Female Genital/Breast Flashcards
pap smear credited with reduction of which cancer?
cervical carcinoma
most important agent in cervical oncogenesis
HPV
low risk HPV serotypes
6,11
high risk HPV serotypes
16,18
HPV interferes with which tumor suppressor gene?
p53
which quadrivalent vaccine confers immunity to HPV types 16 & 18 (70% of cervical cancer) and 6 & 11 (90% of condyloma acuminatum)
gardasil
cervical carcinoma preceded by precancerous (dysplastic) lesion
cervical intraepithelial neoplasia
peak incidence of cervical carcinoma
40-45 years
“genital warts”, sexually transmitted and benign, multiple, HPV types 6 & 11
condyloma acuminatum
STD caused by the spirochete treponema pallidum; main diagnostic tests: VDRL and RPR
syphilis
presence of a chancre at the site of initial inoculation; small papule which enlarges into a painless ulcer with well-defined margins and clean moist base
primary syphilis
generalized lymphadenopathy and a variety of mucocutaneous lesions; lesions can be maculopapular, scaly or pustular; involvement of palms and soles common; typically within 2 months of resolution of the chancre
secondary syphilis
usually after a latent period of 5 yrs or more; 3 categories: cardiovascular, neuro, benign; gummas are focal granulomatous lesions that can occur in multiple organs
tertiary syphilis
common STD, purulent cervicitis typically develops 2-7 days after exposure; vaginal discharge, painful intercourse, dysuria; easily treated with antibiotics
gonorrhea
nongonococcal cervicitis; most commonly reported bacterial STD; caused by a small G-
chlamydia (c. trachomatis)
most common cause of abnormal vaginal discharge; thin, milky vaginal discharge, foul fishy odour; gardenella vaginalis
bacterial vaginosis
eukaryotic organism, parasitic protozoa, STD, burning, itching, malodorous vaginal discharge, can usually be seen on PAP smear
trichomonas vaginalis
most common vaginal and cervical fungal infection; predominantly as yeast buds and forms pseudohyphae
candida
most common in patients using intrauterine contraceptive devices
actinomyces
ground glass nuclei, eosinophilic intranuclear inclusions
herpes
both intranuclear (basophilic) and cytoplasmic inclusions
cytomegalovirus
pelvic pain, adnexal tenderness, fever, vaginal discharge, may induce formation of tubo-ovarian abscess/pyosalpinx; oophoritis, salpingitis; gonococci and chlamydia
pelvic inflammatory disease
also called Stein-Leventhal syndrome; numerous cystic follicles; enlarged ovaries twice their normal size
polycystic ovarian disease
the presence of glands or endometrial stroma in an abnormal location outside uterus; a disorder of reproductive years; responds to hormonal stimulation
endometriosis
common cause of abnormal bleeding; linked to prolonged estrogen stimulation
endometrial hyperplasia
most common invasive carcinoma of the female genital tract; predominately a disease of postmenopausal women; “post-menopausal bleeding”
endometrial carcinoma
tumor of smooth muscle; common during reproductive years; may induce spontaneous aportion
leiomyoma
malignant counterpart of leiomyoma with necrosis
leiomyosarcoma
second most common cancer of the female genital tract: 3 % of all cancers in women
ovarian cancer
account for a disproportionate number of fatal cancers due to presentation at late stage; often asymptomatic until late stages; elevations in CA-125
ovarian cancer
surface epithelial tumor; cystic filled with clear fluid; can be benign
serous tumors
malignant serous tumor
serous cystadenocarcinoma
surface epithelial tumor: closely resemble serous counterparts; 80% are benign
mucinous tumors
germ cell tumors: “dermoid cyst”; mature and immature; may contain elements of all 3 germ layers
teratoma
developmental disorder: may result in supernumerary nipples
milkline remnants
developmental disorder: implications in breast carcinoma
accessory axillary breast tissue
developmental disorder: may be clinically confused with inversion resulting from carcinoma and/or inflammation
congenital inversion of nipple
suspicious findings in mammography
densities, calcifications, nipple-inversion
associated with lactation; breast vulnerable due to fissures induced by nursing; staph and strep species; confusion with inflammatory carcinoma
acute mastitis
erythema, pain, fever, infiltration by neutrophils, necrosis possible
acute mastitis
history of trauma or surgery; presents as painless palpable mass; possible confusion with breast carcinoma
fat necrosis
stromal tumor: most common benign tumor of female breast; occur in reproductive period; size can fluctuate through menstrual cycle; abnormal density and occasionally calcified
fibroadenoma
stromal tumor: “leaf-like”; occur in older age group; most present as palpable masses; high grade lesions behave in malignant manner
phyllodes tumor
benign, non-proliferative changes NOT associated with increased risk of carcinoma
fibrocystic change
most common malignancy in women; 2nd leading cause of cancer death in women
carcinoma of the breast
1/4 of familial breast cancers attributed to mutations in …
BRCA1 and BRCA2
major risk factor of sporadic breast cancer
hormone exposure (estrogen)
all carcinomas are thought to arise from …
the terminal duct lobular unit
1/2 of mammographically detected cancers; malignant cells limited to ducts and lobules by basement membrane
ductal carcinoma in situ
does not produce mammographic findings; most cases will proceed to infiltrating carcinoma; loss of E-cadherin expression
lobular carcinoma in situ
large tumors may be fixed to chest wall; lymphatic blockage may induce “peau d’orange” appearance; by the time carcinoma is palpable 1/2 of patients will have axillary lymph node involvement
infiltrating carcinoma
involvement of dermal lymphatics =
inflammatory carcinoma
drug that inhibits estrogen receptor; for ER, PR positive; used as adjuvant therapy in estrogen receptor positive tumors
tamoxifen
drug for Her2 positive cancers; Her2/neu: member of the epidermal growth factor receptor family; overexpression of Her2/neu seen in some breast and ovarian cancers
trastuzamab
