Test 3 Flashcards
refers to a congenital absence of the
breast.
Amastia
denotes conditions in which
more than two breasts have developed.
Polymastia
The most common inflammatory disease of
the breast, usually affecting women who are
lactating and is caused by purulent bacteria,
such as Staph or Strept.
Acute Mastitis
• A rare disease of unknown cause.
• Because it produces small lumps in the breast, it
may mimic cancer, therefore a biopsy may be
indicated.
Chronic Mastitis
A change sometimes mistaken for carcinoma of the breast.
When extensive necrosis occurs from acute
mastitis, the destroyed breast tissue may be
replaced by a fibrous scar, sometimes
accompanied by nipple retraction
Tends to occur as a solitary, sharply localized
process in one breast, and almost all patients
give a history of previous trauma, prior surgical
intervention, or radiation therapy.
Fat Necrosis of the Breast
A term used to describe fibrosis and cysts with
reactive and degenerative changes that occur in
the breast of older women.
Fibrocystic Change of the Breast
Produces palpable lumps in the breast substance,
and histologic signs are found in approx. 50% of
all women whose breasts are examined at biopsy
or autopsy. Does not occur before puberty, and
is unusual to diagnosis the onset clinically in
postmenopausal women.
Fibrocystic Change of the Breast
Fibrocystic Change of the Breast
is related to…
The pathogenesis is related to sex hormones,
estrogen and progesterone which stimulate the
proliferation of cells in the excretory ducts of
the breast and the intralobular stroma.
When it comes to Fibrocystic Change of the Breast It is estimated that only ____% of women between___ and____ years of age have symptoms pertaining to fibrocystic change.
10-15%
20-50
The most constant feature of fibrocystic
change is fibrosis….
These changes may include dense fibrosis,
cystic dilation of ducts, and various ductal
proliferative changes.
Are the most common types of alterations in Fibrocystic Change of the Breast…
Blue Domed Cysts
The only change related to the development of carcinoma when it comes to Fibrocystic Change of the Breast
When the epithelial hyperplasia becomes
multilayered, with atypical nuclear change, this
is referred to as Atypical Epithelial Hyperplasia,
which is the only change related to the
development of carcinoma.
Fibrocystic Changes of the Breast Mammography may reveal…
condensed areas, cysts, and even areas of calcification. Because these calcified areas are indistinguishable from those seen in cancer, biopsy examination is the only safe way to establish a definitive diagnosis.
Typical fibrocystic change does not require
treatment, but it does when…
Atypical epithelial hyperplasia are found,
additional surgical resection is recommended.
most common of the benign tumors.
Fibroadenomas
Describe Fibroadenomas
Typically, they measure 2-5 cm in diameter and
are well-encapsulated spherical nodules, usually
well-circumscribed from the breast parenchyma
and are freely moveable from the surrounding
breast substance.
The two things Fibroadenomas are composed of…
the tumor is composed of
two components: fibrous stroma and glandular
epithelium.
• Tumors of young women that occurs most
commonly in the upper outer quadrant of the breast.
• Well-encapsulated, gray-white tumors that are
easily removed without consequences.
• They do not recur and do not undergo malignant
change; they have an excellent prognosis.
Fibroadenoma
• A neoplastic papillary growth within a milk duct.
• Most are solitary and are found within the principle
lactiferous ducts or sinuses. Presents clinically as a
serous or bloody discharge from the nipple, a small
sub-areolar mass and rarely nipple retraction.
Intraductal Papilloma
Multiple papillomas are associated with an…
Increased risk of papillary carcinomas.Solitary ones are benign. 2-5 together indicate.
is male breast enlargement associated
with hormonal changes in puberty. The enlargement is
secondary to an inordinate proliferation of the excretory
ducts and the surrounding connective tissue. This may
also occur in adulthood owing to an excess of
estrogens, as from cirrhosis or tumors
Gynecomastia
The second most common cancer in women,
behind lung cancer.
Carcinoma of the Breast
It is estimated that __ in __women will develop breast cancer during her life.
1/14
____ new cases of breast cancer
are diagnosed each year and the numbers are
increasing steadily.
180,000
________ women die of breast cancer
every year
46,000
When it comes to Carcinoma of the Breast The most important risk factor points to…
Hormonal and genetic etiologies which may
act concomitantly, and they may also be
paired with some additional unidentified
carcinogenic substances in the environment,
or with some carcinogenic viruses.
Cancer of the Breast-Risk Factors incidence slowly rises after the age of___ years and peaks in postmenopausal women who are about_____ years of age.
35
60
Cancer of the Breast-Risk is Uncommon in______, and______, and is most common in________, espec._______.
Uncommon in Japanese and Chinese
most common in Caucasians especially jews.
Hormonal Factors contributing to Cancer of the Breast
Women who are exposed to estrogens for prolonged periods tend to develop breast cancer more frequently than those who are not.
What is a Nulliparous women?
A women who has not born offspring…
…are at a greater risk for breast cancer than those
who have multiple children, probably because
pregnancy interrupts the cyclic secretion of
ovarian estrogens.
