BREAST | GOLJAN Flashcards
define : apocrine metaplasia
seen in ?
presence of large, pink cells
seen in FCC - epithelial hyperplasia
greenish brown nipple discharge
plasma cell mastitis AKA mammillary duct ectasia
define: galactorrhea
causes
milky discharge from nipple
- prolactinoma - MC
- hypothyroidism - TRH stimulates prolactin
bloody nipple discharge
intraductal papilloma
ductal cancer
locations of breast pathology
- areola/nipple
- lactiferous sinus
- major duct
- terminal duct
- lobule
- stroma
which pathology is seen in STROMA?
fibroadenoma
phyllodes tumor
which pathology is seen in AREOLA/NIPPLE?
breast abscess
paget’s disease of the nipple
which pathology is seen in LACTIFEROUS SINUS?
breast abscess
intraductal papilloma
plasma cell mastitis
which pathology is seen in MAJOR DUCT?
ductal cancer
FCC*
which pathology is seen in TERMINAL DUCT?
tubular carcinoma
which pathology is seen in LOBULE?
lobular carcinoma sclerosing adenosis (FCC)
*mondor disease
superficial thrombophlebitis of veins overlying the breast
seen as a palpable, painful cord
MCC of breast pain <50
FCC
types of FCC
- fibrous
- cystic
- sclerosing adenosis
- ductal hyperplasia
describe - cystic FCC
cysts hemorrhage
*blue-domed cysts
which type of FCC is mistaken for cancer?
sclerosing adenosis
- b/c of microcalcifications
describe : traumatic fat necrosis
trauma to breast leads to fibrosis and dystrophic calcification
acute- painful mass
chronic- painless indurated mass
lipid laden macrophages with giant foreign body cells
MC breast tumor in women <35
fibroadenoma
describe : fibroadenoma
discrete painful or painless movable tumor
multiple lesions / bilateral - LUMPY BUMPY
located in stroma
estrogen sensitive - size changes accordingly
seen in post renal transplant women
describe : phyllodes tumor
large bulky tumor \ lobules with cysts
LEAF LIKE projections
located in stroma
location of : intraductal papilloma
lactiferous duct
MCC of acute mastitis
staph aureus
red, swollen, painful breast
breast feeding!
*clinical findings in breast cancer
painless mass
painless axillary LAD
skin \ nipple retraction \ discharge
non invasive breast cancer types
DCIS
LCIS
describe DCIS
ductal carcinoma in situ
non palpable
seen on mammogram b/c of microcalcifications
which non invasive cancer shows CASEOUS NECROSIS
comedocarcinoma - DCIS
which non invasive cancer has lacks E-CADHERIN
LCIS
describe LCIS
lobular carcinoma in situ
non palpable
NO calcifications and therefore cant be identified
*cancer in opposite breast
name the INVASIVE types of breast cancer
invasive ductal carcinoma invasive lobular carcinoma Paget disease of the nipple medullary carcinoma inflammatory carcinoma
stellate morphology
invasive ductal carcinoma
describe : invasive ductal carcinoma
stellate morphology firm, fibrous, ROCK HARD mass gray-white color MC type of all breast cancers gritty on cut surface
describe : invasive lobular carcinoma
usually bilateral
“L in lobular”
neoplastic cells are either arranged Linearly ( indian file)
or in Lobules ( bulls eye )
describe : PAGET disease of the nipple
eczematous patches on nipple
with or w/o nipple retraction
extension of DCIS
*paget cells
large cells in epidermis with clear halo
describe : medullary carcinoma
bulky, soft, fleshy tumor
w LYMPHOCTYIC infiltrate
BRCA1
good prognosis
the “medulla” is usually bulky, soft, and filled w/ cells
describe : inflammatory carcinoma*
invasion of lymphatics by carcinoma causes lymphedema this prevents sweat glands from closing leading to ERYTHEMATOUS breast with PEAU D'ORANGE poor prognosis b/c of invasion
peau d’ orange
inflammatory carcinoma
lacks e-cadherin
LCIS
bulls eye appearance
invasive lobular carcinoma
lymphocytic infiltrate
medullary carcinoma
