Flashcards
list the lesions that affect the lobules and terminal ducts
- cyst
- sclerosing adenosis
- small duct papilloma
- hyperplasia
- atypical hyperplasia
- carcinoma
list the lesions that affect the large ducts
- duct ectasia
- squamous metaplasia of lactiferous ducts
- large duct papilloma
- Paget disease
list the lesions that affect the intralobular stroma
- fibroadenoma
- phyllodes tumor
list the lesions that affect the interlobular stroma
- fat necrosis
- lipoma
- fibromatosis
- sarcoma
a galactocele is a cystic dilatation of ___ during ___
a galactocele is a cystic dilatation of obstructed duct during lactation
the condition seen in the image is caused by an ____ response to ____
the condition seen in the image is caused by an exaggerated response to estrogen
the origin of the condition seen in the image is the ____
the origin of the condition seen in the image is the terminal duct lobular unit
describe the 2 types of the condition seen in the image
- simple/non-proliferative = no malignant potential
-
proliferative = epithelial hyperplasia → malignant potential
- ductal = one duct is proliferating
- lobular = all ducts in lobule are proliferating
- sclerosing adenosis = fibrosis of INTRAlobular stroma & pathological adenosis of terminal duct lobular unit
in the condition seen in the image, women of ____ age present with ____
in the condition seen in the image, women of reproductive age present with bilateral cyclical mastalgia (pain during menstrual cycle)
on physical exam of a patient with the condition in the image, the breast would feel ____
on physical exam of a patient with the condition in the image, the breast would feel “lumpy bumpy”
on biopsy of the simple form of the condition in the image, there is ____
on biopsy of the simple form of the condition in the image, there is double layer of cells; ducts are distended & apocrine metaplasia with eosinophilic cytoplasm
on biopsy of the proliferative form of the condition seen in the image, what is seen?
- proliferative: inner cuboidal cells (respond to estrogen) → multilayering
on transillumination of a specific type of the condition seen in the image, ____ can be seen
on transillumination of a specific type of the condition seen in the image, blue-domed cyst can be seen
in the condition seen in the image, mammography may show ___
in the condition seen in the image, mammography may show microcalcification in concretions of secretions or necrosis of epithelial cells (potentially mistaken for carcinoma)
____ can clinically and histologically mimic carcinoma
(seen in the image)
sclerosing adenosis can clinically and histologically mimic carcinoma
acute mastitis usually occurs when ____ and is usually caused by ____
acute mastitis usually occurs when breastfeeding and is usually caused by Staph (small localized, under nipple)
acute mastitis can also be less commonly caused by ____ which causes ____ and heals (with or without?) a scar
acute mastitis can also be less commonly caused by Strep which causes inflammation of the whole breast with marked swelling/tenderness
heals without a scar
describe the pathogenesis of duct ectasia
what occurs after healing?
inspissated secretion → dilatation → rupture, causing plasma cells, histiocytes, giant cells, granulomas
after healing = induration, nipple retraction
the condition seen in the image is derived from ____ which are lined by ____
the condition seen in the image is derived from lactiferous ducts which are lined by inner cuboidal & outer myoepithelial cells
describe the presentation of the condition seen in the image
unilateral sub-areolar mass with serous/bloody discharge in women 35-55 years old
in the condition seen in the image, the ____ are “gatekeepers” for the ____
in the condition seen in the image, the outer myoepithelial cells are “gatekeepers” for the fibrovascular core
in the condition seen in the image, a complication is invasion of ____ due to absence of ___ which is most commonly seen in ____
multiple papillomas (multifocality) → papillomatosis → increased chance of malignant transformation → papillary carcinoma of the breast
in the condition seen in the image, a complication is invasion of the fibrovascular core due to absence of myoepithelial cells which is most commonly seen in post-menopausal women
the condition seen in the image has a potential transformation to ___ due to absence of ____
the condition seen in the image has a potential transformation to papillary carcinoma due to absence of outer myoepithelial cells
the origin of the condition seen in the image is ____
the origin of the condition seen in the image is the intralobular stroma
in the condition seen in the image, ___ makes it grow bigger and regresses at ____
in the condition seen in the image, estrogen makes it grow bigger and regresses at menopause
describe the presentation of the condition seen in the image
mobile, non-tender lump
well-delineated
in the condition seen in the image, ____ is seen on mammography
in the condition seen in the image, popcorn calcification is seen on mammography
on excision biopsy of the condition seen in the image, what is seen?
