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18 Cards in this Set

  • Front
  • Back
bloody or serous discharge from nipple
probably benign
can happen in pregnancy too b/c rapidly made new lobules
young breast: more radioluscent or opaque?
opaque b/c less fat
irregular mass
often invasive carcinoma
reddened painful breast
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
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)
most common cause of lumps in women b/t 30-50
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
ductal proliferation often w/o mass, usually just nipple discharge.
cell not atypical so know not malignant
ductal hyperplasia. lumen fills w/ heterogenous pop of cells of diff morphs, luminal and myoepithelial cell types. irregular slit like fenestrations at peripheary
ductal epithelial hyperplasia benign
sclerosing adenosis
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
radial scar
-stellate lesion of entrapped glands in hyalinized (pink/red) stroma
- looks like carcinoma on mamogram
-no assoc w/ surgery or trauma
intraduct papilloma
papilary structures in ducts
-small ones thought to show increased risk for breast carcinoma
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
breast carcinoma risk factors include
- 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
breast cancer
-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
comedocarcinoma of breast
-rapidly prolif high grade tumor w/ prom central necrosis, periductal fibrosis, minimal chronic inflamm
-cheesy material from ducts
Cribigorm DCIS
-regular spaces (regular means consistent in shape/size)
- lumen often filled w/ calcifying secretory material
- distort lobule
papillary DCIS
fibrovacular cores extend into ducts. columnar cell lining
or micropapillary DCIS w/o fibrovascular core, more solid
Pagat disease
DCIS spreads from lobules to ducts to nipple skin
can see fluid weeping if cells disrupt normal epithelial barrier