breast pathology Flashcards
List three examples of non-proliferative breast changes
- Cyst formation , often with apocrine metaplasia
- Fibrosis
- Adenosis
What is fibrosis
cysts frequently rupture, with release of secretory material into the adjacent stroma. The resulting hronci inflammation and fibrous scarring contibute to the palpable firmness of the breast
What is adenosis
Adenosis is defined as an increase in the number of acini per lobule. The acini are often enlarged (blunt duct andosis) adn are not distorted as is seen in sclerosis adeosis.
WHta histology is associated with BRCA 1/2 breast cancers
- BRCA 1= commonly poorly differntiated, have medullary features and do not express hormone receptors or HER2/neu. Their gene profile signifture is similar to basal like breast cancers,.
- BRCA 2 = poorly differentiated but more commonly estrogen receptor positive
Descrieb the four moelcular sub types of breast clinic
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Defien the hallmarks of lobular carcinoma
The morphologic features of lobular carcinoma differ from those of ductal carcinoma. ILC is characterized by small, round cells that are bland in appearance and have scant cytoplasm, which infiltrate the stroma in single file and surround benign breast tissues in a targeted manner
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Important histopatholgoical features of invasive ductal carcinoma
nvasive ductal carcinoma is the most commonly diagnosed breast cancer and has a tendency to metastasize via lymphatics. This lesion, which accounts for 75% of breast cancers, has no specific histologic characteristics other than invasion through the basement membrane of a breast duct, as seen in the image below.
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Mucinois (Colloid) carcinoma
The tumoru cells are seen as clusters and small islands o cells within large lakes of mucin that push into the adjacent stroma
Tubular carcinoma
These tumours consits exclusively of well formed tubules. However, a myoepthielial cell layer is absent and tumour cells ar ein direct contact with stroma
Invasive papillary carcinoma
Invasive carcinomas with a papillary architecture are rare and represent and represent 1% or fwer of all invasive cancers. Ppaillary architecture is more commonly seen is DCIS
Metaplastic carcinoma
“Metaplastic carcinoma” includes a wide variety of rare types of breast cancer (<1%), incluing conventional adenocarinomas with a chondroid stroma, squamous cell carcinomas amd carcinomas with a prominent spindle cell component that might be difficult to distinguish from sarcomas. Some of these carcinomas express genes in common with myoepithelial cells and likely ot arise from this cell type
WHta is the most commo breast symptom in cancer
- Pain (mastalgia or mastodynia)
- 2nd most is palpable masses
- The nipple discharge but concern when spontaneous and unilateral.
- Desnities - solid massess or calcifications.
Calcifications - whata re they associate with in the breast
Calcificaitons are associatd with secretory material. necrotic debris and hyalinalised stroma. They are associated with malignancy and are then commonly small, irregular, numerous and clustere dor linear and branching.
WHta is the most common malignancy associated with calcifications
DCIS
Most common breast cancer
Adenocarnimoas (95% ish)
Key prognostic features of breast cancer
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Pagets disease
Infiltration of the nipple by large cells with clear cytoplasm is diagnostic of pagets disease. These cells are usually found both singly and in small clisters in the peidermis. Pagets disease is always associated with an undelrying intraductal carcnimoa that extends to infiltrate the skin of the nipple and areola. Paget cells may resemnle cells of superficisl spreading melanoma, but they are PAS positive and diastase resistan (despite resembling cells of superifcil spreading melanoma)
Poorest prognosis breats cancer
Intraductal carcinoma is most common carcinoma of breast and carries poor prognosis.
(What is a kruken berg tumour)
- Metastatic ovarian malignancy whose primary site arose in GI tarct or breast. Mucin secreting signet ring cells,
- Stoamch sit eh primary site in most of the cases of Krukenberg tumour