PATH - Boob Diseases Flashcards
Fibroadenoma
Most common in women under 35 years
Small, well-defined, mobile mass
INC size and tenderness
with INC estrogen (pregnancy, prior to menstruation)
Risk of cancer is usually not increased
Fibrocystic changes
Most common in premenopausal women>35 years.
Presents with *premenstrual breast pain or lumps
often bilateral and multifocal
Nonproliferative lesions include simple cysts (fluid-filled duct dilation, blue dome), papillary apocrine change/metaplasia, stroll fibrosis
Risk of cancer is usually not increased
Sclerosing adenosis
INC *acini and stromal fibrosis, associated with calcifications
Slight risk for cancer.
Intraductal papilloma
Small papillary tumor within *lactiferous ducts, typically beneath areola.
Most common cause of
*nipple discharge (serous or bloody)
Slight risk for cancer
Epithelial hyperplasia
INC cells in terminal ductal or lobular epithelium
INC risk of carcinoma with atypical cells
Phyllodes tumor
Large mass of *connective tissue and cysts with *“leaf-like” lobulations.
Most common in 5th decade
Some may become malignant
Fat necrosis
Benign, usually painless, lump due to injury to breast tissue
Calcified oil cyst on mammography
necrotic fat and giant cells on biopsy
Up to 50% of patients may not report trauma.
Lactational mastitis
During breastfeeding, INC risk of bacterial infection through cracks in nipple
*S aureus is most common pathogen.
Treat with antibiotics and *continue breastfeeding.
Gynecomastia
Breast enlargement in males due to INC estrogen compared with androgen activity
Physiologic (not pathologic) in newborn, pubertal, and elderly males, but may persist after puberty
Other causes include cirrhosis, hypogonadism (eg, Klinefelter syndrome), testicular tumors, and drugs
(Spironolactone, Hormones, Cimetidine, Ketoconazole: “Some Hormones Create Knockers”).
Ductal carcinoma in situ
DCIS
Noninvasive, Malignant breast tumors
Fills *ductal lumen
Arises from *ductal atypic
Often seen early as micro calcifications on mammography
Early malignancy *without BM
penetration.
Comedocarcinoma
Noninvasive, Malignant breast tumors
Ductal, central necrosis
Subtype of DCIS
Paget disease
Noninvasive, Malignant breast tumors
Results from underlying DCIS or invasive breast cancer
*Eczematous patches on nipple
*Paget cells = intraepithelial adenocarcinoma
cells.
Invasive ductal carcinoma
Invasive, Malignant breast tumors
Firm, fibrous, *“rock-hard” mass with sharp margins and small, glandular, duct-like cells
Grossly, see classic *“stellate” infiltration
Most common (∼ 75% of all breast cancers).
Invasive lobular carcinoma
Invasive, Malignant breast tumors
Orderly row of cells (*“Indian file”), due to DEC *E-cadherin expression.
Often *bilateral with multiple lesions in the same
location.
Medullary carcinoma
Invasive, Malignant breast tumors
Fleshy, cellular, lymphocytic infiltrate
Good prognosis
