Pathophysiology of breast cancer

Breast Composition - a mass of glandular, fatty, and fibrous tissues.

Lobules – milk glands that produce milk
Ducts – transport milk from lobules to nipple
Nipple
Areola – pink or brown pigmented region surrounding the nipple.
Connective (fibrous) tissue that surrounds the lobules and ducts.
Fats

(will show the photo of the composition of breast on friday, sorry, the internet connection here is too terrible)


What is Breast Cancer ?
-Uncontrolled growth of breast cells, forming tumor.
-mutations, abnormal changes in the gene
-Benign (not dangerous)
*Grow slowly
*Do not invade nearby tissues
-Malignant ( dangerous , cancerous)
*Spread to other parts of the body


Where does breast cancer begin ?

-Cell of lobules
-ducts
-Less commonly :
Stromal tissues ( fatty and fibrous connective tissues)


Common form of breast cancer :
-Ductal Carsinoma In Situ (DCIS)
Ductal epithelial cells undergo malignant transformation and proliferate intraluminally.
Debris can calcify (tiny calcium deposits)
5 pathologic subtypes : comedo, papillary, micropapillary, solid and cribriform.
Lesions represent a combination of at least 2 of these subtypes

-Lobular Carsinoma In Situ (LCIS)
↑ in the no. of cells within the lobules
Lobular pattern
Rarely detected by examination or mammography
As a marker for development of invasive cancer

-Infiltrating Ductal Carsinoma
Most commonly diagnosed breast tumor.
Invasive
Lobules ?? wall of ducts ?? fatty tissue of breast (possible to other regions of the body)
Tendency to metastasize via lymphatics

-Infiltratiltrating Lobular Carsinoma
Invasive
Begins in lobules , able to metastasize (lymph nodes)
Tendency to be more multifocal.
Indian file arrangement of small tumor cells


Less common form of breast cancer :
-Tubular Carcinoma
Invasive
Forms distinct boundary between tumor tissue and normal tissue.
Rarely metastasize.

-Mucinous Carcinoma
Slow growing lesions
Mucus-producing cancer cells
Bulky
Rarely metastasize.
Better prognosis (expected outcome) than other common types of invasive carsinoma.

-Medullary Carcinoma
Invasive
Poorly differentiate tumor
Distinct boundary between tumor tissue and normal tissue.

-Inflammatory breast cancer
Inflamed breast
Red and warm
Dimples
Thick ridges
Cancer cells blocking the lymph vessels
Extremely fast growing

-Paget’s disease of the nipple
Milk duct → skin of nipple and aerola
Breast skin may appear crusted, red or oozing.
Nipple changes
No lump is felt

-Phylloides tumor
Can be benign or malignant
Develop in the connective tissues of the breast.
Treated by surgical remove.

Link :
http://emedicine.medscape.com/article/1276001-overview
http://www.imaginis.com/breasthealth/dcis.asp
http://www.breastcancer.org