Breast Flashcards
(37 cards)
4 groups of diseases of breast**
- Inflammatory disorders: mastitis, fat necrosis
- Benign epithelial diseases: fibrocystic changes
- Neoplastic conditions: fibroadenoma, carcinoma
- Gynecomastia
diagnostic tests for breast (3)**
- Clinical examination
- Radiology – ultrasound, Mammogram, MRI
- Pathology – FNA (fine needle aspiration), Core Biopsy, Excision Biopsy
acute mastitis pathogenesis
proliferation of staphs in milk
- > acute inflammation w/ neutrophils
- > acute abscess formation
- > inflammatory breast cancer
treatment of breast abscess (3 steps)
- incise and drain
- antibiotics
- excision
idiopathic granulomatous mastitis
- what type of disease
- who it affects
- complications
inflammatory disease (rare) parous women (given birth)
TB (granulomatous inflammation)
treatment of idiopathic granulomatous mastitis (3)
steroids
immunosuppressives
surgery
breast augmentation causes (3)
- paraffin injections
- implants
- autologous tissue (tissue taken from somewhere else then implanted into the breast
breast augmentation (paraffin injections) complications \+ micro characteristics
paraffinoma
- multinucleate giant cell rxn
fibrocystic change (FCC)
- occurs at which age group
- clinical presentation
- micro features (4)**
- complication
benign epithelial breast lesion
- reproductive age group
- lumps (not localised)
(CASE)
- **stromal sclerosis/ fibroadenomatoid change,
cystic dilation of ducts,
epithelial hyperplasia,
apocrine metaplasia (breast epithelial cells -> sweat glandular cells)
- risk of malignancy
histological classification of breast neoplasms (8)**
- Epithelial tumours: Papilloma, carcinoma
- Myoepithelial tumours: adenomyoepithelioma
- Fibroepithelial tumours – fibroadenoma, phyllodes
- Mesenchymal tumours - lipoma
(mesenchymal cells -> develop into connective/lymphatic tissue) - Tumours of nipple – Paget’s
- Malignant lymphoma
- Metastatic tumours
- Tumours of male breast – gynecomastia, carcinoma
fibroadenoma
- what type of tumour
- affects who
- macro + micro characteristics
- behavior
benign fibroepithelial tumour
young women (25yrs)
firm, well defined lump
proliferation of glandular and stromal elements, circumscribed and uniform
can recur/regress
phyllodes tumour
- what type of tumour
- origin
- microscopic appearance
- complication
fibroepithelial
leaflike architecture. not well circumscribed - some parts enter adjacent tissue
risk of malignancy (higher than fibroadenoma)
risk factors of breast cancers (6)**
- caucasian
- perimenopausal age (before menopause - 40yrs)
- nulliparous (never given birth) or give birth >30 yrs
- early menarche (start menstruation early)/ late menopause
- high socio-economic status: obese/ alcohol
- past history of breast disease/ family history (affects 5% - BRCA1 gene mutation)
clinical presentation of breast cancers (5)**
- Palpable NON MOBILE mass
- Nipple discharge, nipple retraction, Paget’s disease
- lumps in axillary area
- skin: tethering/ ulcerations
- Mammographic density and calcifications
non-invasive malignant epithelial carcinomas of breast (5 types)
- Ductal carcinoma in-situ
- Lobular carcinoma in-situ: tend to be invasive
- NST (no special type)
- Special types – mucinous, tubular, medullary, micropapillary, metaplastic etc
- Lobular carcinomas
in-situ cancer vs
invasive cancer vs
metastatic cancer
- in-situ cancer: basement membrane intact
- invasive cancer: basement membrane disrupted, invasion into surrounding stroma
- metastatic cancer: distal spread through blood vessels to lymph nodes/ distant organ
DCIS presentation (5)
Incidental finding Mammographic density Nipple discharge Paget’s disease Palpable mass
LCIS presentation
Incidental finding
not associated with calcifications or stromal desmoplastic reactions that produce mammographic densities
location: DCIS vs LCIS
DCIS: ducts
LCIS: lobules
(based on their name DUH)
cell size: DCIS vs LCIS
DCIS: medium/large
LCIS: Small
histological subtypes: DCIS vs LCIS
DCIS: - Comedo (prominent apoptotic cell death and has greater malignant potential - cribriform - solid - papillary - micropapillary LCIS: - solid
presence of calcifications: DCIS vs LCIS
DCIS: may be present
LCIS: absent
Risk of subsequent invasive breast cancer + location: DCIS vs LCIS
DCIS: higher risk. ipsilateral invasion -> increases risk of invasice carcinoma by 10 times
LCIS: lower risk. can be ipsilateral/contralateral
types of breast carcinoma (8)
- Lobular **
- Mucinous
- Tubular
- Papillary
- Apocrine
- Micropapillary
- Medullary
- Secretory
no special type
