Malignant breast tumors Flashcards
Malignant breast tumors: characteristics
1) post menopause
2) usually from terminal duct lobular unit
3) overexpression of estrogen/progesteron or HER2, affect therapy and prognosis
4) axillary node involvement=single most important prognostic factor
5) most often upper outer quadrant of breast
Malignant breast tumors: risk factors
1) estrogen exposure
2) increased # of menstrual cycles
3) older age at 1st live birth
4) obesity (adrostenedione ->estrone)
5) BRCA 1 and 2
Malignant breast tumors: types
Non-invasive
1) Ductal carcinoma in situ (+comedocarcinoma)
Invasive
2) invasive ductal
3) invasive lobular
4) medullary
5) inflammatory
6) Paget’s disease
Malignant breast tumors:
Non invasive: Ductal carcinoma in situ (DCIS)
Fills ductal lumen
Arises from ductal hyperplasia
Early malignancy without basement membrane penetration
Malignant breast tumors:
Non invasive: comedocarcinoma
Subtype of DCIS,
Ductal, caseous necrosis
Malignant breast tumors:
Invasive: invasive ductal
Firm, fibrous, rock-hard mass with sharp margin
small, glandular, duct-like cells
Classic “stellate” morphology
Worst and most invasive. Most common (76% of all breast cancers)
Malignant breast tumors:
Invasive: invasive lobular
Orderly row of cells “indian file”
Often bilateral with multiple lesions in the same location.
Malignant breast tumors:
Invasive: medullary
Fleshy, cellular, lymphocytic infiltrate
Good prognosis
Malignant breast tumors:
Invasive: inflammatory
Dermal lymphatic invasion by breast carcinoma
Peau d’orange (breast skin resembles orange peels)
Neoplastic cells block lymphatic drainage
50% survival at 5 years
Malignant breast tumors:
Invasive: Paget’s disease
Eczematous patches on nipple
Paget cells= large cells in epidermis with clear halo
Suggests underlying DCIS
Also seen on vulva
