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20 Cards in this Set
- Front
- Back
- 3rd side (hint)
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Normal Breast Anatomy & Histology
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twenty lobes, segmental & sub segmental ducts. rest is skin, nipple, areola, subcutaneous fat. "milk line" from axilla to inguinal may contain ectopic tissue subject to inflammation & disease
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Sclerosing Adenosis
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Fibrocystic change mimicking carcinoma. proliferation of small ducts within fibrous stroma.
histo: lobular architecture, myoepithelial cells present |
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intraductal papilloma
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localized benign papillary epithelial hyperplasia in large duct, no atypia = not pre-malignant (need to excise to exclude). presents w/ discharge "papillomatosis"
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Fibroadenoma
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Painless, moveable lump, young women. benign tumor made up of fibrous and/or myxoid stroma & glandular epithelium. NO risk of malignancy. similar to Phyllodes (less cellular & less atypia)
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fibroadenoma
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Painless, moveable lump, young women. benign tumor made up of fibrous and/or myxoid stroma & glandular epithelium. NO risk of malignancy. similar to Phyllodes (less cellular & less atypia)
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Phyllodes Tumor
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epithelial & stromal components (more cellular & atypical than fibroadenoma). can be massive, may be malignant
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Breast Cancer Epidemiology
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increasing incidence 30% of diagnoses result in death from the dz. incidence increases w/ age & plateaus at 60. lifetime risk is 1:8 of developing 1:30 mortality
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Breast Cancer Risk Factors
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Genetic (5-10% from germline mutations), hormonal, diet (high fat)?, environmental (more common in western world)?, Viral?
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Breast Cancer Genes
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BRCA1 (17q21) >50% develop before 50y/o. Responsible for 50% of inherited breast cancers. new tx w/ PARP inhibitors
BRCA2 (13q) men & ashkenazi jewish women |
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Breast Cancer Classification
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Ductal In situ/Invasive
Lobular In situ/Invasive Special types |
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Prognostic factors
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Stage (TNM), histologic grade (degree of differentiation), ER/PR status, molecular markers
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Ductal Carcinoma in Situ
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Neoplastic cells within dilated duct, confined by basement membrane. Graded by growth pattern & cytologic appearance. typically not palpable. Untreated 25% develop invasive carcinoma in 10yrs
Tx: surg, rad, hormonal (if ER/PR +) |
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Ductal Carcinoma in Situ
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Neoplastic cells within dilated duct, confined by basement membrane. Graded by growth pattern & cytologic appearance. typically not palpable. Untreated 25% develop invasive carcinoma in 10yrs
Tx: surg, rad, hormonal (if ER/PR +) |
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Lobular Carcinoma in Situ
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clinically silent, not palpable (no microcalcification or stromal fibrosis), incidental finding on biopsy. 25% bilateral.
Considered to be an indicator of increased risk |
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Carcinoma of the breast (ductal?)
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(invasive?) ductual carcinoma
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Paget's Disease
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typically associated w/ underlying ductal carcinoma. neoplastic cells spread to epidermis of the nipple. prognosis depends on nature of underlying lesion
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HER2/neu overexpression in invasive ductal carcinoma & FISH identification of HER2/neu
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Lobular Carcinoma in Situ (L)
Signet Ring Carcinoma (R) |
clinically silent, not palpable (no microcalcification or stromal fibrosis), incidental finding on biopsy. 25% bilateral.
Considered to be an indicator of increased risk Signet Ring Carcinoma |
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colloid (mucinous) carcinoma
medullary carcinoma (not in syllabus) |
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