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Flashcards in breast Deck (54):
1

myoepithelium

BM equivalent for invasion of CA
stains with S100
does not have ERs
oxytocin causes contraction

2

inverted nipple

congenital- higher risk of lactiferous sinus obstruction and inflammation and difficulty breastfeeding
acquires- must R/O CA

3

lactational mastitis

1st month postpartum
segmental acute inflammation (10% abscess)
typically S. aureus sometimes strep

4

periareolar non-lactational mastitis

mammary duct ectasia
2ndary to obstructed lactiferous sinus at nipple
associated with inverted nipple, and smoking
dilated sinuses -> can rupture -> acute foreign body inflammation -> fistula

5

peripheral non-lacational mastitis

usually associated with underlying condition like DM, RA, steroids, or trauma

6

fat necrosis

secondary to trauma
necrosis of fat cells -> foreign body granulomatous response -> Bx required to confirm

7

progression of ductal CA

hyperplasia -> atypical hyperplasia -> CIS -> IBC

8

fibrocystic change (FCC)

considered an exaggerated physiologic response
1/3 of women 30-50, stops at menopause
presents as mass, pain, or microcalcifications
cysts, adenosis, apocrine metaplasia and fibroiss
NO increased risk of CA

9

proliferative fibrocystic change w/o atypia

-usual epi hyperplasia, same as FCC, but >4cells in thickness
-radial scar -> mimics CA
-intraductal papilloma

10

proliferative fibrocystic change with atypia

atypical ductal hyperplasia
atypical lobular hyperplasia

11

atypical ductal hyperplasia

low grade neoplastic cells (identified by nucelar cytology)
overlap with DCIS
Is DCIS when duct is completely filled with neoplastic cells and entire lesion is >2mm

12

atypical lobular hyperplasia

proliferation of low grade neoplastic cells in lobule
cytologically different from ductal cells and e-cadherin neg
overlap with LCIS

13

hyperplasia w/o atypia increases risk of BCA by how much

2x

14

hyperplasiaw/atypia increases risk of BCA by how much

3-5x

15

high grade DCIS increases risk of BCA by how much

10x

16

typical age of LCIS

44-47

17

typical age of DCIS

54-58

18

clinical signs of LCIS

none

19

clinical signs of DCIS

mass, pain, discharge

20

mammogram signs of LCIS

none

21

mammogram signs of DCIS

microcalcifications

22

invasive lobular carcinoma

must have radiation following excision

23

low grade DCIS

mild nuclear atypia and micropapillary or cribiform architechture

24

high grade LCIS

malignant nuclear atypia and solif architecture

25

comedonecoriss

cental tumoral necrosis -> toothpaste finding grossly
necrotic cells are prone to dystrophic calcification

26

microinvasion

invasion <2mm

27

LCIS

cannot be detected grossly or with mammogram
histo- dyshesive architecture with signet-cell morphology and mucin +

28

paget disease

eczematous/red change to nipple and areola d/t underlying DCIS +/- invasion

29

pagets histo

infiltration of epi by malignant glandular cells
mucin+
CEA +
EMA+

30

pagetoid

refers to microscopic finding of upward infiltration of epi by glandular neoplastic cells
also seen in melanoma and SCC

31

risk factors for BCA

E exposure
radiation
breast density
proliferative fibrocystic changes
lifestyle (alcohol, obesity, sedentary)
familial
age

32

life-time E exposure

menarch 35
nullparity
longer breast feeding

33

GAD45

inhibits G1/S and GD/M allowing for DNA repairs

34

Li Fraumeni

p53 mutation
90% chance of BCA <30
sarcomas, brain tumors, osteosarcoma, adrenocortical tumors, leukemia, and others

35

inflammatory BC

worst outcome of all BCA
redness, skin thickening, dermal LVI

36

pT1

tumor <2cm

37

pT2

tumor 2-5cm

38

pT3

tumor is >5cm

39

pNO

no CA in regional nodes

40

pN1

CA found in 2-3 regional nodes

41

pN2

CA in 4-9 nodes

42

pN3

CA spread to 10+ nodes

43

Tamoxifen

competitive antagonist to ER on nuclear DNA

44

Arimidex

used in post-menopausal pts to block adrenal/fat cells from conversion of androgens to estrogens

45

angiosarcomas

usually post radiation

46

lobular stroma neoplasias

fibroadenoma
phyllodes tumor

47

interlobular stoma

fat necrosis
lipoma
fibrous tumor
PASH
fibromatosis
sarcoma

48

fibroadenoma

most common benign tumor of breast
typically 20-40
masses w/ or w/o calcification
gross discrete india-rubber balls with lobular cut surface
biphasic (stoma and epi cells)

49

phyllodes tumors

50-60
palpable masses
rubbery, can be very large
more cellular and mito active then fibroadenomas
low-high grade spectrum

50

low grade phyllodes tumors

local recurrence, need wide surgical margins

51

high grade phyllodes tumors

aggressive local invasion w/hematogenous mets

52

lipoma

benign tumor of fat cells
most common soft tissue disorder of adults
round, circumscribed, soft, mobile, painless

53

gynecomastia

associated with cirrhosis, kleinefelters, E-producing tumors
meds, exogenous E

54

BCA in men

1% rate of women, otherwise the same