DIT Breast pathology

Question 1

Mastitis is caused by what and how do you treat?

Answer 1

S aureus

Tx with dicloxacillin and continued breast feeding

NOT DANGEROUS to infant

Question 2

What is fibroadenoma?

Answer 2

Most common breast tumor under 25.

Small firm mass with regular edges

Mobile

Increases in size with estrogen

NOT PRECURSOR

Question 3

How do you recognize non-proliferative changes in breast tissue?

Answer 3

Ages 25-50 and fluctuate with hormone levels. Can be tender and multiple bilateral breast lesions

Question 4

What is intraductal papilloma?

Answer 4

Small tumor inside lactiferous ducts under areola and makes a serous/blood discharge. (maybe straw colored)

tiny cancer risk

Question 5

What is a phyllodes tumor?

Answer 5

large bulky tumor and leaf-like projection on histology

Question 6

What is comedocarinoma?

Answer 6

Caseous necrosis in Ductal carcionma in situ

Think of comedones like acne, it is gross and purulent.

Question 7

What is paget’s of the breast?

Answer 7

Eczema like patches of the nipple. CHECK for ductal carcinoma in situ (confined to duct). PAGET Cells are large cells in epidermis with halo.

Question 8

What are Signet ring cells?

Answer 8

Cells with nucleus pushed to the side. in lobular carcinoma in situ

Also saw it with Kruckenberg tumors!

Question 9

What type of breast tumor is almost always P+ and E+?

Answer 9

Lobular carcionma in situ

Question 10

Does LCIS progress to invasive cancer?

Answer 10

CAn’t tell

DCIS will break through eventually. Always take out DCIS

LCIS may not have to take out cells, b/c sporadic carcinoma is often reoccurring.

Question 11

What is invasive ductal carcinoma?

Answer 11

Firm, rock hard mass. Duct like cells. Will feel like fibroadenoma EXCEPT these won’t move b/c infiltrating into tissues around it.

Most common and worst!

Question 12

What is invasive lobular carcinoma?

Answer 12

Inactivation of E-cadherin (makes it malignant)

ER+ and PR +

Will have signet ring cells again

Question 13

What is medullary carcinoma?

Answer 13

fleshy cellular mass with lymphocytic infiltrate. Good prognosis

Question 14

What is inflammatory carcinoma?

Answer 14

Invasion of dermal lymphatics causes visible inflammatory changes

Peua d’orange
Dimpling of breasts
nipple retraction

Question 15

Tamoxifen mechanism? risks?

Answer 15

Estrogen antagonist in breast tissue (LCIS)

Estrogen agonist in endometrial tissue (careful for endometrial tissue)

Question 16

Raloxifene mechanism? risks?

Answer 16

Estrogen agonist in bone used for osteoporosis

Antagonist in breast

No risk of endometrial cancer

Question 17

Anastrozole? risks?

Answer 17

Inhibits aromatase so androgen is not made into estrogen

Used for postmenopausal women with breast cancer b/c decreases estrogen load and stim of cancer cells

More osteoporosis risk

Question 18

what drugs cause gynecomastia?

Answer 18

Some Dope Drugs Cause Awesome Knockers

Spironolactone
Dope
Digitalis
Cimetidine
Alcohol
Ketoconazole