Pathophysiology Flashcards
(25 cards)
Two main classes of malignant breast lesions
- Non-invasive
- Invasive
Two types of non-invasive lesions (2)
- Ductal carcinoma in situ (DCIS)
- Lobular carcinoma in situ
Two types of invasive breast cancelesions (2)
- Ductal carcinoma
- Lobular carcinoma
What type of carcinoma are most breast cancers?
Adenocarcinomas - glandular epithelial differentiation
Define a non invasive carcinoma (3)
- Tumour confined to ducts/acinci of lobules
- No infiltration of basement membrane
- Pre malignancy
Describe a ductal carcinoma in situ (3)
- Associated with fibrosis
- Not spread beyond basement membrane of ducts
- Originated in a duct
What is paget’s disease of the nipple (4)
- Ductal carcinoma in situ
- Tumour originated in a duct
- Cancerous cell migrated down the duct
- Attached to epithelial skin on outside of nipple
What is lobular carcinoma in situ? (3)
- Occurs in lobules
- Doesn’t affect ducts
- Difficult to detect
What are the typical features of a lobular carcinoma in situ? (2)
- Multifocal
- Bilateral
What is an invasive carcinoma? (2)
- Gone through basement membrane of tissue in origin
- Can metastisise spread to other tissues
Types of invasive ductal carcinoma (5)
- Scirrhous carcinoma
- Medullary carcinoma
- Paget’s disease of the breast
- Mucinous carcinoma
- Anaplastic carcinoma
Typical presentation of scirrhous carcinoma
Hard lump
Mucinous carcinoma - features (3)
- Ill defined border
- No nipple inversion/skin tethering
- Better prognosis
- Mucin in cancer cells
Tubular carcinoma features (2)
- Cells arranged as tubules
- Good prognosis
Medullary carcinoma features
- Large well circumscribed
- Histology: lymphocytic infiltrate + macrophages
What is the rare type of invasive ductal carcinoma?
Medullarly
What lymph nodes do breast carcinomas typically spread to? (2)
- Axillarly
- Periclavicular
3 ways breast carcinomas metastisise
- Local tissue
- Lymph nodes
- Via blood to distant sites
What distant sites do breast carcinomas typically metastisise to? (2)
- Lung
- Bones
Less commonly: liver + brain + adrenal glands
Poor prognostic factors for spread?
- Young age/premenopause
- Large tumour size
- High grade
- Triple negative
- Positive lymph nodes
Types of ductal carcinoma in situ - benign/not?
- Comedocarcinoma (benign)
- Lobular carcinoma
Comedocarcinoma histological description (6)
- High grade malignant ductal epithelial cells
- Dark staining nuclei
- Mitotic figures
- Necrosis
- Central calcification
- Basement membrane intact
Lobular carcinoma (2)
- Malignant cells in terminal duct lobules
- Not invaded through basement membrane
Anaplastic carcinoma
Better prognosis
- T cell non-Hodgkin lymphoma
