Breast (Robbins) Flashcards
Apocrine metaplasia
Calcifications with densities
Does not cause cancer!
Abundant pink cytoplasm
Fibrocytic change
Painless or painful, non-movable, dilated ducts, in premenopausal women
Screen for breast cancer
Mammary duct ectasia
Dilated ducts, greenish-brown nipple discharge
Mass present!
Multiparous postmenopausal women
Periductal mastitis
Think smokers! Due to Vit A deficiency
Subareolar mass+ nipple retraction
Intraductal Papilloma
Premenopausal women with bloody nipple discharge
Finger-like projection lined by epithelial and myoepithelial cells
Intranodular cirrhosis
Can lead to bilateral gynecomastia
Seen in alcoholics
Most significant risk factor for lobular carcinoma
Atypical hyperplasia
Trastuzumab
Rx for HER2/neu BC (-ve for ER/PR)
HER2/neu
Epidermal growth factor
Type A Luminal BC
ER +ve, HER2 -ve.
Low risk of recurrence. Responsive to estrogen therapy
DCIS
My not produce a mass, large atypical cells in cribriform pattern
Does Paget disease of the breast represent an underlying carcinoma?
Yes!
Eczematous nipple
LoBular CIS
Tends to be BILATERAL, ill-defined
Single file metastasis
No E-cadherin
Infiltrating Ductal carcinomas tend to produce what symptoms in what patients
Axillary lymphadenopathy and unilateral breast mass
Medullary carcinoma
High in BRCA1 patients, poorly differentiated, triple negative, lymphoid infiltrates
Major risk factor for male breast cancer
Old age
Rx for triple negative NST no special type BC
Chemotherapy
Why? Too aggressive for surgery and radiation
Nipple retraction is seen in which 2 conditions?
Chronic mastitis and infiltrating ductal carcinoma
Infiltrating ductal carcinoma
Orange peel+ nipple retraction
What hormone can cause the shrinkage of a fibroadenoma?
Estrogen
Do fibroadenomas increase in pregnancy?
Yes
How are breasts related to sweat glands?
They are modified sweat glands
What types of cell layers are found in normal breast tissue?
A luminal (inner) cell layer and a myoepithelial cell layer
When do breasts become hormone sensitive?
After menarche
What changes are seen in breast during menstruation? Why?
They are tender
Due to increased estrogen and progesterone
What changes are seen in breast during pregnancy? Why?
Hyperplasia. To prepare for milk production
What changes are seen in breast during menopause? Why?
Atrophy
No progesterone or estrogen
Which quadrant of the breast has the most breast tissue?
Upper outer quadrant
Define galactorrhea
Milk let down outside of lactation.
Is galctorrhea cancer-related?
No
What causes galactorrhea?
Prolactinoma drugs and nipple stimulation
Acute mastitis common cause
S. aureus
Acute mastitis presentation
Warm, erythematous skin, (?) pruritic
Could lead to abscess formation
Fat necrosis findings
Mass on PE, calcifications on mammogram.
Giant cells on histology
Fibrocystic change definition
Cystic (fibrosis) change of TDLUs
Common in premenopausal women
Fibrocystic change presentation
Blue benign cells
No increased risk for cancer
How much does ductal hyperplasia increase cancer?
2x increased risk of developing invasive BC
Sclerosing adenosis
Fibrosis (Sclerosing) + Increased number of glands (adenosis)
Atypical hyperplasia
Increased risk of bilateral invasive breast cancer
Phyllodes tumor
Fibroadenoma with more proliferation of stroma
Leaf-like projections
