breast Flashcards

Describe the common developmental abnormalities of the breast Define acute mastitis and list the common causes Describe fibrocystic changes (including important clinical associations) Describe the clinicopathologic features of intraductal papilloma, fibroadenoma, and phyllodes tumor List the risk factors for breast cancer development Describe ductal carcinoma in situ Describe and be able to identify mammary Paget's disease and inflammatory carcinoma Compare and contrast the 2 subtypes of (67 cards)

1
Q

causes of acute mastitis

A

cracks in skin or stasis in milk may allow direct or retrograde ductal spread of bacteria

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2
Q

most common cause of bloody nipple discharge

A

intraductal papilloma

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3
Q

most common tumor in adolescent and young adults

A

fibroadenoma

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4
Q

main risk factor for breast cancer

A

age, 1st degree FMX, estrogen exposure, radiation, obestity

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5
Q

worst BRCA mutation

A

BRCA1

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6
Q

US lifetime risk of breast cancer

A

11%

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7
Q

syndromes that can lead to risk of breast cancer

A

li-fraumeni, cowden (PTEN)

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8
Q

comedo type necrosis

A

grade III carcinoma in situ

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9
Q

100% of pts with this will have DCIS

A

paget’s disease of the nipple

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10
Q

35-50% of pts with this will have invasive carcinoma

A

paget’s dx of the nipple

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11
Q

signs of invasive breast cancer

A

lump
firm, non-movable lump
diffuse thickening in breast texture
eczema like changes

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12
Q

small uniform round of oval nuclei in single file pattern infiltrating the stroma

A

onvasive lobular carcinoma

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13
Q

orange peel skin

A

inflammatory carcinoma

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14
Q

staging with direct extention to chest wall

A

T4

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15
Q

staging of ANY distant mets

A

M1

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16
Q

met to any internal mammary node

A

N3

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17
Q

importance of congenital inversion of the nipple

A

similar changes can be produced by underlining cancer

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18
Q

arises from cystic dilation of an obstructed duct

A

galactocele

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19
Q

benign cyst formation and fibrosis of the breast

A

fibrocystic changes

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20
Q

brown to blue cysts filled with watery fluid

A

fibrocystic changes

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21
Q

duct lumen filled with heterogeneous population of cells of difereing morphology with fenestrations

A

epithelial hyperplasia

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22
Q

benign processes at higher risk for invasive breast carcinoma

A

atypical ductal and lobar hyperplasia

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23
Q

proliferation of lumial spaces lined with epithelial cells and myepithelial cells yielding masses of small glands within a fibrois stroma

A

sclerosing adenosis

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24
Q

swirling pattern of cells with a well-circumscribed border

A

sclerosing adenosis

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25
benign processes with small risk of breast carcinoma
fibrosis, cystic changes, apocrine metaplasia
26
carcinoma risk of sclerosing adenosis
slightly higher
27
bugs causing acute mastitis
Staph A, S pyogenes
28
inflamatory breast lesion sometimes preceded by trauma
fat necrosis
29
prominent lymphoplasmacytic infiltrate and occasiional granulomas in the periductal stroma
mammary duct ectasia
30
solitary discrete mobile mass
fibroademoma
31
rubbery well-circumcribed mass
fibroadenoma
32
leaf-like epithelium projections in beign tumors
phyllodes tumor
33
serous or bloody nipple discharge with a small subareolar tumor in a premenopausal woman
intraductal papilloma
34
< 1 cm tumor with delicate branching growths within a dilated duct with double layered epithelium
intraductal papilloma
35
histological way to differentiate intraductal papilloma from carcinoma
precense of double layered epithelium
36
most common genetic breast cancer mutation
HER2/NUE
37
genetic marker in breast cancer associated with poor outcomes
HER2/NUE
38
4 types of breast cancer molecular subtypes
HER2/NUE + estrogen receptor + HER2/NUE + estrogen receptor - HER2/NUE - estrogen receptor + HER2/NUE - estrogen receptor -
39
common non-breast primary cancer in women with breast cancer
ovarian
40
most common location of breast cancer
upper outer quadrant
41
calcifications are frequently associated with
DCIS
42
two types noninvasive breast cancer
ductal/lobular cancer in situ
43
DCIS prognosis
excellent
44
extention of DCIS into the nipple
paget's disease of the nipple
45
bland round nuclei occuring in loosely cohesive clusters within lobules
LCIS
46
in situ carinoma with the highest risk of invasive disease
LCIS
47
marker of increased risk of invasive cancer of either breast
LCIS
48
replaces normal breast fat with tumor cells and forms a hard palpaple mass
invasive ductal carcinoma
49
single-file chains of tumor cells invading into the stroma
invasive lobular carcinoma
50
met to CSF, serosal surfaces, GI, ovary, uterus and bone marrow
invasive lobular carcinoma
51
usually hormone +/ HER2/NEU -
invasive lobular carcinoma,
52
enlarged, swolled, warm breast usually without palpable mass
inflammatory carcinoma
53
reason imflammatory carcinoma looks that was
invades dermal lymphatic spaces
54
can often be mistaken for fibroadenomas
medullary carcinomas
55
"triple-negative" breast cancer
medullary carcinomas
56
first outward sign of breast malinancy
retraction or dimpling of the nipple
57
sign of involvement of the breast lymphatics
peau d/orange
58
outer quadrants and centrally located cancers spread to
axillary nodes
59
inner quadrants cancers spread to
nodes along internal mammilary arteries
60
most common mets in breast cancer
lungs, bones, liver, adrenals
61
better progress cancer types
tubular, medullary, mucinous
62
worst type of breast cancer
inflammatory
63
frequent cause of angiosarcoma
previous breast radiation therapy
64
expression of estrogen and progesterone is (good/bad)
good
65
expression of HER2/NEU is (good/bad)
bad
66
drug thats use is based on HER2/NEU profile
trastuzumab
67
most important cause of hyperestrtinism in males
liver cirrhosis