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Flashcards in Breast Deck (51):
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Acute Mastitis

breast-feeding -> Staphylococcus aureus infection -> intramammary abscess

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Periductal Mastitis

Smoker, reproductive age, painful mass, Squamous Metaplasia from nipple into ducts, keratin blocks ducts -> Granulomatous inflammatory reaction

4

Mammary Duct Ectasia Clinical Presenation

50-60 y/o, non-smoker, multiparous, cheesy nipple discharge, painless mass

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Mammary Duct Ectasia Histological Presentation

Mucin-plug causing dilation of ducts filled with lipid-laden macrophages + granulomatous inflammation w/ infiltrate of lymphocytes, macrophages and plasma cells

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Fat Necrosis

Trauma, lipid-laden macrophages, granulomatous inflammation, calcifications + crystallized lipid

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Granulomatous Mastitis

Secondary to disease, infection, foreign body

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Cyst Formation

PURE fibrocystic change; blue dome cysts, calcification, apocrine metaplasia

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Fibrosis

PURE fibrocystic change; Cyst rupture -> overproduction of collagen -> fibrosis

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Adenosis

PURE fibrocystic change; Fibrosis + aggregated glands w/ increased acini -> calcifications

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Usual Ductal Epithelium Hyperplasia

Proliferation of ductal epithelium w/ no cytological changes, 2 cell types present

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Atypical Ductal Epithelium Hyperplasia

Proliferation of ductal epithelium w/ cytological changes: mitotic figures, hyperchromia; Microcalcifications lining ducts (much like DCIS); Increased risk for cancer

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Non-Complex Sclerosing Adenosis

Swirling fibrous tissue + increased acini + duct compression into cords

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Complex Sclerosing Adenosis

Abundant central fibrosis / elastosis, Few, tiny glands separated by extensive bands of collagen

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Atypical Lobular Epithelium Hyperplasia:

Proliferation of lobular epithelium w/ cytological changes: mitotic figures, hyperchromia

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Sclerosing Papillomas

Typical sclerosing adenosis features + Papillary projections into lumen

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Small Duct Papillomas

Occur deep w/in breast; Papilloma (arise from epithelium) in small ducts

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Fibroadenoma

Most common neoplasm

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Phyllodes

>60 y/o, large, low-grade tumor, less-defined, more cellular w/ few mitotic figures, SCALLOPED clefts

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Cystosarcoma phyllodes

Highly CELLULAR, a lot of ATYPIA, less stromal tissue

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Stewart-Trevis Syndrome

Lymphangiosarcoma may develop outside the breast in patients who have had mastectomy - lymphedema in unilateral UE

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Large Duct Papilloma

Serous or bloody nipple discharge; ductal papilloma in a large duct

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Ductal Carcinoma In Situ – Comedo

High-grade, high risk for IDC, solid sheets of tumor cells + central area of necrosis and microcalcifications

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Ductal Carcinoma In Situ – Comedo on mammogram

microcalcifications lining ducts

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Ductal Carcinoma In Situ – Non-Comedo

Low-grade, less atypia, characterized by the way cells grow in ducts (cribriform, papillary, etc)

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Paget Disease of the Nipple

Nipple is fissures, ulcerating, oozing; DCIS extends from nipple ducts into contiguous epithelium of nipple and areola

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Lobular Carcinoma In Situ

does not calcify or show up on mammogram, hard to detect, high incidence of BILATERALITY

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Invasive Ductal Carcinoma

Hard, gritty, chalky-like mass; • Cords, solid nests, anastomosing sheets of malignant cells

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African Americans tend to have

Triple negative IDC

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Medullary Carcinoma

IDC, 20-30y/o, BRCA1 mutation, HIGH-GRADE w/ LOW-GRADE BEHAVIOR; circumscribed, marked anaplasia + lymphocytic infiltrate

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Colloid/Mucinous Carcinoma

IDC, Elderly, well-circumscribed, mucin-lakes w/ malignant cell islands (PALE BLUE, gelatinous)

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Tubular Carcinoma

IDC, Low-grade, well-formed tubules, but lack myoepithelial cell layer, appears similar to Sclerosing Adenosis

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Invasive Papillary Carcinoma

IDC, rare, DCIS + papillary architecture

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Invasive Lobular Carcinoma

BILATERAL 20%, RUBBERY/scorrhous stroma, SINGLE-FILE Invasion; no tubules w/ rings about normal ducts

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cheesy discharge

Mammary Duct Ectasia

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blue dome cysts

Cyst Formation - fibrocystic change

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fibrous area b/w cysts that shows an aggregation of glands w/ enlarged lumens

Adenosis

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Proliferation of ductal epithelium + cytological changes

Atypical Ductal Epithelium Hyperplasia (DCIS)

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Swirling fibrous tissue, compression of ducts into cords + aggravated small glands

Sclerosing Adenosis

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Most COMMON neoplasm

Fibroadenoma

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glands forming flattened elongated /cleft-like spaces

Fibroadenoma

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GLAND spaces are more scalloped and may have breakdown of the epithelia

Phyllodes

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Serous or bloody nipple discharge

Large Duct Papilloma

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Nipple is fissured, ulcerating or oozing

Paget's

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Hard, gritty, chalky-like mass

Invasive Ductal Carcinoma

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solid sheets of cancer cells

Invasive Ductal Carcinoma

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High-grade features w/ LOW-GRADE BEHAVIOR

Medullary Carcinoma

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Mucin lakes with malignant cell islands.

Colloid Carcinoma

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similar to Sclerosing Adenosis, tubules w/o myoepithelial cell

Tubular Carcinoma

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Rubbery, single-file

Invasive Lobular Carcinoma

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BILATERAL

Invasive Lobular Carcinoma