Breast Disorders, Breast Pathology Flashcards
common causes of glactorrhea
- xs stim
- prolactinoma
- hypOthyroid
- DA antagonists
bloody nipple discharge causes
intaductal papilloma
breast cancer
intraductal papilloma
- lactiferous duct, usu 2-4mm, solitary
- bloody/serous discharge (arise in lactiferous duct
- women 30-50 y/o
- multiple + atypia –> underlying cancer
Paget’s
skin involvement with underlying breast cancer
clinical breast exam recommendation
25-39: every 1-3 years
greater than 40: every year
screening mammography guidelines
~1-2 years starting at 40-50
annual >50
fibrocystic breast disease tx
NSAIDs
supportive bras
pill/patch/ring
fibroadenomas
- most comm breast mass in younger women
- firm, well-circumscribed, mobile, non-tender
- may fluctuate slowly
shrink: menopause
grow: preg (via inc estrogen)
firm, fixed, feels stuck to chest wall
breast cancer
Phyllodes tumor
rare
younger women
single breast, lg, germ
RAPIDLY grown but rarely mets
mastitis tx
dicloxacillin QID
CONTINUE BREASTFEEDING/PUMPING
benign breast diseases
fibrocystic change fibroadenoma fat necrosis (traumatic) acute mastitis intraductal papilloma* phyllodes*
malignant phyllodes is a
sarcoma
benign, non-proliferative disease
adenosis
apocrine metaplasia
duct ectasia
ductal hypERplasia of usual type
slightly inc risk of breast CA
(WITHOUT ATYPIA)
- ductal hyperplasia of usual type, moderate or florid
- intraductal papilloma
- sclerosis adenosis
fibrocystic change
25-45 y/o
-cysts, apocrine metaplasia, fibrosis, calcification, chronic inflammation, ductal hyperplasia
High risk of invasive breast CA
carcinoma in situ (non-invasive malignancy)
Ductal carcinoma in situ
DCIS
- intact BM
- microcalcifications
- often multicentric, may be extensive
DCIS tx
surgery and hormonal
estrogen and progesterone receptor expression predicts response to
hormonal therapies…
tamoxifen
aromatase inhibitors
fulvestrant
HER2 oncoprotein/oncogene status predicts response to
trastuzumab
HER2+ tumors have a _____ prognosis
HER2+ tumors have a WORSE prognosis
Inflammatory breast carcinoma
- erythematous, swollen breast
- peau d’orange
- tumor present in dermal lymphatics
- POOR PROGNOSIS (stage T4d)
most common type of invasive breast CA
invasive ductal CA
most common benign tumor of the breast
fibroadenoma
fibroadenoma
- biphasic, stromal epithelial
- most common benign tumor of breast
- young women <30
- well-circumscribed, movable mass
- UOQ
Is malignant phyllodes common?
No, rare
most common cause of bloody/serous discharge
intraductal papilloma
