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Kaplan High yield: Reproductive > Breast carcinoma > Flashcards

Breast carcinoma Flashcards

1
Q

3 general features of breast carcinoma

A

most common cause of CA in women;
rare in women under 25;
lifetime risk w/ no family Hx is 8-10%

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2
Q

Risk factors for breast carcinoma

A 
40+ y/o; nulliparity; Fam Hx; early menarche; late menopause;
Fibrocystic disease (other than fibrosis); obesity; high fat diet
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3
Q

Clinical features for breast carcinoma

A

50% upper outer quadrant;
90% in ductal epithelium;
slightly more common in Left breast=> bilateral 4%
self exam / routine physical discovery

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4
Q

What tumor suppressor genes are associated with breast carcinoma?

A

BRCA1 and BRCA2

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5
Q

What is the risk for a mutated BRCA1?

A

almost 100% lifetime risk for breast CA in 30-40s;

increased risk for ovarian CA

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6
Q

Risk associated with men in BRCA1 mutations?

A

yes=> increase risk for prostate CA

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7
Q

risk for mutated BRCA2 gene

A

men & women => increase breast CA;

no increase in ovarian CA in women

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8
Q

Where are the 4 locations for invasion in breast carcinoma?

A

thoracic fascia becoming fixed to chest wall;
extend into skin, causing dimpling and retraction;
obstruction of subQ lymphatics=> peau d’orange;
Cooper ligaments w/in ducts to cause nipple retraction

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9
Q

How and where does breast carcinoma spread?

A

lymphatic or hematogenous routes;
axillary, supraclavicular, internal thoeracic nodes;
contralateral breast nodes

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10
Q

6 types of breast carcinoma

A 
infiltrating ductal carcinoma;
Paget disease of breast;
noninfiltrating intraductal carcinoma;
medullary carcinoma w/ lymphoid infiltration;
colloid (mucinous) carcinoma;
lobular carcinoma
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11
Q

most common breast CA

A

infiltrating breast carcincoma

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12
Q

gross path of infiltrating breast carcinoma

A

rock hard, cartilaginous consistency, 2-5cm;

foci of necrosis and calcification common

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13
Q

Can infiltrating breast carcinoma be found on mammography?

A

yes

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14
Q

Histo path of infiltrating breast carcinoma

A

anaplastic duct appear in epithelial cells appear in masses that invade the stroma

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15
Q

pathogenesis of infiltrating breast carcinoma

A

fibrous reaction responsible for hard, palpable mass

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16
Q

Epidemiology and prognosis of Paget disease of breast

A

older women;

poor Px

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17
Q

Define Paget disease of breast

A

form of intraductal carcinoma involving areolar skin and nipple

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18
Q

Gross path of Paget disease of breast

A

skin of nipple and areola ulcerated and oozing

19
Q

histo of Paget disease of breast

A

ductal carcinoma;

large, anaplastic, hyperchromatic Paget cells

20
Q

What and why are noninfiltrating intraductal carcinomas referred to?

A

comedocarcinomas=> cheesy, necrotic tumor tissue may be expressed from ducts

21
Q

Gross path of noninfiltrating intraductal carcinoma

A

focus of increased consistency in breast tissue

22
Q

histo path of noninfiltrating intraductal carcinoma

A

typical duct epithelial cells proliferate and fill ducts => leading to ductal dilatation

23
Q

Prognosis of medullary carcinoma w/ lymphoid infiltration

A

better than infiltrating ductal carcinoma

24
Q

gross path of medullary carcinoma w/ lymphoid infiltration

A

5-10cm fleshy masses w/ little fibrous tissue;

foci of hemorrhage and necrosis is common

25
Q

histo path of medullary carcinoma w/ lymphoid infiltration

A

sheets of large, pleomorphic cells w/ increased mitotic activity and lymphocytic infiltrate

26
Q

Epidemiology and prognosis of colloid (mucinous) carcinoma

A

older women, slow growing;

better Px than infiltrating ductal carcinoma

27
Q

gross path of colloid (mucinous) carcinoma

A

soft, large, gelatinous tumors

28
Q

histo of colloid (mucinous) carcinoma

A

islands of tumor cells w/ copious mucin

29
Q

Etiology of lobular carcinoma

A

multicentric w/ estrogen receptors arising from terminal ductules

30
Q

gross path of lobular carcinoma

A

rubbery and ill-defined => from multicentric nature

31
Q

histo path of lobular carcinoma

A

small tumor cells that may be arranged in rings

32
Q

5 characteristics differentiated FIBROCYSTIC DISEASE from breast cancer

A 
often bilateral;
multiple nodules;
menstrual variation;
cyclic pain and engorgement;
may regress during pregnancy
33
Q

5 characteristics differentiating fibrocystic disease from BREAST CANCER

A 
unilateral;
single nodule;
no menstrual variation;
no cyclic pain or engorgement;
does NOT regress during pregnancy
34
Q

define acute mastitis

A

usually unilateral fissures in nipples during early nursing w/ pus in ducts;
necrosis may occur

35
Q

what is acute mastitis associated with?

A

predisposes to bacterial infection

36
Q

What are common pathogens assoc. w/ acute mastitis?

A

Staph aureus and Streptococcus

37
Q

Tx for acute mastitis

A

Antibiotics and surgical drainage

38
Q

Epidemiology in mammary duct ectasia (plasma cell mastitis)

A

occurs in 5th decade in multiparous women

39
Q

How does mammary duct ectasia (plasma cell mastitis) present?

A

pain, redness, and induration around areola w/ thick secretions;
usually unilateral

40
Q

What characteristics of mammary duct ectasia (plasma cell mastitis) make it difficult to distinguish from malignancy?

A

skin fixation;
nipple retraction;
axillary lymphadenopathy

41
Q

Define gynecomastia

A

enlargement of male breasts;

often unilateral but may be bilateral

42
Q

What does gynecomastia signal in a male?

A

high estrogen state

43
Q

What diseases are associated with gynecomastia?

A 
Klinefelter syndrome, testicular tumors;
hepatic cirrhosis (liver cannot degrade estrogens)
44
Q

What ages are typical of males developing gynecomastia?

A

puberty or old age

Kaplan High yield: Reproductive (18 decks)

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