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Flashcards in Breast Path Deck (22):
1

acute mastitis

occurs during lactation
-staph most common
-strep

2

fat necrosis

-generally associated with trauma
Clinical Sig: confusion with cancer due to palpable mass or calcification on mammogram
Histology: Necrotic fat cells surrounded by macrophages and neutrophils, then fibroblasts, lymphocytes, and histiocytes

3

What is the single most common breast disorder?

non proliferative fibrocystic changes
(there is also proliferative)
20-40y.o
-no risk

4

Fibroadenoma

most common benign tumor, usually small
-occur during reproductive life (more common

5

Phyllodes tumor

older patients -6th decade
-larger than fibroadenoma
-benign, borderline and malignant types (mostly benign)
phyllodes=leaf life
-distinguished from fibroadenoma on the basis of cellularity, mitotic rate, nuclear pleomorphism, stromal overgrowth, and infiltrative borders
-increased risk both breasts

6

Intraductal papilloma

most common cause of bloody nipple discharge in younger women
-multiple branching fibrovascular cores, each having a connective tissue axis lined by luminal and myoepithelial cells
-increased risk both breasts 1.5-2

7

Atypical ductal hyperplasia

duct expansion
-increased risk
4-5

8

Atypical lobular hyperplasia

TDLU expansion
-increased risk
4-5

9

Where do 50% of breast carcinomas arise in?

upper outer quadrant

10

Lobular carcinoma in situ and ductal carcinoma in situ have how much of an increased risk for carcinoma? both breast or ipsi

8-10
lobular-both
duct-ipsi

11

Paget Disease

Rare manifestation of breast cancer (1-4%)
DCIS arising within ductal system of the breast can extend up the lactiferous ducts into nipple skin without crossing the bm
-underlying invasive carcinoma or DCIS
-prognosis depends on extent of the underlying carcinoma

12

What is the most common type of invasive carcinoma?

ductal carcinoma (no special type)

13

Which invasive carcinomas have better prognosis?

-tubular/cribriform carcinoma
-mucinous carcinoma
-medullary carcinoma

14

How do invasive lobular carcinoma look?

single file

15

What features indicate increased likelihood of having BRCA?

-multiple cases of early onset breast cancer (

16

BRCA1 vs BRCA 2

BRCA1=17q21
-triple negative (basal-like cancers)
BRCA2=13q12.3
-similar to sporadic breast cancers
both tumor suppressor
BRCA higher risk ovarian
BRCA2 higher risk male breast

17

Gynecomastia

unilateral or bilateral
-indicator of hyperestrinism (cirrhosis or functioning testicular tumor)
-marked micropapillary hyperplasia of ductal lining occurs
-periductal lymphocytic infiltrate
-fibrosis

18

carcinoma of the male breast

rare
risk factor:
-first degree relatives with breast ca
-decreased testicular function
-age
-infertility
-obesity
-radiation
-residency in waster countries
-GYNECOMASTIA NOT A RISK FACTOR
-BRCA2 mutation (4-14%)
-the same histologic subtypes of invasive cancer are present

19

Invasive ductal carcinoma luminal A

ER+
PR+
HER2-

20

Invasive ductal carcinoma luminal B

ER+
PR+
HER2+

21

Invasive ductal carcinoma HER2+

ER-
PR-
HER2+

22

Invasive ductal carcinoma basal like

ER-
PR-
HER2-
CK5/6
EGFR+