pathology Flashcards
BIRADS categories
0
1
2
3
4
4A
4B
4C
5
6
BIRADS 0
incomplete- need additional imaging
BIRADS 1
negative
BIRADS 2
benign
BIRADS 3
probably benign. FU in 6m
BIRADS 4
suspicious
4A- low suspicion
4B- moderate
4C- high
BIRADS 5
highly suggestive of malignancy
BIRADS 6
proven malignancy
a mass found during a mammo will typically be described according to what 3 things
shape, density and margin
when the density in a mass is ___, it is suspicious of cancer
high
3 mass shapes
round
oval
irregular
5 mass margins
circumscribed-round
indistinct-not like any other
spiculated-fingers growing off
obscured-partly seen
micro lobulated-bumpy
3 benign mass margins
circumscribed-round
obscured-partly seen
micro lobulated- bumpy
3 malignant mass margins
micro lobulated- bumpy
indistinct-not like any other
spiculated-fingers growing off
calcifications randomly throughout the breast
diffuse
calcifications occupying a large portion of the breast
regional
few calcifications occupying a small portion of the breast
grouped
calcifications arranged in a line
linear
calcification deposits in a duct and their branches
segmental
calcifications in scar tissue
dystrophic
calcifications typically benign (8)
round
dystrophic
skin calcifications
vascular calcifications
rimed/halo
milk of calcium
rod like
popcorn
calcifications so small and/or hazy that a more specific shape cannot be determined. about 20% biopsied are malignant
amorphous or indistinct
irregular calcifications that are clearly visible. about 15% biopsied are malignant
course heterogeneous
calcifications usually more clearly visible than amorphous forms and are seen to have individual, separate and distinct shapes, without fine linear branching. about 25-40% chance of malignantcy
fine pleomorphic
thin, linear irregular calcifications, may be discontinuous, occasionally branching forms can be seen
fine linear/fine linear branching
a mass with a sac like pocket that contains fluid, air or other substances often circumscribed and can be seen through
cyst
smooth, thin walls and are filled with fluid. US waves pass right through them, indicating there are no solid areas. always benign
simple cysts
contain something besides clear fluid. usually indicates close follow up and sometimes biopsy
complex/complicated cysts
a milk filled cyst common in pregnant or breast feeding women; occur more after breast feeding has stopped; benign
galactocele
benign tumors composed of stromal and epithelial elements
fibroadenoma
a pocket of fat that is encapsulated by a thin fibrous capsule; more common in post menopausal women
lipoma
results from a benign proliferation of fibrous, glandular, and fatty tissue. surrounded by a thin capsule of connective tissue. though of as a breast within a breast.
hamartoma (fibroadenolipoma)
when the lactiferous duct widens, the duct walls thicken and the duct fills with fluid; the milk duct may become blocked or clogged with a thick sticky substance. green black discharge
ductal ectasia
a blood filled swelling caused by trauma to the breast. common after biopsy. not cancerous. can sometimes lead to inflammation, fever, skin discoloration. may leave behind scar tissue that mimics the shape of a breast tumor
hematoma
mostly occurs because of a complication of mastitis
breast abscess and inflammation
damaged or dead tissue; can happen following needle biopsy or surgery; feels like a firm round painless lump; usually goes away by itself
fat necrosis (oil cyst)
small clumps of immune cells that act as filters for the lymphatic system
lymph nodes
a common disorder of the endocrine system in which there is a noncancerous increase in the size of male breast tissue; can be caused by marijuana
gynecomastia
an area of hardening of the breast tissue that can occur as the breast ages; can radiologically mimic malignancy due to its speculated configuration
radial scar
a tumor growing in the ducts inside the nipple with finger like fronds; benign and high risk; felt as a small lump near the nipple; may cause bleeding/discharge; requires surgery to remove
papilloma
cells that look like cancer cells are growing in the lobules but dont grow through the walls of the lobules; not considered a cancer; increases risk of cancer
lobular carcinoma LCIS
increased cellular activity in the ducts or lobes and surrounding tissue. cells have an irregular or nonstandard structure; not a form of BCA but a risk factor
atypical ductal
or
atypical lobular hyperplasia
the presence of abnormal cells inside a milk duct; considered the earliest form of breast cancer; noninvasive, meaning it hasn’t spread out of the milk duct to invade other parts of the breast
ductal carcinoma in situ
cancer that began growing in the duct and breaks the wall of the duct and grows into the fatty tissue of the breast; the most common form of breast cancer representing 80% of all diagnoses
invasive/infiltrating ductal carcinoma
breast cancer that begins in the lobules of the breast; the cancer cells have broken out of the lobule and have the potential to spread; typically doesn’t form a lump; instead, there is a change in the breast that feels like a thickening or fullness in one part and is different from the surrounding tissue
invasive lobular carcinoma
a rare and very aggressive cancer in which the cells block lymph vessels in the skin of the breast; usually starts with reddening and swelling of the breast instead of a lump. a patient may also have warmth, orange peel skin, swelling of lymph nodes, flattening or inversion of the nipple or aching and burning breasts
inflammatory carcinoma
malignant cells extend from the lactiferous ducts to nipple; patient presents with nipple/areolar thickening; associated with or without a mass; can be in situ or invasive. very rare
paget’s disease
cancers arising from connective tissue such as fat, nerves, muscles, cartilage, blood vessels or bone; very rare; begins in the connective tissue that supports the ducts and lobules; presents as a large non-spiculated dense mass
sarcoma
a neoplasm which originates in lymph tissue; it is not actually breast cancer but can be difficult to distinguish from BCA in its early stages; most common symptoms are a painless mass- in right outer quadrant; may have enlarged lymph nodes in neck or armpits
lymphoma
