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breast 2,3

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a rare maignant neo in which the smears show sheets of epi cs similar to those from fibroadenoma. fragments ofl loose but cellular connective tissue, traversed by capillaries arae evident.
cystosarcoma phyllodes
what % br cancer men
1
a blood tinged nipple discharge usually related to-
intraductal papilloma
what color cyto of apocrine met on pap
greenish-orange
what is overall 10 yr survival rate of breast cancer
50%
non-neo/smears show many anucleated squames and sq cs in an acute and chronic inflam bkgrnd
subareolar abscess
what cancer of fem genital tr increases risk for breast cancer
cancer of endometrium
what is usual diagnostic procedure once abnomality is identified to distinguish benign from malig
biopsy
what is cell shape of apocrine met
large round to polygonal
what stain other than pap for pagets dis
wright/MGG
the most common benign solid mammary neo
fibroadenoma
what stage is regional
2
whaat cond of breast may ocur with history of trauma, previous surg, or radiation therapy
fat necrosis
is br cancer common cause of cancer death in women
second most common
what are reproductive factors that increase risk of breast cancer
younger age of menarche and later menopause,nulliparity, older age at biirth of first child
Is Ni in paget's dis cells round or mishapen
mishapen
geo,where is br cancer most common
us, northern europe, then japan, taiwan
apocrine cell
Relating to a type of glandular secretion in which the apical portion of the secreting cell is released along with the secretory products.
in what pop are the majority of br cancers
postmenapausal
which stage is disseminated disease
4
describe cells in aspiration of paget's disease of br
usually large,round hyperchromatic N and promNi
how does genetics affect risk of breast cancer
individual risk increases with greater no of affected first deg relatives, younger age onset, and bilateralilty. High risk in some families. Li-Fraumeni syndrome
most common of all breast lesions(benign or malig,solid or cystic)
breast cyst
% women affected by fibrocystic changes
10%
what individual factors increase risk factor for breast cancer
atypical ductal or lobular hyperplasia, contralateral breast cancer, cancer of endometrium
survival rate stage 4
10% 5 yr survival
10 benign breast neoplasms
SUBAREOLAR ABSCESS,FIBROADENOMA,FIBROCYSTIC CHANGES,DUCTAL HYPER-PAPILLAMATOSIS,INTRADUCTAL PAPILLOMA,PAGEEET'S DISEASE,INTRAMMARY LYMPH NODE,FAT NECROSIS,APOCRINE MET,BREAST CYST
3 possible causes of nipple discharge
systemic neuroendocrine disorders,lesions within breast as intraductal papillomas,lactational changes induced by tranq drugs or oral contraceptive
what are ducts lined by
cuboidal or low columnar epi and outer layer of myoepithelial cells
percentage of women who will get br cancer
1 in 9
malignant neo/smears thick with abundant pink mucoid material(brownish on pap) traversed by branching capillaries. the neooplastic cells may be arranged in tight clusters lacking N atypia. they may also be arranged in sheets or singly with cyto vacs of aried sizes, and slight to mod variaation in N size and shape
colloid carcinoma
describe involvement of all 4 stages br carc
stage1-LOCALbreast only/stage2 REGIONAL no distant met mobile oxillar lymph node/stage3 ADVANCED REGIONAL-no dist met llymph,skin,chest wall pectoral muscle involstage4 FULL BLOWN BOTH SIDES-distant met, lymph node involvem
6 risk factors for br carc
1.GEOGRAPHY/2.GENETICS/3.INDIVIDUAL --FACTORS - atypical hyper , endomet carc/endocrine-obessity,estrogen sups or obesity/diet/ENVIRO,-smokingDIET-high fat REPRODUCTIVE FACTORS-multiparity,older at first birth,early menarche, late menapause
what color cyto of apocrine met on hematologic stain
grayish pink
survival rate stage2
65% 5 yr surv
name epi that lines distal sinuses of br
kert.sq epi?
