pathology of the breast Flashcards
what is the normal structure of the breast
epithelial - ducts and lobes
mesenchymal fat and fibrous tissue
hormone dependent ER, PR
physiological changes with age and pregnancy
what are benign breast conditions
fibrocystic change
fibroadenoma
intraductal papilloma
fat necrosis
duct ectasia
what is fibroadenoma
proliferation of epithelial and stromal elements
most common breast tumour in adolescent and young adult women
well circumscribed, freely mobile, non painful mass
may regress if untreated
ducts distorted elongated - slit like structures - intracanalicular pattern, ducts not compressed - pericanalicular growth pattern
intraductal papilloma
middle aged women
nipple discharge
epithelial hyperplasia
fat necrosis
stimulate carcinoma clinically and mammorgraphically
history atecedent trauma per surgical intervention
histiocytes with foamy cytoplasm
lipid filled cyts
fibrosis calcifications
phyllodes tumour
fleshy tumour leaf like pattern
circumscribed connective tissue and epithelial elements
metastases are haematogeneoous
genes causative of breast cancer
BRCA1
BRCA2
TP53
PTEN
histological classification of breast cancer
non invasive
ductal and lobular carcinoma in situ
invasive
in situ carcinoma
preinvasibe does not form palpable tumour
not detected clinically
multicentricity and bilaterality
no metastatic spread
risk of invasion depend on grade
in situ cancer risk of progression
low grade DCIS 30% in 15 years
high grade DCIS 50% in 8 years
LCIS 19% in 25 years
diagnostivc procedures
clinical examination
radiology
FNA
needle core biopsy
diagnostic excision
spread of breast cancer
local - skin pectoral muscles
lymphatic capillary and internal mammary nodes
blood - bone lungs liver brain
important molecular markers
ER?PR strong predictors of response to hormonal therapies
ER/PR negative tumour do not respond
HER 2 about 20-30 % positive predicts response
molecular classification through gene expression technology
ER and luminal A
luminal B
basal
Her 2
normal breast
