Breast & Endocrine Flashcards
fibrocystic changes in the breast are benign. what are 3 examples?
- simple cyst
- fibrosis
- apocrine metaplasia
breast pathology that presents w/bloody discharge
- intraductal papilloma (benign tumor, “myoepithelium included”)
- papillary carcinoma (“myoepithelium popped”)
(myoepithelium=physical and chemical prevention of cancer)
name this breast pathology
fibroadenoma (estrogen sensitive)
(dark grey distinguishes them from breast cysts, benign)
3 benign inflammatory conditions of the breast
- mammary duct ectasia (dirty white, green or black discharge)
- fat necrosis
- mastitis (lactation & periductal/smokers)
name this breast pathology
phyllodes tumor
(“lea-phyll-like” projection. benign, seen in 5th decade of life)
name this breast disorder
mammary duct ectasia
(green, white or black nipple discharge, no pain)
6 breast carcinoma risk factors
- female
- over 80 y/o
- 1st degree relative w/breast ca (mother, sister, daughter)
- increased estrogen exposure (early menarche/late menopause)
- obesity
- first child > 35y/o
95% of breast tumors are…
adenocarcinoma
why does the nipple form this crust in paget’s disease of the breast?
dcis cells penetrate lactiferous ducts –> extends to nipple –> fluid leaks out and forms crust
(rare presentation of breast cancer, usually invasive carcinoma)
location of ductal carcinoma on the breast
superolateral quadrant of breast
(intraductal papillomas are under the aereola and present with nipple discharge)
define triple negative breast tumors
negative for predictive markers er, pr and her2
(these are most aggressive and effect younger women)
infalmmatory carcinoma of the breast (invasive carcinoma) is often mistaken for paget’s disease of the breast (noninvasive carcinoma). what is a key difference?
inflammatory carcinomas (e) lack palpable mass
infalmmatory carcinoma of the breast (invasive carcinoma) is d/t …
paget’s disease of the breast (noninvasive carcinoma) is d/t …
- dermal lymphatic space invasion (e)
- extension of underlying dcis/invasive breast cancer cells migrate up the lactiferous ducts. (c)
“indian files” or “lines of cells” is a/w which breast pathology?
invasive lobular carcinoma
“lines of cells = lobular”
physical exam findings of medullary breast carcinoma (mbc)
- soft-to-firm well-circumscribed breast mass (like a fibroadenoma)
- rarely symptomatic
histologic features of medullary carcinoma of the breast
poorly differentiated cells in a syncytial growth pattern with a large lymphocytic infiltrate.
(on palpation: soft fleshy masses; mc a/w brca)
3 benign inflammatory conditions of the breast
- mammary duct ectasia (dirty white, green or black discharge)
- fat necrosis
- mastitis (lactation & periductal/smokers)
(inflammatory breast cancer = ductal or lobular cancer that gets into the lymphatic system and causes blockage)
6 breast carcinoma risk factors
- female
- over 80 y/o
- 1st degree relative w/breast ca (mother, sister, daughter)
- increased estrogen exposure (early menarche/late menopause)
- obesity
- first child > 35y/o, no children and/or no breast feeding
why does the nipple form this crust in paget’s disease of the breast?
dcis cells penetrate lactiferous ducts –> extends to nipple –> fluid leaks out and forms crust
(rare presentation of breast cancer, usually invasive carcinoma)
2 histologic features of medullary carcinoma of the breast
- syncytial growth pattern
- large lymphocytic infiltrate
(on palpation: soft fleshy masses; mc a/w brca)
breast-conserving surgery (not a mastectomy, but high-yield)
lumpectomy (wide local excision)
✅ removes tumor with negative margins while preserving most of the breast
✅ always followed by radiation therapy
✅ preferred when:
* tumor is small (<5 cm)
* negative margins can be obtained
* patient can tolerate radiation
causes of gynecomastia
“stacked”
spironolactone
testosterone deficiency
anabolic steroids
cirrhosis
kidney failure
endocrine tumors
drugs (i.e. cimetidine, ketoconazole, finasteride, digoxin)
alcohol can worsen which benign breast mass?
fibrocystic changes
(does not increase cancer risk unless associated with epithelial proliferation or atypia, tx is supportive: low-fat diet, supportive bra)
