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OBGYN > Breast Pathology > Flashcards

Breast Pathology Flashcards

1
Q

What are the non-invasive malignant tumors of the breast?

A

DCIS
ComedoCA
Paget Disease

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2
Q

What are the invasive malignant tumors of the breast?

A

Invasive Ductal (76-79%)
Invasive lobular
Medullary
Inflammatory

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3
Q

What are the risk factors of Malignant Breast tumors?

A 
Inc Estrogen exposure 
Inc number of menstrual cycles
Older age at 1st live birth
Obesity/High fat diet
BRCA1 and BRCA2 gene
African American
Radiation exposure
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4
Q

What are the benign tumors of the Breast?

A

Fibroadenoma
Intraductal Papilloma
Phyllodes tumor

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5
Q

What are the common breast condtions?

A

Proliferative Br disease
Acute mastitis
Fat necrosis
Gynecomastia

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6
Q

What are the common traits of Malignant breast tumors?

A

Postmenopausal
Upper outer quadrant
Overexpression of est/progest receptors or HER-2
Triple Negative (ER-, PR-, and HER-) more aggressive
Axillary LN involvement indicating mets is MOST IMPORT prognostic factor

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7
Q

What is the common presentation of Breast CA?

A 
Left Breast 
Upper outer quadrant
Painless mass
Skin dimpling, ulceration, nipple retraction
Peau d'orange
Abn Mammogram- Mass/density/microCa++
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8
Q

What is the most common route of spread of Breast CA?

A

Local: Skin, nipple, chest wall
Lymph: LN
Blood: lungs, liver, bones

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9
Q

What is the most important prognostic factor in Br CA?

A

LN status/Size/Grade

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10
Q

What is DCIS?

A

From ductal atypia
Fills ductal lumen
MicroCa++ on mammogram
Early malignancy w/out BM penetration

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11
Q

What is ComedoCA?

A

Subtype of DCIS
Ductal Caseous Necrosis
Central Necrosis surrounded by CA cells

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12
Q

What is Paget Disease?

A

Results from underlying DCIS
Eczematous patches on nipple
Paget cells: Large cells in epidermis w/ clear halo

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13
Q

What are the gross features of Invasive Ductal CA?

A

Firm, fibrous, Rock hard mass with sharp margins
MOST COMMON
WORST, MOST INVASIVE

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14
Q

What are the Micro features of Invasive Ductal CA?

A

Small, duct like, or glandular cells with collagenous stroma between cells

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15
Q

What are the features of Ivasive Lobular CA?

A

Bilateral with multiple lesions in same location

Orderly Row of Cells (indian file)

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16
Q

What are the Micro Features of Invasve Lobular CA?

A

Indian file strands of neoplastic cells
Small and uniform cells
Dense Stroma

17
Q

What are the features of Medullary CA of breast?

A

Good prognosis

Fleshy, cellular, lymphocytic infiltrate.

18
Q

What is charicteristic of Inflammatory CA of the breast?

A

1) Dermal lymphatic invasion
2) Peau d’orange
3) Neoplastic cells block lymphatic drainage

19
Q

What is the most common Benign breast tumor in Pts

A

Fibroadenoma

20
Q

What are the features of Fibroadenoma?

A

1) Not a precursor to Br CA
2) Small, mobile, firm mass with sharp edges
3) Size and tenderness increase when estrogen is higher

21
Q

WHat are the Microscopic Features of Fibroadenoma?

A

Circumscribed Tumor

Fibroblastic Stroma enclosing glandular structures lined by Epithelium

22
Q

What are the features of Intraductal Papilloma?

A

Beneath Areola
Small mass that grows in lactiferous ducts
Serous or bloody nipple discharge
1.5-2x inc risk for Br CA

23
Q

What is a Phyllodes Tumor?

A 
6th decade
Periductal stomal cells 
grows fast
Bulky mass with cysts 
Leaf-like projections
Some may become malignant
24
Q

What is the most common cause of breast lumps from 25 to MP?

A

Proliferative breast Disease

25
Q

What are the features of Proliferative Br Disease?

A

Premenstrual Br Pain andMultiple lesions
Bilateral
Fluctuation in size
No inc risk of CA

26
Q

What are the Histologic Types of Proliferative Br Disease?

A

SCLEROSING ADENOSIS
EPITHELIAL HYPERPLASIA
Fibrosis
Cystic Changes

27
Q

What are the features of SCLEROSING ADENOSIS?

A

Inc acini and intralobular fibrosis
Associated with Ca++
Confused with CA
Inc Risk of CA devt

28
Q

What are the features of EPITHELIAL HYPERPLASIA?

A

Pt >30yo
Inc in number of Epi cell layers in terminal duct lobules
Inc risk of CA with Atypical cells

29
Q

What are the Most common microbes in Acute mastitis?

A

S. Aureus

Tx with Dicloxacillin and Continue Br Feeding

30
Q

What are the causes of Gynecomastia?

A

Hyperestrogenism
Klinefelter syndrome
Drugs

31
Q

What drugs cause Gynecomastia?

A 
Spironolactone
Marijuana
Digitalis
Estrogen
Cimetidine
Alcohol
Heroin
D2 antagonists 
Ketoconazole
32
Q

What are the causes of Hyperestogenism?

A

Cirrhosis
Testicular tumor
Puberty
Old Age

OBGYN (18 decks)

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