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Flashcards in Breast Deck (130)
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20

CLinic- Single mobile encapsulated nodule 1-10 cm Gets larger in later part of menstrual cycle, pregnancy Mam- Popcorn calcification

Fibroadenoma

22

Clinic- Periareolar mass Thick white nipple secretion Skin retraction

Duct Ectasia

23

What is HER2 (human epidermal growth factor receptor)

Is a prognostic and predictive marker EGF receptor family Her2/neu oncogene (17q21) regulates cell proliferation, survival, motility, invasion Overexpression has worse clinical outcome

24

HER2/Neu status determines

Response to herceptin (humanized monoclonal antibody directed against cells that express Her2/neu Herceptin does not cross BBB

25

Most common benign tumor of breast

Fibroadenoma

26

Solitary Situated in lactiferous sinuses of nipple Bloody discharge

Large duct papilloma

27

What are the types of noninfiltrating breast ca

Ductal carcinoma in situ Lobular carcinoma in situ (based on architecture)

28

Peak age of breast ca

75-80

29

Equivocal (score 2+) HER2 result

complete intense circumferential membrane staining

30

Lobular carcinoma in situ types

Infiltrating carcinoma Ductal (80%) Lobular (10%) Tubular/Cribiform (6%) Mucinous, medullary, papillary, metaplastic (4-5%)

31

Stroma- Fibrosis • Epithelial proliferation -Mild simple severe atypical ± cysts (micro, macro) • Mammography may show microcalcifications in concretions of secretions or necrosed epithelial cell heaps- mistaken for carcinoma

FCC

31

How to diff fibroadenoma from CA

DX

31

What group is at increased risk for genetic breast ca

Ashkenazi

32

Histo Necrotic center (toothpaste) Intraduct tumor

Comedocarcinoma (high grade DCIS)

33

Major prognostic factors of breast ca

Distant mets In absence of distant mets- axillary lymph node presence

35

Is intraduct papilloma Benign or malignant

Benign

37

Staph infection on breast

Small Localized inflammation under nipple May leave scar

38

Clinic Ipsilateral node Entire lobule distended Lack E-cadherin Noncohesive cells, no pleomorphism or mitoses

Lobular carcinoma in situ

38

Most common lobular carcinoma in situ

Infiltrating duct Ca NST (no special type) (75%)

40

• Sclerosing adenosis • Florid benign hyperplasia • Radial scar/Complex sclerosing lesion • Papilloma • Fibroadenoma with complex features

Proliferative disease without atypia (RR - 1.5-2.0) Epithelial lesions

41

Staging - In situ and pagets

I- up to 2cm, no LN 80% II- 2-5cm + regional LN 65% III >or =5 CM +other LN 40% IV any size + distant met 10% Percentages are 5 year survival

41

Positive (score 3+) HER2 result

Complete, intense, circumferential membrane staining >10% of invasive tumor cells

43

Benign cysts filled by serous fluid often have this blue color when viewed from the outside.

Blue dome cysts found in FCC

44

Where does breast ca metastasize to

Lungs, Bones, Liver, Adrenals may appear 15 years after tx of primary lesion

46

Histo Compressed glands in middle Dialated glands in the periphery Fibrous stroma Double layer of myoepithelial cells

Sclerosing adenosis

47

Simple FCC (no epithelial hyperplasia), FA

Non-proliferative Epithelial lesions (RR – 1)

47

Luminal A

40-55% of ductal carcinomas ER+, HER2/NEU -ve Postmenopausal Slow growing Well differentiation Responds to hormonal tx not ctx

47

Grading based on

Tubule formation Nuclear atypia Mitosis Score these from 1-3

49

Modified Radical processing

pectoralis major muscles include Axillary LNs

51

CLinic- Serous discharge Nipple retracted No inflammation Firm subareolar lump

Intraduct papilloma RR 1.5- 2