Breast Cancer
Pathophysiology of Breast Cancer
Breast cancer is a:
1) neoplastic transformation of glandular epithelium of the terminal duct unit, lactiferous proximal ducts, or lobules of the breast
2) almost always adenocarcinoma
3) classification is controversial, but most experts recognize in situ (malignant cells do not invade through the basement membrane) and invasive forms
4) in situ types – intraductal (comedo and noncomedo sutypes) in situ, lobular in situ, and papillary in situ
5) invasive types – ductal, lobular, tubular, colloid, and medullary
Signs and Symptoms
1) palpable mass – hard, irregular, no discrete margins, fixed to underlying tissue
2) nipple discharge
3) breast pain
4) retracted or puckered skin
5) skin erythema and edema owing to blocked lymphatics in skin (peau d’orange)
6) itchy, scaly, ezcema-type tissue on nipples (Paget’s disease)
7) palpable lymph nodes
Characteristic Test Findings
Radiology
mass or suspicious calcifications on mammogram
Histology/Gross Pathology
Comedo intraductal in situ
1) large, pleomorphic cells
2) distended ducts with necrotic material
Nocncomedo intraductal in situ
3) cells usually smaller than comedo
4) lacks necrotic material
Lobular in situ
5) often an incidental finding on breast biopsy
6) small cells with minute nucleoli
7) considered marker for high risk for subsequent invasive cancer
Invasive ductal
8) stromal invasion occurs with irregular nests and cords of epithelial cells
9) fibroblastic proli...
Source: Inside Surgery - Category: Surgeons Authors: Editor Tags: Breast Surgery Oncology adenocarcinoma BRCA1 BRCA2 comedo in situ invasive ductal Li Fraumeni lobular peau d'orange Source Type: blogs
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