Breast Pathology Flashcards
What are the three basic elements of breast?
skin/nipple
ducts/lobules
fibroadipose stroma
young - mostly fibrous stroma
older - largely adipose stroma
What tissue in the breast makes about 90% of breast cancers?
the epithelia within the breast
WHat are two minor non-cystic breast issues we think about?
mastitis
fat necrosis
What are the two major BENIGN tumors of the breast?
fibroadenoma
lipoma
What is the single most common disease of the breast - 60% of women?
fibrocystic disease with cystic change and epithelial hyperplasia - may cause lumps, may be painful
The big bad entity is carcinoma. What are the two GENERAL flavors?
in-situ
invasive
Fibrocystic change is almost always benign, but can progress to carcinoma if associated with what?
atypical epithelial hyperplasia
Uilateral bloody discharge…what’s the usual diagnosis?
intraductal papilloma
What does a fibroadenoma look lke grossly?
circumscribe, rubbery, shite
WHat does fibroadenoma look like microscopically?
staghorn branching ductal epithelium with bland stroma
Where does most breast cancer occur - the duct system or the lobules?
duct system - about 90%
Describe the progression from hyperplasia to carcinoma
- normal duct
- hyperplasia of the epithelium
- hyperplasia becomes atrypical
- progresse sto carcinoma in situ
- breaks out and invades
- enters lymphatics and venous system - metastasize
What does lobular in situ caricnoma look like?
bland cells filling up the lobules with no acini
If you have DCIS, where is the risk for subsequent cancer? What about with LCIS?
DCIS - the same quadrant on the same breast
LCIS - BOTH breasts will have equal risk!
So what is the treatment for LCIS?
usually bilateral mastectomy with chemo or radiation.
How long does it typically take for DCIS to progress to invasive?
usually less than 10 years
How long does it typically take for LCIS to progress to invasive cancer?
over 15 years
What quandrant is most common for cancer to arise?
upper outer quadrant (has the most breast tissue)