Breast - Dobson Flashcards
Reproductive age woman (under 35). Small, well-circumscribed, mobile mass. Changes in size and tenderness with menstrual cycle
Cancer risk?
Fibroadenoma
No
Reproductive age woman (> 35). Bilateral and/or multifocal breast pain or lumpiness that changes with menstrual cycle. Fluid-filled dilated ducts, apocrine metaplasia, stromal fibrosis.
Cancer risk?
Fibrocystic changes
No
Palpable breast mass, increased compacted acini w/ stromal fibrosis. Calcifications on mammogram.
Cancer risk?
Sclerosing adenosis
1.5-2x risk
Increased cells in terminal ductal or lobular epithelium.
What means cancer risk?
Epithelial hyperplasia
Atypia
Older reproductive-age, large breast mass, proliferative stroma covered by epithelium, lobulations. Nuclear pleomorphism, stromal overgrowth, high mitotic rate.
Cancer risk?
Phyllodes tumor
Small chance
Painless breast mass, skin thickening or retraction. Neutrophils and macrophages. Giant cells, calcifications, hemosiderin
Fat necrosis
Fever, red painful breast. Eventually develops small masses. Improves w/ antibiotics.
What are the masses?
Acute mastitis
Staph. aureus abscesses
Smoker. Painful red sub-areolar mass that recurs. Inverted nipple.
Characteristic?
Squamous metaplasia of lactiferous ducts
Fistula tract, opens onto skin at areola edge
Middle age woman, multiple kids. Palpable peri-areolar mass. Thick white nipple secretions. Numerous lipid-laden macrophages. Inflammation
Duct ectasia
Causes of gynecomastia (males)
Liver cirrhosis
Klinefelter syndrome (hypogonadism)
Testicular tumor
Drugs (various)
Most important risk factor for breast cancer
1st degree family history
Most important prognostic factor for breast cancer
LN involvement (or metastasis)
