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76 Cards in this Set
- Front
- Back
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Prepubertal female breast histo
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dense stroma & very little fat
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Adult female breast
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distinct lobular units with unique stroma, acinar structures, & increased fat
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Normal breast duct & lobule lining
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double layer of myoepithelial cells & luminal cells
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Actin stain
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for myoepithelial elements
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Neoplastic breast cells
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Luminal epithelial cells, & don't include myoepithelial cells
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Normal breast involution
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progressive replacement of the specialized CT by dense structural collagen with loss of lobular glands
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Acute mastitis cause
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acute bacterial infection, usually S. aureus, in 1st mo postpartum
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Major finding in periductal mastitis
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squamous metaplasia of lactiferous ducts block ducts
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breast fistula
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Periductal mastitis
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breast duct rupture
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Periductal mastitis: ensuing intense inflammatory response to keratin results in erythematous painful mass
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Mammary duct ectasias
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inspissated secretions plug ducts & spill into the surrounding stroma, eliciting a marked plasmacytic &/or granulomatous inflammatory response
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Greenish brown nipple discharge
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Mammary duct ectasias
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Mimic carcinoma (skin retraction)
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Mammary duct ectasias, Fat necrosis, Fibrocystic changes (cyst, fibrosis, adenosis), Sclerosing adenosis, Lymphocytic mastopathy, Granulomatous mastitis
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Cause of fat necrosis
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almost always secondary to trauma
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Silicone breast implant histo
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refractile material
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3 nonproliferative breast changes: fibrocystic changes
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Cyst formation, FIbrosis, Adenosis
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2 proliferative breast diseases without atypia; & cell(s) involved
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Epithelial (ductal) hyperplasia & Sclerosing adenosis; both myoepithelial & luminal cells present
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Epithelial hyperplasia histo
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Presence of >2 layers of myoepithelial & luminal cells of breast ducts & lobules; irregular slit-like fenestrations at the periphery
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Intraductal papilloma
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Central fibrovascular core extends from the wall of the duct; lined by both myoepithelial cells & luminal cells
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Nipple discharge
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Intraductal papilloma
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Radial scar
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Complex sclerosing adenosis
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Mammogram microcalcifications
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Most often seen in DCIS & Sclerosing adenosis
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Sentinel node
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initial node draining the tumor
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Cause of atypical ductal hyperplasia
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excessive estrogen stimulation
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histo of atypical ductal hyperplasia
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peripheral columnar cells & rounded central cells; irregular & slit-like fenestrations; microcalcifications
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Path of Atypical lobular hyperplasia
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Lobule packed with uniform cells (loosely cohesive cells); no microcalcifications
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Low Grade Noncomedo DCIS chance of invasive cancer
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32%
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Cookie cutter histo
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Cribiform DCIS
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Intraductal papilloma v. Papillary DCIS
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Papillary DCIS without myoepithelial cells
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Papillary DCIS v. Micropapillary DCIS
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Micropapillary without fibrovascular cores
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High Grade Comedo DCIS chance of invasive cancer
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70-90%
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High Grade Comedo DCIS histo
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Large central zones of necrosis; atypia; calcfications; myoepithelial cells preserved
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Paget Disease of nipple
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nipple has roughened red eczematous apperance
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Topical treatment of eczema of nipple & doesn't go away
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Pagent Disease of nipple
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Paget Disease of Nipple path
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Paget cells extend from DCIS within the duct system, via the lactiferous sinuses, into nipple skin without crossing the basement membrane
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Paget Disease with mass
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Infiltrating ductal carcinoma
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PAS + cells
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Paget Disease of Nipple
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Lobular CIS histo
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lobules enlarging & expanding with uniform population; rarely calcifications; usually ER & PR +
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Lobular CIS path
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Loss of E-cadherin: lose cohesiveness
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Lobular CIS risk of invasive carcinoma
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25-35%
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CIS b/l
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LCIS
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Luminal A
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ER+, HER2/neu-, postmenopausal, well- to moderately differentiated, slow growing, respond to hormonal tx
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Luminal B
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"Triple positive:" ER+, HER2/neu+, high proliferative rate; moderately to poorly differentiated, more likely to have node mets
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Normal breast-like
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ER+, HER2/neu- : but less abnormal genes than Luminal A
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Basal-like
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"Triple negative:" ER-, PR-, HER2/neu-; high proliferative rate; poorly differentiated; aggressive; frequent mets; poor prognosis; many are BRCA1; younger patients
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HER2 positive
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ER-, HER2/neu+; high proliferative rate; poorly differentiated; frequent mets to brain
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>80% of densities with irregular borders in mammograms prove to be?
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invasive carcinomas
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Gross: white mass with yellow adipose tissue
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Invasive carcinoma, NST
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Basal-like invasive carcinoma
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Medullary carcinoma (ER-, PR- HER2/neu-)
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Increased E-cadherin
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Medullary carcinoma of the breast
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Invasive carcinoma of older women
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Mucinous (Colloid) carcinoma
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Histo: neoplastic cells surrounded by EC mucin
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Mucinous (Colloid) carcinoma of the breast
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Tubular carcinoma receptors
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ER+, HER2/neu-
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No myoepithelial cells
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Papillary DCIS, Tubular carcinoma
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Well-formed tubules lined by a single layer of cells
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Tubular carcinoma of the breast
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Non-lactating inflamed breast
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Inflammatory carcinoma of the breast
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Inflammatory carcinoma of the breast invasion
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lymphatics, resulting in local lymphedema
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Infiltrating lobular carcinoma receptors
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ER+, HER2/neu-
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Distinguish Infiltrating lobular carcinoma from NST
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ILC with hematogenous met (NST lymphatic?), ILC with lower prevalence of microcalcifications, ILC >80% ER+ (NST 50% ER+)
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Parallel array of cells
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Infiltrating lobular carcinoma of the breast
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E-cadherin negative
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LCIS, Infiltrating lobular carcinoma of the breast
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3 categories of Nottingham grading
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Tubule formation: 1= >75%, 2=310-75%, 3= <10%
Nuclear pleomorphism: 1: small uniform cells; 2: moderate increase in size/variation; 3: marked variation Mitotic count: 1= up to 7; 2=8-14; 3=15+ |
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2 diagnostic studies on malignant tumor tissue sample
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ER & HER2/neu
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ER+ prognosis
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~10% better 5y survival
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HER2/neu+ prognosis
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Worse prognosis
(epidermal growth factor receptor) |
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Stromal tumor spread
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locally or hematogenously
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Fibroadenoma gross appearance
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Bulging, circumscribed, white, firm nodule which is rubbery or solid; often multiple & b/l
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Most common breast tumor in women
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Fibroadenoma
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Leaflike architecture
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Phyllodes tumor
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Breast tissue
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No associated breast lobules for secretion; estrogen sensitive
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Gynecomastia histo
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Multilayered epithelium with small papillary tufts; surrounding periductal hyalinization & fibrosis
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BRCA1
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female breast & ovarian cancer
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BRCA2
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female & male breast cancer
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Carcinoma in the male breast: location
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Subjacent to nipple & surrounding areola
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Male nipple discharge
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Carcinoma in the Male breast
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Klinefelter syndrome
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Association with Carcinoma in the male breast
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