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Breast Pathology
Path Assessment 12
23
Pathology
01/25/2012

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Cards

Term
Non-Neoplastic - Acquired
Definition
Acute mastitis/Abscess
Silicone Implants
Fibrocystic Change/Disease
--Sclerosing Adenosis
--Large Duct Papilloma
Traumatic Fat Necrosis
Term
Silicone Implants and Assoc Changes
Definition
pseudo-capsule - resembles pearly white joint capsule
Foreign Body Type Granulomatous response
Term
Fibrocystic Changes/Disease
Definition
Most Common Disorder of Breast
Women 25-45
Increased Estrogen or Decreased Progesterone
Lumpy Breast
Midcycle tenderness
Blue Dome Cysts
Apocrine metaplastic cells in Papillary configuration

Nonproliferative: No increased risk of breast cancer
Proliferative: Epithelial hyperplasia or Sclerosing adenosis, slight increased risk of cancer
Term
Sclerosing Adenosis
Definition
Fibrocystic Change

Proliferation of small duct and Myoepithelial cells with Fibrosis

Microcalcifications

Firm, Rubbery, painless, well-circumscribed
Actin + myoepithelial cells
Radial Scar

Compressed Tubular Glands
Dense Fibrous Stroma
Term
Large Duct Papilloma
Definition
Fibrocystic Change

Estrogen Sensitive
Apical Ductal Hyperplasia-> increased risk of cancer

Intraductal papilloma-> Bloody Nipple discharge
Women <50yo
Term
Fat Necrosis
Definition
Trauma
Lactation, Pregnancy, Sports Activity
Lipid Laden macrophages
Calcifications
Puckering of Skin
Foamy Macrophages or Giant cells
Term
Fibroadenoma
Definition
Most Common Benign Tumor
Women 20-35
Fibroadenomatosis
-- Post Renal Transplant
-- EBV in immunosuppressed
Circumscribed
Freely Mobile
Stromal w/ epithelial component
Stroma-> Benign
Estrogen Responsive
Term
Phyllodes Tumor
Definition
Derived for Stromal Cells
45yo, Latin American Hispanics
Like Fibroadenomas but recur
can be malignant

Benign: Resemble FA w/ cell stroma
Borderline: Mitotic figures. Recur
Malignant: Rare, stromal>ductal growth, Hypercellular stroma with mitoses.
Term
Gynecomastia
Definition
Male breast enlargement
increased estrogen/androgen ratio
alcohol, cirrhosis, drugs, Kleinfelter's, decreased estrogen metabolisium,
Term
Atypical Ductal Hyperplasia
Definition
Ductal structures with epithelial proliferation and cellular atypia

Lumens not fully occluded/not sharply defined
Increased risk of carcinoma
Multilayering of cells
Enlarged Nuclei
Term
Atypical Lobular Hyperplasia
Definition
Lobular proliferation
Monomorphic
Focal preservation of luminal spaces
Term
Breast Cancer
Predisposing Factors
Definition
Age
(+)FH
Hx of Cancer in one breast
Early menarche/Late menopause
Obesity
Nulliparity
HRT
1st pregnancy after 30yo
High Fat Diet
Proliferative Fibrocyctic Disease
Endometrial Cancer, Ionizing radiation, Smoking
High Breast Density
Term
l
Definition
Term
Ductal Carcinoma in situ
(DCIS)
Definition
Nonpalpable
microcalcifications
Do Not involve Stroma
4x more common than LCIS
1/3 eventually evade
Term
Lobular Carcinoma in situ
(LCIS)
Definition
Cluster of Neoplastic cells
Bilateral
Nonpalpable
not identified by mammography
Usually E/P receptor positive
Term
Comedo Carcinoma
Definition
DCIS variant
Tumors fill ducts, necrosis results in cheese like consistency
40%-> invasive
Her2 amplification
p53 positive
ER/PR negative
Term
Paget's Disease of Breast
Definition
Eczematoid lesion of nipple/areola
Underlying Ductal Carcinoma
Large Cells, Clear Cytoplasm
PAS stain
Term
Ductal Carcinoma NOS
Definition
Most Common Type
Penetrative
Calcifications
Tubule Formations
Nuclear pleomorphism and mitoses
Invades Stroma
Tumor cells arranged in Sheets
Term
Invasive Lobular Carcinoma
Definition
Neoplastic cells arranged in lines
Mets-> CSF, BM, GIT, Serosal Surfaces, ovary, uterus
Signet Ring Cells
Term
Inflammatory Carcinoma
Definition
Enlarged Edematous Breasts
Peau d'orange
Lymphatic occlusion
Tumor plugs lymphatics-> lymphedema
Poor Prognosis, Aggressive
Term
Colloid Carcinoma
Definition
Extracelluar mucus surrounding clusters of tumor cells
Elderly Women
Slow Growth
Term
Tubular Carcinoma
Definition
Terminal Ductules
Well differentiatied
Good Prognosis
50yo
Term
Angiosarcoma
Definition
usually younger women
Poor Prognosis
Anastomosing vascular channels lined by atypical cells
Hyperchromatic malignant endothelial cells
Stain + for Factor VIII antigen & CD34