Nulliparous women
The incidence of breast cancers is increased in women who have…
cancer in the other breast, as well as
those who have ovarian or endometrial cancer, maybe because these tumors are hormonally
induced, occurring in women in whom there is hyperestrinism.
A breast cancer risk factor that includes atypical epithelial hyperplasia.
Premalignant Fibrocystic Changes and Multiple Intraductal Papillomatosis
Most malignant breast tumors are of________
origin and are therefore_________.
epithelial
Carcinomas
Most breast carcinomas (____%) occur in the
________ quadrant and approx.____% of breast
cancers are______, underneath the areola.
45%
upper outer
25%
central
20-30% of carcinomas and defined as a malig-
nant population of cells that lack the capacity to
invade through the basement membrane and
therefore no distant spread.
Non-Invasive Intraductal Carcinoma
Non-Invasive Intraductal Carcinoma cells spread through a ductal system and still produce extensive lesions involving a large area of the breast. It is thought to be
It is thought to be a precursor of invasive carcinoma.
Non-Invasive Intraductal Carcinoma AKA
AKA Comedocarcinoma
Seen in breasts removed for fibrocystic
change and is also seen in the vicinity of
invasive carcinoma or can be admixed with
foci of intraductal carcinoma.
Lobular Carcinoma In-Situ
Lobular Carcinoma In-Situ is Frequently a marker for…
invasive ductal or lobular carcinoma.
More than 2/3 of invasive carcinomas
Invasive Ductal Carcinoma
Invasive Ductal Carcinoma appearance.
The tumor appears firm and gritty on
sectioning
An adenocarcinoma that is accompanied by
a very strong “Desmoplastic” reaction
where the tumor cells infiltrating the tissue
are surrounded by dense connective tissue
that is produced by the host in response to
the tumor.
Invasive Ductal Carcinoma
The dense connective tissue pulls on the
adjacent tissue of and Invasive Ductal Carcinoma causes…
causing puckering of the skin
and retraction of the nipple which are typical
signs of a malignant breast lesion.
On palpation, Invasive Ductal Carcinoma these tumors are…
firm and do not
have sharp margins, as they infiltrate into the
surrounding tissues.
Histologically, Ductal Carcinoma are…
malignant duct lining cells in cords, solid nests,
and tubules invading the surrounding stroma.
- 5-10% of all breast cancers.
- Arise from terminal ductules of the acini.
- Tends to be bilateral far more frequently than invasive ductal cancers, and tends to be multicentric within the same breast.
- The tumors are rubbery and poorly circumscribed (no Desmoplasia).
Invasive Lobular Carcinoma
Invasive Lobular Carcinoma are Known for having…
solid nests and sheets arranged in concentric rings about normal ducts, called a Targetoid pattern of
arrangement.
A ductal carcinoma that forms in the nipple and
areolar area, with usually an underlying
carcinoma beneath. Affects the skin of the
nipple, causing ulcers, fissures, discharge
oozing, along with edema and inflammation
surrounding the nipple.
Paget’s Disease of the Breast
Describe Paget’s Disease of the Breast Histologically…
Involvement of the epidermis by malignant,
large clear-staining cells (Pagets cells), from the
underlying cancer present beneath the nipple that
is palpable in about 60% of cases.
Two common ways breast cancer spreads…
Metastasize via the lymphatics
Become adherent to the deep fascia of the chest wall and become fixed in position.
The breast tumors located here may spread into the internal mammary lymph nodes.
Medially or centrally located
common Distant metastases for breast carcinomas
are common in the lungs, liver, bones, brain, and adrenals.
In ___% of cases of breast carcinomas, the
mass lesion is detected by self-examination,
palpation in the clinician’s office, or by
Mammography.
In 80-90%
This technique delivers a biopsy specimen is relatively small and consists of cells that are smeared on a slide
for cytologic examination.
Fine needle aspiration
is the most conservative surgical procedure, as it is limited to resection of the tumor with surrounding fat tissue.
Lumpectomy
refers to removal of the entire breast, which is associated with axillary lymph node resection.
Mastectomy
The cancer consists of relatively small,
localized tumors (less than 2.5 cm in diameter)
without any distant metastases. Surgical
removal of the tumor is associated with an 80%
5 year survival rate.
Stage I Breast Cancer
Tumors measure more than 2.5 cm, but
less than 5 cm. in diameter. There may be
lymph node metastasis, but no evidence of
distant metastasis. 5 yr. survival rate is 65%.
Stage II Breast Cancer
tumors measure more than 5 cm,
with or without regional lymph node spread,
but without distant spread. The 5 year
survival rate is about 40%.
Stage III Breast Cancer
Tumors may be of any size and
may or may not be associated with local
lymph node metastasis, but are associated
with distant metastasis. The 5 year survival
rate is only 10%.
Stage IV Breast Cancer
most breast cancers are _________ and the more favorable variants are less common.
invasive ductal carcinomas
The overall 10 year survival of patients
operated on for breast cancer is in the range of…
50%
Although the sex is determined genetically at
the point of fertilization, the gonads do not acquire male or female characteristics until the_______ week of development.
seventh