Wednesday - breast disease - Witrak

Question 1

common benign tumor of breast under 30 y/o

Answer 1

fibroadenoma

Question 2

lump in reproductive age woman that is worse during period

Answer 2

fibrocystic disease
20% have this grossly
60% have it microscopically
can lead to cancer if there is epithelial hyperplasia

Question 3

is breast cancer usually in ducts or lobules

Answer 3

ducts

Question 4

fibrous change vs cancer on mamogram

Answer 4

fibrous change is well circumscribed

Question 5

lobular carcinoma cells

Answer 5

usually smaller cells than ductal carcinomas.
moratility is high if it becomes invasive
LCIS - invasive
don’t actually look bad on histo

Question 6

age profile of LCIS

chance at subsequent cancer

Answer 6

premenopausal

20-30% - bilaterally. so consider bilateral mastectomy

Question 7

DCIS usually becuases invasive where?

Answer 7

same stop you found it.

Question 8

half of people with invasive ductal carcinoma also have what

Answer 8

DCIS contralateral

Question 9

pagets disease of nipple

Answer 9

tumor that is infiltrating the nipple
underlying breast cancer cells in the epidermis. they’re larger, with a light ring around them

crusty discolored nipple

Question 10

2 main risk factors for breast cancer

some others

Answer 10

estrogen
genetics
- brca1 or 2
- need to consider male genetics too

no kids, or late kids
fibrous change

Question 11

Most common tumor in US

Answer 11

breast

it’s the second cause of death next to lung

Question 12

at first - we would cure breast cancer by taking out breast and lymph nodes

then, we thought it was already spread by the time it presented - so treat systemically

now what do we do

Answer 12

catch early

minimal surgery

Question 13

mammograpy’s efficacy

Answer 13

of 25% of suspicious are actually cancer

best in older people (young people have more fibrous tissue)

Question 14

diagnosis

Answer 14

needle core biopsy

Question 15

surgical tx

Answer 15

lumpectomy

lumpectomy and node sample

lumpectomy then mastectomy

Question 16

staging

Answer 16

stage 1 = less than 2 cm, no nodes
2 - over 2cm or ipsilateral nodes
3 - lots of node and goes to chest
4 - metastatic

Question 17

radiation is used when

Answer 17

in-situ and early invasive. use with lumpectomy

Question 18

chemo

Answer 18

estrogen antagonists
and general cytotoxic

herceptin - monoclonal agains HER2. also called trastuzomab

Question 19

phylloides tumor

Answer 19

low to high grade malignant tumor. “leaf like” - soft spongy cystic

Question 20

gynecomastia

Answer 20

due to increased estrogen

- tumors that produce it

Question 21

was this lecture garbage covered in shitty shit?

Answer 21

oh, yeah! Yeah, it was that.