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Pediatric and Superficial Structures > Malignant Breast Pathology > Flashcards

Malignant Breast Pathology Flashcards

1
Q

Where do the majority of breast cancers occur? (hint: quadrants)

A

UOQ

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2
Q

What are the risk factors of breast CA?

A
  1. Increased age
  2. Female
  3. History of breast CA
  4. BRCA 1 and BRCA 2 genes
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3
Q

T or F? Breast CA is the leading cause of cancer in women?

A

FALSE: it’s the 2nd most common

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4
Q

What is non-invasive breast cancer termed?

A

Carcinoma in-situ

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5
Q

What are the two types of non-invasive carcinomas?

A

Lobular carcinoma in situ (LCIS)
Ductal carcinoma in situ (DCIS)

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6
Q

What is the most common non-invasive cancer?

A

DCIS - ductal carcinoma in situ

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7
Q

What is the difference between LCIS and DCIS?

A

LCIS is confined to the lobules or ducts within the lobules

DCIS is confined to within the DUCTS either in the lobules or surrounding lobules

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8
Q

Where are malignant cells located in DCIS?

A

Confined within the ducts and does not surround outside tissue

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9
Q

What is the earliest form of cancer that can be detected on ultrasound?

A

DCIS

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10
Q

SF of ductal carcinoma in situ (DCIS)?

A
  1. Microcalcifications
  2. Distension of ducts
  3. Hypoechoic mass
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11
Q

What is Paget disease?

A

Cancer of the epidermis of the nipple

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12
Q

What are patient symptoms of Paget disease?

A
  1. Nipple discharge
  2. Itching
  3. Eczema like crusting of nipple or redness
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13
Q

What does it mean when breast cancer is invasive?

A

It has spread to other tissues

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14
Q

What are two ways breast cancer can spread?

A
  1. Via blood
  2. Via lymphatics
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15
Q

What is the most common breast cancer?

A

Invasive ductal carcinoma (IDC)

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16
Q

Do invasive ductal carcinomas have a good prognosis?

A

NO

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17
Q

Which quadrant of the breast does IDC usually occur?

A

UOQ

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18
Q

SF of IDC?

A
  1. Hypoechoic
  2. Spiculated
  3. Irregular shaped
  4. Microcalcifications
  5. Shadowing
  6. Non-parallel
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19
Q

What is the second most invasive breast malignancy?

A

Invasive lobular carcinoma (ILC)

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20
Q

Why does ILC have higher rates of being multifocal, multicentric and bilateral than IDC?

A

Because it’s diffuse rather than focal

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21
Q

SF of invasive lobular carcinoma (ILC)?

A
  1. Hypoechoic
  2. Spiculated
  3. Irregular, ill-defined
  4. Shadowing
  5. NO calcifications
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22
Q

What are major differences in SF between IDC and ILC?

A

IDC - mass like and has calcifications and a symptom is bloody nipple discharge

ILC - diffuse and no calcifications and “shrinking” of the breast

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23
Q

What are the four types of special-type invasive ductal carcinomas?

A
  1. Papillary
  2. Medullary
  3. Tubular
  4. Colloid
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24
Q

Patient symptoms of Medullary carcinoma?

A
  1. Palpable
  2. Mobile
  3. Soft
  4. Grows rapidly
  5. UOQ
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25
SF of medullary carcinoma?
1. Hypoechoic 2. Well-circumscribed 3. Lobulations 4. Round 5. Vascularity 6. Central necrosis
26
In what population is medullary carcinoma most common?
Before age 50
27
Colloid carcinoma is also known as?
Mucinous carcinoma
28
In what population is colloid carcinoma most common?
Elderly women
29
Is colloid carcinoma slow or fast growing?
SLOW growing
30
SF of colloid carcinoma?
1. Iso-/hypoechoic 2. Well-circumscribd 3. Lobulated 4. Homogenous or mildly heterogenous
31
What carcinoma has a higher incidence in men?
Papillary
32
In what population of women is papillary carcinoma most common?
Elderly women
33
What is the prominent patient symptom for papillary carcinoma?
Bloody nipple discharge
34
SF of papillary carcinoma?
1. Overlap of benign and malignant characteristics 2. Prominent vascularity or vascular stalk
35
Intra-cystic types of what cancer contain bloody fluid?
Papillary
36
Common size for tubular carcinoma?
<2cm - slow growing
37
Which carcinoma is also known as prominent reactive fibrosis?
Tubular carcinoma
38
What type of carcinoma occurs when highly invasive CA infiltrates the lymphatics of the skin?
Inflammatory carcinoma
39
What pathology shows signs of "orange peel appearance of the skin"?
Inflammatory carcinoma
40
What can inflammatory carcinoma mimic?
Mastitis
41
SF of inflammatory carcinoma?
1. Edema/thickened skin 2. Hypoechoic shadowing mass 3. Spiculated 4. Hypervascular SURROUNDING tissues
42
What are the 3 routes for METS of the breast?
1. Blood 2. Lymphatics 3. Direct extension
43
Where is the first site of mets spread to with primary breast cancer?
Ipsi-lateral axillary lymph nodes - SLN
44
What lymph node is at most risk of metastases?
Sentinel node (SN)
45
What other organs are the most frequent for breast cancer to spread?
1. Bone 2. Liver 3. Lung 4. Brain
46
What is the most common metastases site FROM the breast?
Axillary lymph node - Sentinel Node
47
What is the most common and 2nd most common metastases site TO the breast?
1. M/C = The contralateral breast 2. 2nd M/C = melanoma
48
SF of suspicious lymph nodes?
1. Node enlargement 2. Loss of fatty hilum 3. Rounded shape 4. Hypoechoic or heterogenous
49
What is the normal size of a benign intra-mammary lymph node?
< or = 1cm
50
What is the most common male breast abnormality?
Gynecomastia
51
Cause of gynecomastia?
Abnormal estrogen to testosterone levels
52
Gynecomastia vs. pseudo-gynecomastia?
Gynecomastia = proliferation of ductal tissues Pseudo-gynecomastia = Fatty deposits WITHOUT tissue proliferation
53
T or F? Pseudo-gynecomastia is a normal variant?
TRUE
54
SF of gynecomastia
1. Hypoechoic 2. Triangular area beneath areola
55
What is the most common primary breast cancer in men?
IDC
56
Where is primary breast cancer in men usually located?
Beneath the areloa
57
Male age of incidence of breast cancer?
Over 60 years
58
What is male breast cancer strongly associated with? (2)
1. Klinefelter syndrome 2. Genetics
59
Male patient symptoms of breast cancer?
1. Bloody nipple discharge 2. Nipple retraction or ulceration 3. Hard and painless 4. Palpable axillary nodes
60
SF of male breast cancer?
1. Hypoechoic 2. Complex 3. Well-circumscribed 4. Irregular, spiculated 5. Vascular
61
Where do malignant breast masses most commonly originate from?
The ducts (TDLU)
62
What stage (0-3) is DCIS considered to be?
Stage 0
63
Paget disease is often initiated by underlying what?
DCIS within a main subareolar duct

Pediatric and Superficial Structures (23 decks)

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