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28 Cards in this Set
- Front
- Back
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What is a unilateral breast mass that appears after trauma?
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Probably fat necrosis that can mimic a tumor
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What common breast disease is seen on mammography as microcalcifications?
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Fibrocystic disease, present in over 50% of females
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Name the types of nonproliferative fibrocystic changes.
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Cysts
Fibrosis Adenosis |
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What does fibrocystic change feel like?
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Lumpy
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What are the characteristics of nonproliferative fibrocystic changes?
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Fibrous stroma with dilated ducts
Apocrine metaplasia |
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What are the characteristics of proliferative fibrocystic change?
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Epithelial hyperplasia
Sclerosing adenosis Radial scar |
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What is characteristic of epithelial hyperplasia of the breast?
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multilayered duct cell proliferation (could be luminal duct cell or myoepithelial cells)
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What is firm proliferation of small ductules with accompanying fibrosis?
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Sclerosing adenosis
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Which fibrocystic changes have an increased risk for carcinoma?
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Sclerosing adenosis
moderate/sever hyperplasia papillomatosis cellular atypia |
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What is the most common tumor of the female breast?
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Fibroadenoma
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Fibroadenomas occur in what age group? What are the features?
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under 30
Circumscribed, soft, moveable |
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What is a fibroadenoma with increased amounts of cellular stroma?
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phyllodes tumor
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What is the average age and features of phyllodes tumors?
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45 y/o
Large, typically benign, but can be low and high grade. Appears in broad leafy patterns Very much like fibroadenoma |
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What are the common metastatic sites for phyllodes tumors?
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bones and lungs
rarely to axillary nodes |
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How are phyllodes/fibroadenomas treated?
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Wide excisions
Mastectomy is unusual |
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What is suspected if the pt has bloody discharge from the nipple?
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Intraductal papilloma: benign neoplasm of the subareolar region
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What risk factors increase the risk of breast cancer?
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BRCA 1 and BRCA 2
Early menarche Late menopause Nulliparity Firstborn at over 30 Obesity High dose estrogen therapy Fibrocystic changes with hyperplasia and atypia |
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What are the classifications for breast cancer?
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Invasive or noninvasive
Ductal or lobular |
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What region of the breast is effected by Paget Disease? Where are the Paget cells found?
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Nipple and duct
Paget cells found in the epidermis |
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What cancer forms 80% of all mammary carcinomas?
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Invasive ductal carcinomas
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Describe the features of invasive ductal carcinoma with paget's disease?
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A ductal carcinoma which arises in the main excretory ducts and extends through the intraepithelium to the nipple and areola. Look for paget cells in the epithelium. Areolar skin will be inflamed, fissured, and oozing.
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What features hallmark invasive lobular carcinoma?
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Multicentric with small cells
Infiltrate in rows of single cells or concentric rings around ducts Loss of e-Cadherin |
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If biopsy shows large pleomorphic, vesicular syncytial cells with lymphocytic infiltrate, what do we suspect?
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Medullary carcinoma
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Who gets colloid carcinomas? What is the typical presentation?
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Older women
Can be mixed or pure in presentation, pure is better. |
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What are the typical breast features of invasive carcinoma?
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Fixed position
Retraction of skin Orange peel appearance (Peau d'orange) Firm, hard nodule Gritty texture if needle inserted |
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What factors influence the prognosis of breast cancer?
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Size
Cellular margins Lymph involvement Type and grade Estrogen and progesterone receptors (ER and PR) Her-2/neu |
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What diagnostic tests are required for any breast tumors?
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ER
PR Her-2/neu |
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What are the main factors causing gynecomastia?
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Puberty
Kinefelter's Testicular neoplasms Drugs Cirrhosis (decreased estrogen breakdown) |
