Breast Pathology Flashcards
In the breast, instead of using dysplasia, we use ___ +/- ___
In the breast, instead of using dysplasia, we use hyperplasia +/- atypia
Usual ductal hyperplasia = too many epithelial cells in the duct, but no atypia
Atypical ductal hyperplasia = too many epithelial cells with atypia
Carcinoma in situ: epithelial cells have features of malignancy, but not invasive.
grading of breast cancer is based on three histologic featues:
- ____ formation
- ___ pleomorphism
- ____ figures (the less the better)
Grading is based on three histologic features:
Tubule formation: more tubule formation the lower the grade
Nuclear pleomorphism: if the cells look a lot like each other and are fairly uniform the lower the grade
Mitotic figures: a count of mitotic figures per a specific area is done, the fewer mitotic figures the better
Lower grade tumors tend to be less aggressive, BUT special types of breast cancer aren’t graded like this because they don’t follow the rules
3 key makrers routingely done on breast cancers to guide therapy
estrogen receptor, progesterone receptor, HER2
Biomarkers
There are three markers routinely done on brease cancers to help guide therapy:
Estrogen receptor: target for ____
Progesterone receptor: often paired with ER
HER2: target for ____
ER-/PR-/HER2-: makes up 15% of breast cancer. These tend to be ___ but also have a better response to ____. Therapies targeting ER/PR/Her2 would NOT be helpful in these patients.
Biomarkers
There are three markers routinely done on brease cancers to help guide therapy:
Estrogen receptor: target for tamoxifen
Progesterone receptor: often paired with ER
HER2: target for herpceptin
Lower grade tumors tend to be ER+.
ER-/PR-/HER2-: makes up 15% of breast cancer. These tend to be aggressive but also have a better response to chemotherapy. Therapies targeting ER/PR/Her2 would NOT be helpful in these patients.
Benign Breast Mass: Fibrocystic Disease
Definition: ____ lesion, basically a distended lobule/collection of lobules
NONPROLIFERATIVE
Benign Breast Mass; Fibroadenoma
Definition: ____ lesion, solid, not cystic
Extremely common
Benign Breast Mass: Fibrocystic Disease
Definition: Epithelial lesion, basically a distended lobule/collection of lobules
NONPROLIFERATIVE
Benign Breast Mass; Fibroadenoma
Definition: Stromal lesion, solid, not cystic
Extremely common
- Describe limitations of Fine Needle Aspiration (FNA) vs core/excisional biopsy in terms of pathology diagnosis
Fine needle aspiration does not include architecture, and therefore makes the definitive diagnosis of invasive carcinoma challenging
Cause of bloody nipple discharge
Similar to polyp in other organs: fibrovascular core with epithelium around it.
There are also papillary carcinomas, so don’t drop guard if you see papillary on a path report.
Intraductal papilloma
Nipple Crusting: Paget’s Disease of the Nipple
An unusual presentation of ____ where the malignant cells extend up ____ ducts and trickle into the skin
The malignant cells disrupt the normal connections between squamous cells so fluid can ooze out and form a crust
Nipple Crusting: Paget’s Disease of the Nipple
An unusual presentation of DCIS where the malignant cells extend up lactiferous ducts and trickle into the skin
The malignant cells disrupt the normal connections between squamous cells so fluid can ooze out and form a crust
Indurated Breast Rash/Peau D’Orange
Indication of ___ breast cancer
Odd pattern of breast cancer growth which infiltrates the ____ of the skin
Causes swelling and can mimic ___/rash
Does not respond to cream or ___
Indurated Breast Rash/Peau D’Orange
Indication of inflammatory breast cancer
Odd pattern of breast cancer growth which infiltrates the lymphatics of the skin
Causes swelling and can mimic cellulitis/rash
Does not respond to cream or antibiotics
