Exam 2 — malignant

Most common sign of a malignancy

New lump

Where does most breast cancer originate and arise

Originated from duct and arise from the TLDU

Where is most breast cancer located

UOQ

What are the 5 risk factors for breast cancer

Age, relatives, period longevity, amount of children, hormone therapy

Biggest sign of malignancy on ultrasound

Taller than wide

Used for the classification of mammographic masses

BI RADS

What does BI RADS stand for

Breast imaging reposting and data system

Number 4 of BIRADS usually requires:

Biopsy

Number 3 of BI RADS needs what

Short term follow up

What are the 2 categories for breast carcinoma

Cancer cell origin

probability of spreading

In situ

Same area/ in its origin

Malignant stage 2

Localized spread

Malignant stage 3

Locally advanced

Malignant stage 4

Metastatic - spread beyond liver

Speculations

Finger like

Sonographic characteristics of malignant lesions

Angular margins

Speculations

What will a malignancy sometimes do in order for it to stay in place

It will anchor itself

What size microlobulations indicates malignancy potential

more than 3

Sonographic characteristics of malignant lesions

Posterior shadowing, hypogenicity, microcalcifications, fixed, not compressible, increased vascularity

DCIS

Duct carcinoma in situ

Papillary carcinoma

Mole turned cancerous + bloody nipple discharge

Pagets disease

Nipple skin changes

Inflammatory breast cancer IBC

IMPORTANT to get history, mastitis but cancerous, skin changes - pedu de orange

What does Pedu de Orange refer to

IBC

Duct carcinoma in situ (DCIS)

Excessive growth of abnormal epithelial cells within the duct without spreading outside walls

If left untreated, DCIS can lead to:

Invasive cancer

What is common in DCIS

calcifications and ductal enlargement with extension

Ducts carcinoma in situ is AKA

Intraductal carcinoma

What is the most common type of breast cancer

Invasive ductal carcinoma

What breast cancer accounts for nearly 80% of all breast cancers

Invasive ducal carcinoma

Invasive/infiltrating ductal

Palpable mass, hard/gritty texture, fixed position

Invasive ductal carcinoma invades the fatty tissue of the breast and can then metastasize via

the bloodstream or lymphatics

Lobular carcinoma in situ

Precancerous growth that begins in the lobule

Women are at more risk of developing a breast cancer in:

The same breast or in the opposite breast later on

Where is LCIS at

Confined to gland and does not penetrate walls of lobule

What non malignancy does not form a distinct mass and is difficult to see on a mammogram or ultrasound

Lobular carcinoma in situ

Multicentric

multiple quadrants of same breast, different cell type

Multifocal

Multiple areas same quadrant, same cell type

Other than IDC, what other invasive tumor type can metastasize to other parts of the body

Invasive lobular carcinoma

Where does invasive lobular carcinoma start and end

Starts in the lobules and extends to fatty tissue

Milk producing glands

Lobules

Tell tale sign of papillary carcinoma

Bloody nipple discharge

What is papillary carcinoma

Benign tumor that grows in the acini in the duct of the breast

Where does papillary carcinoma arise from

An intraductal papilloma

How might papillary carcinoma arise as

Intracystic tumor or benign ductal papilloma

How rare is papillary carcinoma

1-2%

When might papillary carcinoma occur

Postmenopausal

Any deformity of the nipple and areola should suggest

Paget’s disease

Paget’s disease arises in ________ and grows in ____________

Retroareolar ducts; direction of nipple

Who is Paget’s disease normally in

Women over 50

What disease causes rash like appearance as well as burning and itching

Paget’s disease

Heterogenous mass behind the nipple with irregular margins and posterior shadowing

Paget’s disease

What is Paget’s disease almost always associated with

DCIS

What is the treatment for Paget’s disease

Mastectomy

Progression of inflammatory breast cancer

Rapid

How does the breast appear for inflammatory breast cancer

Red swollen and tender

Occurs when cancer cells block the lymphatic vessels in the skin covering the breast, causing the characteristic red, swollen appearance of the breast

Inflammatory breast cancer

Similar to mastitis

Inflammatory breast cancer

Well circumscribed mass with central necrosis

Medullary carcinoma

what can medullary carcinoma resemble

Fibroadenoma

Main clinical finding for medullary carcinoma

Discoloration of skin

What size does a lymph node have to be to biopsy it

Greater than 2.5mm