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35 Cards in this Set

  • Front
  • Back
Nonproliferative Lesions breast lesions
Cysts, Papillary apocrine change, Epithelial calcifications, Mild hyperplasia-usual type
Proliferative breast lesions without Atypia
– Moderate/florid hyperplasias
– Intraductal papillomas
– Sclerosing adenosis
– Radial Scar
– Fibroadenomas
Atypical breast Hyperplasias
- proliferative lesions that possess some, but not all features of carcinoma insitu
– ADH (features similar to DCIS)
– ALH (features seen in LCIS)
– Pseudoencapsulated, demarked, ovoid
– Mobile, multilobulated
– Well circumscribed tumors of benign epithelium elements with sparse stroma
– Tubular, Lactating, Nipple
Mammory Duct Ectasia
- Dilated, thick walls, fibrotic stroma, rupture, leakage of pasty secretion into surrounding tissue -> inflamm and fat necrosis
– Sx are Pain, nipple inversion, greenish D/C
Granulomatous Mastitis
– Immune response
– firm tender nodules, capsule
– varying imflamm, fibrosis
– needs surgery
Mondor’s Disease
- phlebitis of the breast
Diabetic Mastopathy
- Autoimmune, painful mass development with fibrotic nodularity
- from SA
- overweight, large breasted, previous surgery, radiation, sebaceous cysts are RFs
– extensive, painful “Boils” – from weird sweat glands in black smokers
Tx of Lactiational Infections
– Dicloxcillin, Flucloxacillin, Augmentin, Erythromycin, Clindamycin – Tetracycline, Cipr and Chloremphenicol shouldn’t be used – Continue Breastfeeding – Post I&D w/ General anesthesia: stop
– 17q21 for breast, ovarian
– 1/200-400 w/ 85% lifetime risk
– its in > half by age 50
– 1/2 of “inherited” cancers (10% of cancers)
– also increased risk of ovarian and colon cancers
– 13q breast in women and men
– 70% of inherited not due to BRCA1
– 30-40% lifetime risk
Mucinous (Colloid) Carcinoma
– Older women
– Malignant cells in pools of mucin
– Better prognosis
Tubular Carcinoma
– Younger women – Well differentiated, characterized by haphazardly arranged tubules – Excellent prognosis
Inflammatory Carcinoma
– Invasive carcinoma involving superficial dermal lymphatic spaces
– Erythema and induration of skin – dimpling
– Poor prognosis finding
Sentinel Lymph Nodes Identified by
Radioactive technetium-labeled sulfur colloid and Isosulfan blue dye
– Recombinant humanized anti-HER2 antibody
– Inhibits growth of breast cancer cells that overexpress c-erbB-2
– Enhances tumoricidal effects of chemo
genes w/ high penetrance for breast cancer
BRCA1, BRCA2, P53, Ataxia Telangiectasia mutation (ATM) – PTEN, NBS1, LKB1
DCIS Management
– Can be detected on screening MAMM w/ prognosis favorable
– Mastectomy or Lumpectomy + radiation OK
– tamoxifen + lumpectomy + rad decreases recurrence of DCIS & invasive
– best pre-menopausal women
– Selective ER modulator that blocks effects of E at tumor ERs
– E-like effects in other tissues such as bones and the endometrium, and on lipids
Tamoxifen SE’s
– altered menses, hot flashes, nausea, fatigue vaginal discharge, cataracts
– risk of thromboembolism, stroke, and uterine cancer (1:160)
– most thromboembolic events and strokes were non-fatal
– most endometrial cancer are early stage and curable
Ovarian suppression
– can be given w/ tamoxifen to pre-menopausal pts
– surgical by bilateral oopherectomy
– with radiotherapy, or w/ Gn-RH agonists like goserelin or leuprolide
– it reduces risk of recurrence
– Benefit of ovarian suppression + tamoxifen unknown
– aromatase inhibitor
– in post-menopausal
– more osteoporosis, but lower risk of thromboembolism and stroke
– aromatase inhibitor
– in post-menopausal
– more osteoporosis, but lower risk of
– aromatase inhibitor
– in post-menopausal
– more osteoporosis, but lower risk of
AC therapmy
– 3rd and 4th gen chemo regemins for breast cancer
– (better, more SE)
– every 3 weeks X 4 cycles
– topoisomerase II inhibitor and DNA intercalating -> strand breaks
– causes myelosupression, NandV, mucositis and alopecia, fatigue
– rare risk of leukemia and cardiac toxicity
– Alkylating agent binds DNA, cross-links, cell death
– Causes myelosupression, NandV
– Rare tox of hemorrhagic cystitis and SIADH
Dose Dense Therapy with AC + Taxol
– AC x 4 cycles, then Taxol x 4 cycles
– Given every 2 weeks from theory that 3 wks allows cancer cells to recover, and GFs that allow every 2 wk
– good in in LN (+) pts
– Paclitaxel may cause peripheral neuropathy, myalgias, and allergies
– does cell signaling and prolif
– Overexpression means more aggressive cancer (in 25 - 30%)
– (Herceptin)
– a monoclonal Ab against HER2-neu protein
goes against VEGF and should be used for angiogenesis of breast cancer
– inhibit osteoclast activity and monthly infusions help
– for breast cancer mets