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Endocrine > Breast Path > Flashcards

Flashcards in Breast Path Deck (31):
1

apocrine cyst morphology

large cystic areas

2 layer epithelium

apocrine metaplasia

may have calcifications 

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1

presentation papilloma

any age

many centrally located

discharge common, bloody in many

subareolar mass possible

1

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Atypical ductal hyerplasia

atypical lobule hyperplasia

2

malignant phyllodes tumor features vs benign

marked stromal cellualrity

increased mitoses

cellular pleomorphism

iniltrating border

necrosis

3

lesions with moderately increased risk and signifcantly increased risk for invasive carcinoma

atypical ductal hyperplasia

atypical lobular hyperplasia

 

DCIS (ipslateral breast)

LCIS (both)

3

phyllodes tumor histo

circumscribed but not encapsulated

interlacing celfts

necrosis and hemorrhage due to rapid growth 

leaf-like or epithelium lines clefts or cysts

incresaed stromal cellularity with overgrowth 

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4

three manjr influences for devleoping breast carcinoma

genetic changes (HER2/Neu, BRCA1 BRCA2)

hormonal 

environmental 

5

stromal tumors

fibroadenoma

phyllodes tumor

sarcomas

6

proliferative breast disease without atypia = 

Ecamples

mammographic densities

califications

moderate florid hyperplasia

sclerosising adenosis

complex sclerosing lesions

papillomas

7

Clinical presentation of breast disease

 

finding most consistent with cancer

pain

papable mass

nipple discharge or skn changes

lumpiness or other

7

phyllodes prognosis

benign - recur often, but stay benign

low grade - recur, rarely metastasize

high grade - aggressive, often distant metastases, often axillary node

9

periductal mastitis

keratin plug - sup nipple nodule

may be painful if infected > abcess

9

side effects Tamoxifen prophylaxis breast caricinoma

venous thromembolicism

endometrial cancer

cataracts

10

clincial presentation complex sclerosing lesion

40-60y

rarely palpable, detected by mammography

stellate or spiculated lesion with central core

complete excision warranted after biopsy 

(hyalainezed stroma with entrapped glands, dialted ducts at periphery)

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11

fat necrosis typically due to 

trauma

13

breastmrophology neonatal

 

pubretal

neonatal - ducts,no lobules, 3 layer epithelium

pubertal - lobular unit develops

14

most common lesion by age group

15-25

25-35

35-50

50+

Pregnant or lactating

15-25 Fibroadenoma

25-35 Fibroadenoma  (cyst or CA rare)

35-50 Fibrocystic changes, CA, cyst

50+ CA until proven otherwise

Pregnant or lactating - lactating adenoma, cyst, mastitis, CA

14

lesions indicated no incresed risk for invasive carcinoma

adenosis

fibroadenoma

fibrosis

hyperplasia without atypic

cysts

apocrine metaplasia

16

papilloma histo

branching fibrovascular cores within a duct

epithelial hyperplasia often present (more than 2 layers)

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18

presentation non-prolifeerative changes (fibrocystic

Premenopausal 30-50

lumpy breast, mass, caclifications discharge

pain

multiple or bilateral, flucate in size

19

"triple test" 

self exam

radiology

biopsy

if 1/3 is suspcisious, rebiopsy

20

fibroadenoma histolgy

overgrowth compresses ducts to slit like psaces

21

phyllodes tumor presentation

5-6th decade, latin women increased risk

discrete, palpable mass

rapid growth 

22

Risk factors breast carcinoma

early menarch/late menopause 

first live birth later 35y

1st degree relative with CA (only 13%)

 

24

fibrocystic changes examples (non-proliferative)

cysts

fibrosis

apocrine metaplasia

25

lesions with slighlty increased risk for carcinoma

complex fibroadenoma

florid hyerplasia without atypia

sclerosisng adenosis

solitary papilloma

26

sclerosing adenosis histo

enlarged lobule, cicumscribed edge

preserved architecture

compresse+distorted acinin

dense stroma w/ calcifications 

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28

suspicious mamogram findings

density

microcalicfications

29

acute mastitis

infection typically younger, lactating women 

Staph Aa. infection

often bilateral

30

preesentation fibroadenoma

young adults

solitary, well circumscribed

painless and movable

multiple

regress during menopause

31

indications for breat MRI

preop eval of exten of malignant disease

evaluate tumor response to neo adjunvatn chemo

axiallary lymph node pos for metastatic carcinoma with unkonwn primary

evaluate integrity of implant

high risk screening