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18 Cards in this Set
- Front
- Back
bloody or serous discharge from nipple
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probably benign
can happen in pregnancy too b/c rapidly made new lobules |
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young breast: more radioluscent or opaque?
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opaque b/c less fat
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irregular mass
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often invasive carcinoma
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reddened painful breast
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inflammation
like staph aureus infection via cracks/fissures in nipple during lactation "acute mastitis" OR periductal mastitis in smokers where keratinizing sq surface epithelium extends into ducts and keratin trapped in ducts--> dilation and RUPTURE |
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lipid laden macrophages in ducts
granulomatous inflammation palpable mass thick discharge dilated ducts 50-60 yr old woman w/ many kids |
mammary duct ectasia (inspissated secretions)
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most common cause of lumps in women b/t 30-50
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fibrocystic changes
-mostly nonproliferative breast change -not usually sig risk for carcinoma - morphs: 1. cysts via lobule dilation (looks like apocrine sweat gland) 2. fibrosis (stroma rxn to cyst rupture) 3. adenosis: incrased number of acini in lobule (proliferative) -repeat hormone stimulation> increased firmness of tissue and cysts -bilateral, upper outer quad or underside |
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ductal proliferation often w/o mass, usually just nipple discharge.
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cell not atypical so know not malignant
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ductal hyperplasia. lumen fills w/ heterogenous pop of cells of diff morphs, luminal and myoepithelial cell types. irregular slit like fenestrations at peripheary
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ductal epithelial hyperplasia benign
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sclerosing adenosis
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increased number of acini per terminal duct
-acini compressed/distorted in center and dilated in periphery -stromal fibrosis can compress lumens can look like carcinoma BUT unlike carcioma acini arranged in swirling pattern and well circumscribed outer border -calcifications |
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radial scar
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-stellate lesion of entrapped glands in hyalinized (pink/red) stroma
- looks like carcinoma on mamogram -no assoc w/ surgery or trauma |
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intraduct papilloma
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papilary structures in ducts
-small ones thought to show increased risk for breast carcinoma |
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atypical ductal hyperplasia
atypical lobular hyperplasia |
'proliferative disease w/ atypia'
ductal: 'columnar at peripheary, rounded cells in center; peripheral spaces irregular and slit like) lobular: monomoprhic small rounded loosely cohesive cells partialy fill a lobule. only little lumina seen some increased risk of developing invasive carcinoma |
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breast carcinoma risk factors include
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- menarche b/f 12
-menopause post 55 -first liver birth post 30 atypical hyperplasia or LCIS -postmenopausal obesity -alcohol -hormone replacement therapy -race, age, sex lifetime probability of being diag for american women is 1 in 8 (b/c ppl living way longer) AGE MOST IMPORTANT RISK FACTOR -incidence more in white but mortality more in black women ~3% BRCA1 and BRCA2 genes - BRCA1: (chrome 17) (tumor suppressor, protein involved in DNA repair w/ RAD51 protein) BRCA2: chrome 13. risk w/ other syndrome assoc: -Cowden syndrome (PTEN gene mutation) -Li-Fraumeni syndrome (p53) -Peutz Jeghers syndrome -Ataxia telangiectasia -or estrogen exposure (can cause mutation or DNA damging free radicals via metabolities; or E itself causes cell prolif in premalig lesions/cancers) male breast cancer occurence more w/ BRCA2 female member w/ ovarian cancer more in BRCA1 |
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breast cancer
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-mostly from luminal cells (vs myoepithelial)
-stromal invasion may be result of loss of ability of myoepithelial and stromal cells to maintain BM rather than malig cell gain of functions most adenocarcioma (in situ mostly ductal, evades PE, found on mammo) -calcifications, so know to investigate |
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comedocarcinoma of breast
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-rapidly prolif high grade tumor w/ prom central necrosis, periductal fibrosis, minimal chronic inflamm
-cheesy material from ducts |
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Cribigorm DCIS
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-regular spaces (regular means consistent in shape/size)
- lumen often filled w/ calcifying secretory material - distort lobule |
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papillary DCIS
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fibrovacular cores extend into ducts. columnar cell lining
or micropapillary DCIS w/o fibrovascular core, more solid |
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Pagat disease
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DCIS spreads from lobules to ducts to nipple skin
can see fluid weeping if cells disrupt normal epithelial barrier |