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  • Malignant Breast Diseases

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    Lily Margaret Charlotte
    90 vues28 pages
    Malignant breast diseases include breast cancer, carcinoma in situ, and other rare cancers. Breast cancer is the most common cancer in women and a leading cause of cancer death. It commonly spreads from the breast to lymph nodes under the arm and can then spread to distant sites like the bones, lungs, liver and brain. Carcinoma in situ involves abnormal cell growth confined to the ducts or lobules but has not invaded further. Invasive ductal carcinoma is the most common type of breast cancer and has the poorest prognosis.

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    Malignant breast diseases include breast cancer, carcinoma in situ, and other rare cancers. Breast cancer is the most common cancer in women and a leading cause of cancer death. It commonly spreads from the breast to lymph nodes under the arm and can then spread to distant sites like the bones, lungs, liver and brain. Carcinoma in situ involves abnormal cell growth confined to the ducts or lobules but has not invaded further. Invasive ductal carcinoma is the most common type of breast cancer and has the poorest prognosis.

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    90 vues28 pages

    Malignant Breast Diseases

    Transféré par

    Lily Margaret Charlotte
    Malignant breast diseases include breast cancer, carcinoma in situ, and other rare cancers. Breast cancer is the most common cancer in women and a leading cause of cancer death. It commonly spreads from the breast to lymph nodes under the arm and can then spread to distant sites like the bones, lungs, liver and brain. Carcinoma in situ involves abnormal cell growth confined to the ducts or lobules but has not invaded further. Invasive ductal carcinoma is the most common type of breast cancer and has the poorest prognosis.

    Droits d'auteur :

    Attribution Non-Commercial (BY-NC)
    Téléchargez comme PPTX, PDF, TXT ou lisez en ligne sur Scribd
    Signaler comme contenu inapproprié
    sur 28

    Malignant Breast Diseases

    Breast Cancer
    Most common site-specific cancer in women Leading cause of death from cancer 20-59 years Primary Breast Cancer
    80% productive fibrosis that involves epithelial and stromal tissue Skin retraction shortening of Coopers suspensory ligaments Ulceration invasion of the skin

    Metastasis
    Axillary Lymph Node Metastasis
    Via lymphatics Level 1 (low) > level II (apical) > Level III (axillary) Axillary LN status most important prognostic correlate of disease free and overall survival

    Distant Metastasis
    Neovascularization Batsons plexus of veins or axillary and intercostal veins Bone>lung>pleura>soft tissue>liver

    Carcinoma In Situ
    Does not invade basement membrane

    Lobular CIS
    Lobular CIS
    Usually incidental finding (-) calcification Younger women Histo
    Distention and distortion terminal duct lobular units Cytoplasmic mucoid globules

    Almost always ER and PR (+) Higher propensity to be bilateral Sx: (B) prophylactic mastectomy, tamoxifen

    Ductal CIS
    Ductal CIS
    15-30% Mammogram calcification
    Papillary growth pattern Cribiform growth pattern Solid growth pattern Comedo growth pattern

    Anatomic precursor of invasive ductal CA 5x increase for invasive breast CA Mastectomy curative in 95% but BCT is SOC

    BRCA1 vs BRCA 2
    BRCA1
    Only females Poorer differentiation Aggressive clinical course Do not express hormone receptors Over expression of Her 2 ne

    BRCA2
    Both males and females Poor differentiation ER (+)

    Invasive Breast CA
    Pagets Disease of the Nipple Invasive Ductal Carcinoma
    Adenocarcinoma with productive fibrosis 80% Medullary carcinoma Muinous carcinoma Papillary carcinoma Tubular carcinoma

    Invasive Lobular Carcinoma Rare cancers (adenoid cyst, squamous cell, apocrine)

    Pagets Disease of the Nipple


    Unilateral chronic eczematous eruption Ulcerated weeping lesion Associated with extensive DCIS Pathognomonic sign: large vacuolated cells (Paget Cells) in the Rete pegs of the epithelium Sx: lumpectomy, mastectomy, MRM

    Invasive Ductal CA
    Most common Poorest prognosis

    IDC: Adenocarcinoma with productive fibrosis


    60% of axillary lymph node metastasis Perimenopausal/postmenopausal 5th to 6th decades Solitary firm mass, poorly defined margins Central satellite configuration with chalky white or yellow streaks

    IDC: Medullary Carcinoma


    BRCA1 Soft and hemorrhagic Rapid increase in size -> necrosis and hemorrhage Bulk, well circumscribed and often positioned deep within the breast 50% are associated with DCIS

    IDC: Mucinous Carcinoma


    Elderly Bulky tumor Histo
    Extracellular pools of mucin, which surround aggregates of low grade cancer cells Glistening and gelatinous

    66% have hormone receptors 33% have lymph node mets 5 year survival 73% 10 year survival 59%

    IDC: Papillary Carcinoma


    7th decade of life Small <3cm With papillae with fibrovascular stalks and multilayered epithelium

    IDC: Tubular Carcinoma


    Perimenopausal or early menopausal Histo:
    Haphazard array of small randomly arranged tubular elements

    Distant metastases are rare Only 10% have lymph node metastases

    Histologic grading system for Invasive Breast CA

    Invasive Lobular Carcinoma


    2nd most frequent type (5-10%) Replaces the entire breast with poorly define mass Multifocal, multicentric, bilateral Hallmark single file pattern Bone mets more common (mets to leptomeninges, peritoneum, GI tract and reproductive organs)

    Phyllodes Tumors
    Benign, borderline, malignant Sharply demarcated Bulk is connective tissue with mixed gelatinous, solid and cystic areas Cut surface: leaf life appearance Rare axillary LN mets

    Inflammatory Breast CA
    Stage IIIB Skin changes:
    Brawny induration, erythema with a raised edge and edema (peau dorange)

    Frequent distant mets

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