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Flashcards in Breast Deck (130)
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52

Markers for comedocarcinoma

Less often ER, PR positive, HER2Neu positive High recurrence rate

53

Breast CA age

Over 40, 25% postmenopausal

54

Sclerosing adenosis age

young

54

Clinic- Spread to leptomeninges, GIT, Gyne, peritoneum May present with duct carcinoma Histo- Single file lines Bulls eye pattern (tumor cells around normal acini and ducts

Lobular carcinoma

56

Intracanalicular fibroadenoma

Elongated compressed distorted ducts

57

Characteristics of Ductal carcinoma in situ

Calcifications Vague palpable mass Malignant clonal population of cells to ducts and lobules, preserved myoepithelial cells Bilateral 10-20%

57

Molecular classification of Ductal carcinoma

Luminal A Luminal B Normal breast like Basal like HER2+

58

Pathogenesis of FCC

Exaggerated,distorted cyclical changes associated with hormonal changes of menstrual cycle • Cysts, Fibrosis, Adenosis - Blue dome cysts - “Milk of calcium

58

Other terms for Duct ectasia

plasma cell mastitis Granulomatous mastitis

59

Pagets is associated to what

DCIS

61

Etiology fibroadenoma

Related to excess estrogen, prepubertal and young women, drugs such as cyclosporine

62

What is the prognosis for inflammatory carcinoma

poor

64

Malignant phyllodes tumour

>10 HPF (high power field) inflitrative borders Mod-marked atypia

65

Clinic- Swollen erythematous breast -> d/t dermal lymphatics Underlying carcinoma diffusely infiltrative

Inflammatory carcinoma

66

Age of lobular carcinoma in situ

Younger women Incidental finding

67

ER/PR testing

Estrogen and progesterone receptor testing Done in all newly dx invasive breast ca

68

Histo- Loose edematous myxoid fibroblastic stroma Mixed pattern

Fibroadenoma

69

Breast ca proliferation stages

I proliferative dz w/o atypia- 2 layers II Atypical ductal hyperplasia- 2 layers w/ nuclei changes III Ductal Carcinoma in situ- multiple layers for epi cells but within meoepithelial cells IV Invasive ductal carcinoma- Epi cells break from myoepithelial cell and spread

70

Common cause of abnormal nipple discharge

Intraduct papilloma

70

Clinic 2.5cm nodule Upper outer quadrant Firm, ill defined borders Skin dimpling Skin adherent to mass Axillary LN enlarged

Carcinoma

71

Breast ca tx

Lumpectomy Simple mastectomy +/- LN dissection Postop irradiation Chemo Immuno (herceptin) Hormone tx (tamoxifen)

72

Pericanalicular fibroadenoma

Oval ducts, surrounded by stroma

73

Polythelia

Accessory nipples along milk line

74

Pathogenesis of duct ectasia

Dilated duct ruptures causing inflammation, plasma cells repleased with histicytes, giant cells , granulomas

75

Her2 positive

7-12% ER-Her2+ Poorly diff, high freq of brain mets

76

What is the most COD malignancy in woment

Lung

78

What has the same invasive freq as DCIS

Lobular carcinoma in stiu

79

Scirrhous- hard dense desmoplasia 3-4cm infltrative edge Cords and nests of cells Necrosis, calcification

Infiltrating duct Ca

80

Clinic- Large pendulous breast Mimics carcinoma

Traumatic fat necrosis

82

Age of duct ectasia

5-6th decade