Test 3 Flashcards
What is the only finding in fibrocystic condition of the breast that has an increased risk of having carcinoma?
Atypical Epithelial Hyperplasia
What is the most common benign breast tumor? Also seen most commonly in young women?
Fibroadenoma
Describe 2 key features of a fibroadenoma
- Well Encapsulated (2-5 cm in diameter)
2. Freely Movable
Name 2 components of a fibroadenoma
- Fibrous Stroma (resembles normal intralobular stroma enclosing glandular and cystic spaces lined by epithelium)
- Glandular Epithelium
Where area of the breast of fibroadenomas found?
Upper outer quadrant
What breast disease usually affects both breasts, and because the changes are symmetrical, patients may complain mostly of pain, nodularity, and sensitivity on palpation. Small lumps may fluctuate, corresponding to the fluid filled cysts, and even areas of calcification.
Fibrocystic disease - mammography may reveal condensed areas, cysts and even areas of calcification -> indistinguishable from those seen in cancer, biopsy exam needed. Usually no tx necessary unless hyperplasia is found ->lumpectomy
Name for neoplastic papillary growth within a duct.
Intraductal papilloma -> usually solitary and are found with the principle lactiferous ducts or sinuses.
How does an intraductal papilloma present?
with serous or bloody discharge from the nipple, with a small subareolar mass, and sometimes nipple retraction
Multiple papillomas are associated with an __________ risk of papillary carcinomas. Solitary ones are _______.
Increased
Benign
What 3 breast diseases have fibrous tissue?
- Chronic mastitis
- Fibroadenomas
- Gynecomastia/Carcinoma
What disease is characterized by blue-domed cysts?
fibrocystic change of the breast
What is the term for when tumor cells infiltrating the tissue are surrounded by dense CT that is produced by the HOST in response to the tumor.
Desmoplasia
What is the #1 cause of fat necrosis of the breast?
Trauma
What happens over time to the area of trauma in the breast after fat necrosis?
Grossly there is hemorrhage with central fat necrosis which later forms a nodule of gray-white firm tissue with foci of chalk-white debris
Possible confusion with cancer when fibrotic
Name 2 breast conditions what mimic cancer in appearance
- Fat necrosis of the breast
2. Chronic Mastitis
Name for male breast enlargement associated hormonal changes at puberty and its process
Gynecomastia- enlargement is caused by proligeration of the excretory ducts that surround CT. Forms a fibrous cap directly under the areola.
Why would gynecomastia occur in adulthood?
due to an excess of estrogen as from cirrhosis or tumors.
Why does male breast cancer spread more rapidly?
Less adipose tissue to impede the cancer growth
8 Risk factors related to breast cancer
Most importantly -> hormonal and genetic etiologies
- Sex - Females 100x more likely
- Age - incidences rise over 35
- Race - most common in caucasians
- Genetics
- Hormonal- exposed to estrogen for prolonged periods
- Presence of other cancers
- Premalignant Fibrocystic changes and multiple intraductal papilloamtosis
- Obesity, high fat diets, mod alcohol consumption
What is the main difference from invasive and in-situ, is breachment of?
Basement membrane
What is the process called when a biopsy is needed and the sample is too small to establish a definitive diagnosis and the procedure must be repeated? done at initial screening
FNA - fine needle aspiration
________ ______ requires incision of the skin and is usually performed under general anesthesia. Confirms diagnosis of cancer.
Surgical Biopsy (incisional)
Mammogram : Specialized ______ technique that allows detailed examination of the breast with _____ _______ radio graphs. ______ masses can be detected in _____ stages of development even before they are _________ seen as increased density with frequent ________. Smallest tumor can be less than____cm
x-ray low density Tumor early palpable calcification 0.5cm
______: most conservative surgical procedure as it is limited to resection of the tumor with surrounding fat tissue.
Lumpectomy
_______________: removal of breast tissue, skin, areola, nipple, pectoralis, and most of underarm lymph nodes
Modified radical mastectomy
What route do breast cancers metastasize via?
Lymphatics - bc most lymph ducts drain into the axillary lymph nodes, it is expected that most metastases are found in the axillary area
Most common metastases sites?
Lungs, liver, BONES, brain, and adrenals
What is the other name for sertoli cells?
Sustenticular Cells
What is the function of sertoli cells?
Support and nutrition of the spermatozoa, located between the germ cells. “inside”
Which 3 male glands produce the largest amount of seminal fluid?
- Seminal Vesicles 60%
- Prostate 13-30%
- Cowpers (bulbourethral) gland 7-10%
________: lined with ciliated pseudostratified columnar epithelium and their walls contain smooth muscle
Epididymis
____________: Lined by pseduostratified epithelium with a heavy coat of three muscle layers that propel the sperm towards the urethra by peristalsis
Vas Deferens
A congenital malpositioning of the testes outside of their normal scrotal location - it is the most important of the congentital abnormalities.
Crytorchidism
If crytorchidism is left untreated, it can cause what malignant and non malignant complications?
Non malignant -> infertile
Malignant -> Seminomas and Embryonal Carcinomas
Type of surgery done on babies born with crytorchidism before the age of 2. Generally prevents any future complication
orchiopexy
What 2 types of cancers are 10-35 times more likely in untreated cases of cryptorchidism?
- Seminoma
2. Embryonal Carcinoma