Breast patho 0514FA Flashcards
fibroadenoma
benign breast tumor. small mobile firm mass. sharp edges. MOST COMMON in pts < 35 yo. not a cancer precursor.
what happens to fibroadenoma in increased estrogen states?
increase size and tenderness.
ex: preg, menstruation
intraductal papilloma
benign breast tumor.
small tumor in LACTIFEROUS DUCTS.
typically beneath areola.
1.5-2x risk for carcinoma.
nipple discharge from intraductal papilloma
serous or bloody
phyllodes tumor
benign breast tumor. LARGE bulky mass of conn tissue and cysts. "LEAF LIKE" projections. some may become malignant. most common in 6th decade.
what age group most affected by malignant breast tumors?
postmenopause
what do malignant breast tumors arise from?
mammary duct epith
OR lobular glands
over expression of what receptors affect therapy and prognosis of malignant breast tumors?
- estrogen receptors.
- progesterone receptors.
- erb-B2 (HER-2, an EGF receptor).
what is the single MOST IMPORTANT prognostic factor with malignant breast tumors?
axillary lymph node involvement
where are malignant breast tumors most commonly located?
upper outer quadrant of breast
RF for malignant breast tumors
increase estrogen expo.
increase total #menstrual cycles.
older age at 1st live birth.
obesity.
how does obesity contribute to malignant breast tumors?
adipose tissue = major source of estrogen in postmenopausal women. converts androstenedione to estrone.
so, obesity = increased estrogen.
what cells are lost in malignant breast tumors?
myoepithelial cells - outer layer lining ducts and lobules for contraction
ductal CIS
noninvasive malignant breast tumor.
fills ductal lumen.
arises from ductal hyperplasia.
NO BM PENETRATION.
comedocarcinoma
noninvasive malignant breast tumor.
subtype of DCIS.
CASEOUS NECROSIS.
invasive ductal carcinoma
invasive malignant breast tumor.
firm fibrous rock hard mass with sharp margins and small, glandular duct-like cells.
STELLATE morphology.
which malignant breast tumor has worst prognosis?
invasive ductal- most invasive.
also most common (76%).
invasive lobular carcinoma
invasive malignant breast tumor.
orderly SINGLE FILE row of cells.
often multiple, bilateral.
medullary carcinoma
invasive malignant breast tumor.
DUCTAL subtype.
fleshy, cellular, lymphocytic infiltrate.
good prognosis.
inflammatory carcinoma
invasive malignant breast tumor. DUCTAL subtype. dermal LYMPHATIC invasion by cancer. neoplastic cells block lymph drainage - inflamed swollen breast. PEAU D'ORANGE.
peau d’orange
breast skin resembles orange peel -
pitting edema in SQ tissue, skin thickening around hair follicles
Paget’s disease
invasive malignant breast tumor.
ECZEMATOUS patches on nipple.
suggest underlying carcinoma.
also seen in vulva.
Paget cells
large cells in epidermis with clear halo
fibrocystic disease
most common cause of breast lumps.
age 25 to menopause.
no increased risk of carcinoma.
