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Endo/Repro: Week 6 > Witrak: Breast Diseases > Flashcards

Witrak: Breast Diseases Flashcards

1
Q

functional unit of breast

A

TDLU

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2
Q

layers of epithelium that line lobules and ducts

A
  1. luminal cell layer> milk production

2. myoepithelial layer> contractile fxn propels milk to nipple

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3
Q

hormones that affect breast tissue

A

estrogen and progesterone

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4
Q

happens to breast tissue during pregnancy

A

hyperplasia

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5
Q

bacterial infection of the breast that is usually caused by S. AUREUS and is assoc w/ breast feeding (micro-org enters through fissure)

A

acute mastitis

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6
Q

erythematous breast w/ purulent nipple discharge that can progress to abscess

A

acute mastitis

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7
Q

tx for acute masttis

A

drainage (continue feeding)

DICLOXACILLIN (can continue breast feeding while on this Abx)

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8
Q

breast tissue w/ NECROTIC fat, calcificaitons and GIANT CELLS

A

Fat necrosis d/t trauma

*see abnormal calcifications on mammography

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9
Q

MC benign neoplasm of BREAST

seen in women <35 (PRE-MW)

A

Fibroadenoma

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10
Q

tumor of fibrous tissue and glands

ESTROGEN sensitive> painful during menstruation and grows / preg

A

fibroadenoma

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11
Q

small
well circumscribed
mobile
firm mass

A

fibroadenoma

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12
Q

bloody nipple discharge

A

intraductal paipilloma

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13
Q

papillary growth in LARGE duct made up of TWO cell layers
beneath areola
in PRE-MW

A

intraductal papilloma

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14
Q

can intraductal papilloma increase your risk of carcinoma?

A

yes!

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15
Q

it’s impt to distinguish intraductal papilloma from…

A

papillary carcinoma

DOES NOT have myoepithelial layer

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16
Q

overgrowth of fibrous component of breast tissue that leads to “leaf like” projections

occurs in POST-MW

A

phyllodes tumor

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17
Q

can a phyllodes tumor become malignant?

A

YES

greater chance of this since it occurs in POST MW

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18
Q

MC cancer in women in US

and 2nd MCC of cancer motrality in women

A

breast cancer

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19
Q

breast cancer MC affects

A

POST MW

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20
Q

is it possible to have DCIS and fibrocystic changes at the same time in malignant breast tumors?

A

YES!

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21
Q

most important prognostic factor for malignant breast tumor

A

axillary LN involvement–>indicates metastases

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22
Q

MC location of breast cancer

A

upper OUTER quadrant

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23
Q

medial metastases of cancer goes to what LNs

A

INTRAthoracic LN chain

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24
Q

breast cancer likes to metastasize to…

A

bone
lung
skin
CNS

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25
Q

1st degree relative w/ breast cancer

maternal and paternal family hx

A

both are RF for breast canacer

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26
Q

malignant proliferation of DUCT cells w/ NO INVASION of BM

A

DCIS

27
Q

what does DCIS arise from and what is often seen on mammography?

A

ductal atypia> malignant proliferation of duct cells> DCIS

microcalcifications

28
Q

Does DCIS usually produce a mass?

A

NOOOO

29
Q

2 subtypes of DCIS

A

comedocarcinoma

paget disease

30
Q

ductal atypia>
CENTRAL calcification of dead cells>
ductal CASEOUS NECROSIS

A

comedocarcinoma

31
Q

underlying DCIS that spreads to involve the skin of the nipple

A

Paget disease

32
Q

eczematous patches on nipple

A

paget disease

33
Q

large clear cells in epidermis w/ CLEAR halo

A

Paget disease

34
Q

MC type of invasive carcinoma in the breast

A

ICIS

35
Q

peau d’ orange

A

inflammatory IDCIS> POOR prognosis

36
Q

fleshy cellular IDCIS

A

Medullary

GOOD prognosis

37
Q 
firm
fibrous
rock hard mass
sharp margins
\+
small, glandular, duct like cells
A

Invasive DCIS

38
Q

stellate infiltration

A

IDCIS

39
Q

malignant proliferation of cells in LOBULES w/ NO invasion of BM

A

LCIS

40
Q

dyscohesive cells that lack E Cadherin adhesion proprotein

A

LCIS

41
Q

often forms bilaterally
multiple lesions int eh SMAE location
does NOT produce a mass or calcifications

A

LCIS

42
Q

tx for LCIS

A

tamoxifen

43
Q

orderly row of “indian file cells” d/t decrased cadherin expression
bilateral
multiple

A

Invasive lobular carcionoma

44
Q

90% of the time a lump is…

A

benign

45
Q

clinically can detect lumps

A

> 2 cm

46
Q

mammographically dectect masses

A

<1 cm

47
Q

results in dimpling of skin/retraction

A

advanced tumors

48
Q

detects cancers MUCH earlier than palpation

A

Mammogarphy

49
Q

recommended for HIGH risk women

A

MRI

50
Q

why is it more difficult to screen young women w/ mammography

A

increase in fibrous stroma

51
Q

gold standard dx for breast cancer that defines the EXACT NATURE of abnormality (palpable/mammorgaram)

A

OPEN SURGICAL BIOPSY

52
Q

current standard 1st Bx procedure

A

sterotactic needle core bresat biopsy

53
Q

used to confirm clinically benign cyst or obvious cancer

A

FNA

54
Q

tx for DCIS

A

lumpectomy

+/- radiation

55
Q

can lead to lymphadema nad increase risk of angiosarcoma

A

removing axillary LN

56
Q

tumor < 2 cm

AN negative

A

stage I

57
Q

tumor >2cm
OR
+ but IPSILATERAL mobile axillary nodes

A

stage II

58
Q

extensive axillary nodal disease
supraclavicular node involvement
inflammatory breast cancer

A

stage III

59
Q

metastatic breast cancer

A

stage IV

60
Q

in the past was only used for advanced/recurrent cancer, or pts w/ distant mets

NOW used for in situ, early invasive in conjunction w/ lumpectomy

A

radiation

61
Q

herceptin

A

targets overexpressing Her 2 neu recetpors

*oncogene targeting therapy

62
Q

why is early detection of BC crucial

A

> 1cm have high likelihood of CURE

63
Q

why don’t we do masectomies much anymore

A

lumpectomy alone has basically the SAME results as a total masectomy

64
Q

asssoc w/ male breast cancer:

subareolar mass + nipple discharge

A

BRCA2 mut

klinefelter syndrome

Endo/Repro: Week 6 (8 decks)

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