describe cytologic appearance of a cell from apocrine met-cell shape, N Ni, cyto
cell shape is large, round or p olygonal/Nround/ Ni prom/cyto-abundant( grayish pink with hematologic stain/green-orange on pap)
whaat is 5 yr survival rate for stage 1
80%
what is it generally assumed that paget's disease of the br is due to
infiltration of sq epi of nipple by carc cs derived from underlying intraductal or infiltrating carc
non-neo/smears varied pop of mature lymphocytes,immunoblasts,plasma cells,histeocytes(some with ting bods) and lylmphoid tangles
intramammary lymph node
5 yr survival rate stage 3
40%
what is usual age for fibrocystic change
30's and 40's
malignancy assoc with paget's disease of br
ductal adeno-in situ or infiltrating
name and explain the four stages of br carc
STAGE 1-localized ,less than 2cm,limited to breast-80%,5yr survival/STAGE 2-regional, less than 5 cm, with involved but mobile oxillary lymph nodes,or tumor more than 5 cm with regular nodes. no distant mets-65% 5 yr survival/STAGE 3 advanced regional disease, tumor involving pectoral muscles or chest wall;fixed involved lymph nodes,no distant met 40% ,5 yr survival/STAGE 4 distant mets, including ipsilateral,supraclavicular lymph node-10% 5 yr survival-Full blown-both sides
a benign neo in which smeaars extremely cellular. the ei cells are arranged in sheets with honeycomb appearance and in irreg clumps and clusters with blunt branching(staghorn). the small hyperchromat N of myoepithelial cells are scattere through the sheets and clusters of epi cells. Many bipolar N are seen in bkgrnd
fibroadenoma
name neoplasm related to blood-tinged nipple discharge
intraductal papilloma
other than stage what are prognostic factors of br cancer
grade-(well,mod or poorly diff),steroid hormone(estrogen,progesterone)receptors, growth rate, oncoagene expression, invasive potential(evidence of lymphatic or vascular invasion
3 cellular elements frequently found in breast aspirates
bipolar naked n,fibroadipose tiss,ductal cells
non-neoplastic process in which smears exhibit sheets(monolayers),often folded,composed of regular ductal cells and occasional myoepithelial cells. Clumps of ductal cells with glandular lumina in their centers and irreg borders with fingerlike projections are also present. Stripped N may be present
ductal hyperplasia-papillamatosis
does the incidence of br cancer risk increase with age
yes
8 malignant neoplasms of breast,
ductal adeno(NOS), ductal cell carcinoma with sq diff, lobular, colloid,apocrine cell carcinoma. mucus cell,cytosarcoma phylloides, medullary carcinoma
what is connection of menstrual cycle on fibrocystic change
may wax and wane with cycle
is br cancer decreasing
no increasing
what are dietary and enviromental risk factors
high fat diet, moderate alcohol consumption, smoking and side-stream smoke, enviromental toxins, pesticides
which stage is localized
1
describe Ni of apocrine met
prominent
6 cellular elements found in br aspirates
ductal cells/apocrine met cells/stripped naked bipolar n/myoepithelial cells/histeocytes/fibroadipiose tiss
do oral contraceptives increase risk of breast cancer
no apparent risk
what is most important predictor of outcome
stage-determined by size and exent
what are 7 risk factors in br cancer
geography,genetics, individual factors, reproductive factors, endocrine, diet and enviromental
the ducts of the br are lined by what epi
cuboidal or columnar
a malignant neo in which smears display enlarged, irreg naked N with prom Ni. It is important to differentiaate these cels from malignant lymphoma. many lymphocytes,histiocytes, and p lasma cells are observed surrounding the epithelial cell clusters and in the background
medullary carcinoma
in what age group is br cancer uncommon
under 25
3 collection methods for br cytology
scraping of nipple/nipple secretions(discharge),FNA
the outer layer of br ducts is layer of------
myoepithellial cells
describe cytologic pic of benign breast cyst-at least 3 components
amorphous debrit/leukocytes/a few macrophages/clusters of ductal cells with small regular n and scanty cyto/some groups ductal cells with appocrine met
what must be present for adequacy in br aspirate
fibroadipose tiss
non-neo smears with bubbly appearance due to inumeraable lipid laden macs with abundant vacuolaated cyto. may be caused by jogging and aerobic excercise withour support
fat necrosis
what are endocrine factors that increase risk of breast cancer
estrogen suppliments,obesity
which stage is advanced regional disease
3
5 yr survival rate ppercentages of 4 stages br carc
stage one 80%/stage2-64%/stage3-40%/stage4-10%
what carcinoma accounts for 75% of all br cancers
ductal
malignant neoplasm that may be interpreted as unsat by inexperienced. scant cellularity. small gps of loosely cohesive cells with scant cyto and enlarged irregular N,whaich are sometimes attached to p ale pink fibrocollagenous tissue
lobular carcinoma

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