- pericanalicular = loos fibroblastic stroma with irregularly shaped duct-like spaces lined by epithelial cells
- intracanalicular = loose fibroblastic stroma with ducts compressing to slit-like epithelial lined spaces
the origin of the condition seen in the image is ____, which is similar to ____
the origin of the condition seen in the image is intralobular stroma which is similar to fibroadenoma
the condition seen in the image usually occurs in ____ women
the condition seen in the image usually occurs in post-menopausal (>50 yrs) women
describe the malignant form of the condition seen in the image; it invades ____
atypia, mitotic figures, stromal hypercellularity
it invades the INTERlobular stroma
the condition seen in the image has a ___-like appearance
the condition seen in the image has a leaf-like appearance
the condition seen in the image can undergo ___ spread, and therefore there is no ____
the condition seen in the image can undergo hematogenous spread, and therefore there is no lymphadenopathy
the most important predisposing factor for breast cancer in elderly women is ____
the most important predisposing factor for breast cancer in elderly women is AGE
a poor prognosis for breast cancer is ___ positive since ___ cannot cross the BBB
a poor prognosis for breast cancer is Her2/Neu positive since Herceptin cannot cross the BBB
____ is the major prognostic factor for breast cancer; in the absence of this, ____ is the most important, followed by ____
distant metastasis is the major prognostic factor for breast cancer; in the absence of this, axillary lymph node status is the most important, followed by size
the condition seen in the image lacks ___ and therefore leads to ____ cells
the condition seen in the image lacks E-cadherin and therefore leads to discohesive cells
the condition seen in the image is (unilateral or bilateral)?
the condition seen in the image is bilateral
the condition seen in the image leads to obstruction of ____ with intact single ____
the condition seen in the image leads to obstruction of lactiferous duct with intact single outer myoepithelial layer
the condition seen in the image can cause Paget’s disease, which is when ____ migrate ____
the condition seen in the image can cause Paget’s disease, which is when Paget/Toker cells (hyperchromatic nucleus, perinuclear halo & mucin filled cytoplasm) migrate retrograde to the nipple
describe the presentation of Paget’s disease
older women with unilateral nipple changes (crusting, oozing, hyperemia, ulceration, fissure)
describe the comedo type of the condition seen in the image
high-grade cells with necrotic center & dystrophic calcification
describe the basal-like type of the condition seen in the image
triple negative (ER - /PR - /Her2neu -)
associated with BRCA1
high grade and metastasize to brain
describe the Her2 positive type of the condition seen in the image
poorly differentiated, high frequency of brain metastasis
mucinous (colloid) carcinoma is associated with ____
mucinous (colloid) carcinoma is associated with solid/non-invasive papillary carcinoma
medullary carcinoma has a ____ appearance which is identical to ___ and ____
medullary carcinoma has a fried-egg appearance which is identical to dysgerminoma of ovaries and seminoma of testes
the condition seen in the image is caused by loss of ____
the condition seen in the image is caused by loss of outer myoepithelial cells
describe the 2 patterns seen in the condition in the image
- Indian file pattern (malignant cells in stroma): single file of tumor cells, round, uniform
-
Bull’s eye pattern: tumor cells around normal acini & ducts
- can produce Krukenberg (signet ring cells in both ovaries)
list risk factors for male gynecomastia
- cirrhosis
- Klinefelter syndrome (XXY)
- anabolic steroids
- testicular neoplasms
male gynecomastia presents as _____
while on histology, there is _____
male breast cancer presents as button-like beneath areola
while on histology, there is intraductal hyperplasia
list the risk factors for breast carcinoma in males
- reduced testicular function
- XXY karyotype
- 1st degree relatives with breast cancer
- BRCA2 mutation
