LC 2 Flashcards
Types of Primary Breast Cancer
Epithelial tumors (carcinoma)
Stromal tumors (sarcoma)
Mixed epithelial/stromal tumors
Lymphoma that starts in breast (rare)
DCIS
Ductal Carcinoma In Situ;
Early malignancy without ductal basement membrane penetration
Paget Disease of the Breast
Subtype of DCIS;
Eczematous patches on nipple
Presents with red, itchy, swollen rash of nipple/areola
LCIS
Lobular Carcinoma In Situ
Atypical hyperplasia
Increased cells in terminal ductal or lobular epithelium;
Increased risk of carcinoma with atypical cells
Phyllodes tumor
Large mass of connective tissue and cysts with “leaf-like” lobulations. Most common in 5th decade. Can become malignant.
Breast Carcinomas in situ
DCIS Comedocarcinoma Paget Disease LCIS Atypical Hyperplasia
Breast Invasive Carcinomas
Invasive ductal carcinoma Invasive lobular carcinoma Tubular Carcinoma Mucinous Carcinoma Medullary Carcinoma
Causes of Breast Sarcomas (stromal tumors)
Spontaneous
Following Radiation Tx
Stewart-Treves Syndrome (chronic edema)
Mixed breast tumors (biphasic; stromal/epithelial)
Fibroadenoma (benign)
Phyllodes tumor
DCIS Path
No BM invasion; Myoepithelial cell layer intact; no blood supply.
Comedocarcinoma
DCIS subtype with central necrosis
Low grade hormonal receptor(s)
ER and PR
High grade hormonal receptor(s)
HER2/neu overexpression (oncogene)
Breast sarcomas
Angiosarcoma
Lymphangiosarcoma
Tubular Carcinoma
Well-differentiated, Usually ER+/PR+ and Her-, excellent prognosis;
Lesion with BILATERAL risk of malignancy
LCIS
Atypical lobular hyperplasia
transformation of the ductal epithelial cells into an apocrine phenotype; commonly found in in the context of fibrocystic change of the breast
Apocrine metaplasia
Cysts/fibrosis without hyperplasia (blue dome cysts); premenopausal women >35yo; premenstrual breast pain or lumps; microcalcifications on mgm, but not diagnostic.
Non-proliferative FCC
leaf-like stromal growth into cystic spaces; large fleshy tumors, two-cell layer epithelium (benign); 30% recurrence within 2 years. Can metastasize to lungs and bones.
Phyllodes tumor
Cysts/fibrosis with epithelial hyperplasia
Proliferative FCC
glandular proliferation, enlargement, and fibrosis (adenosis) compressing/distorting the tubules (ductal/acinar lumens) into cords; no cyst formation; benign and localized, but can mimic invasive carcinoma.
Sclerosis adenosis
Blue-domed cysts
Non-proliferative FCC
Epithelial proliferation in
Atypical lobular hyperplasia
Epithelial proliferation in >50% of lobules
LCIS (Lobular Carcinoma In Situ)
Biphasic tumor of the breast
Tumor composed of both stroma and epithelium
Tumor arising from stromal tissue
Sarcoma
Tumor arising from epithelial tissue
Carcinoma
LCIS is associated with increased risk for:
Invasive Lobular Carcinoma
Invasive Ductal Carcinoma
Required for milk ejection during lactation
Oxytocin (from the hypothalamic terminals in the posterior pituitary)
Regulates lactation by inducing prolactin waves
Suckling
Temporarily reduces fertility by suppressing GnRH
Suckling
Increases risk of inability to initiate or sustain lactation (breastfeeding)
Decreases PRL response to suckling.
Obesity
Increases energy requirement by 20% in pregnant women
Lactation
Benefits of breastfeeding for mother
Reduces breast cancer risk
Benefits of breastfeeding for infant
Passive immunity (IgA) = fewer infections More oligosaccharides than bovine milk (antimicrobial and probiotic) = fewer infections
Risks of breastfeeding for infant
Vitamin D deficiency
