Breast Path Flashcards
Discharge (Purulent, Green/Brown, Bloody)
Purulent: Acute Mastitis
Green/Brown: Plasma Cell Mastitis/Chronic Mastitis (Duct Ectasia)
Bloody: Intraductal Papilloma (or carcinoma!)
Nipple Retraction
Benign: Periductal Mastitis aka recurrent subareolar abscess (Vit A, smokers)
CA: IDC
Histol feature to distinguish IDC vs ILC and why
Formation of ducts in IDC, none in ILC due to lack of E-cadherin
Calcification seen in …
Fat necrosis (Benign) - ILL DEFINED MASS Sclerosing adenosis (Benign but 2x risk of invasive carcinoma) DCIS (carcinoma)
Does Apocrine Metaplasia increase CA risk?
NO!
Does Fibroadenoma increase CA risk? (And how does it differ from CA in appearance)
NO! - mobile, encapsulated, well circumscribed as opposed to ill defined - origin in TDLU
Normal breast (& benign lesions) have how many epithelial layers compared to CA?
2 to 1
Inflamed breast could be acute mastitis unless …
Does not respond to ABX, and CA seen in dermal lymphatics - then it is INFLAMMATORY IDC (poor prog)
Does Atypical hyperplasia increase CA risk?
YES - 5x - and in BOTH breasts regardless of where initial hyperplasia was found
Chronic Mastitis
NON BACTERIAL
Either plasma cell, or foamy histocytosis –> granuloma
Does Fibrocystic change increase CA risk?
It can innocuous or pre-malignant - unlike fibroadenoma
Male breast has no _____ and neither does pre-pubetry female
lobules
Can phyllodes tumor be malignant?
Yes - if you see mitotic figures
DCIS risk for ….
LCIS risk for ….
IDC
IDC or ILC in either breast
Proliferative vs non-proliferative fibrocystic change depends on …
Presence of epithelial hyperplasia
Sclerosing adenosis is fibrocystic change without the …
What do you see?
cysts
You see solid cords of cells, a hard rubbery mass BUT it still has two-epi-layers
BRCA1 vs BRCA2
BRCA1 ovarian and breast
BRCA2 men
Comedo DCIS
classic, dark necrotic center, target on histol
