Clinical Anatomy of Breast Cancer

00:01 I told you earlier that I would walk you through the clinical anatomy of breast cancer.

00:05 On the left is your nipple and as you move from the nipple all the way down to stroma, we’ll take a look at various pathologies underneath.

00:14 With the nipple, two major issues that could occur.

00:17 You can have Paget’s disease or you could have acute mastitis.

00:22 Acute mastitis, you might have an abscess formation.

00:25 If there’s abscess formation, close your eyes, what does the breast look like in a female there? The center area might be a little bit yellowish and purulent and the surrounding tissue, inflammatory, will be erythematous.

00:37 Then you have Paget’s disease of the nipple.

00:39 And we’ll talk about that in greater detail. We have to.

00:41 This is mammary type, obviously.

00:44 From your nipple, you’ll then move into lactiferous sinus.

00:47 The major pathology that we discussed in lactiferous sinus thus far is intraductal papilloma.

00:54 Would you please take a look at how close your lactiferous sinus is to the nipple.

00:59 So therefore any lesion or pathology to the sinus is then going to result in -- 80% of your patient, what kind of discharge? Bloody or serous.

01:08 You could also have the mastitis that may affect this area as well, but superficially. Superficially.

01:14 After this, we’ll get into our ducts.

01:16 You have a big major and you have a little terminal duct.

01:20 Group them together, please. And you call them ductal.

01:24 In the previous discussion, we began with malignancy.

01:26 We looked at ductal carcinoma in situ.

01:29 That means that the ducts here, if they undergo cancerous change with maybe ductal hyperplasia and specifically I told you about comedocarcinoma that the basement membrane is going to be intact.

01:42 But that’s where you’d find your ductal carcinoma in situ.

01:45 And then if you finally go distally, you see these lobules? There down distal, down by the stroma or back deep by the stroma.

01:54 And then we’ll talk about lobular carcinoma in situ and invasive lobular cancer.

02:01 What’s then hanging on to the breast? Or should I say the breast is then implanted onto the stroma.

02:08 So think of this as being kind of like your scaffolding.

02:11 The stroma here, a couple of important benign tumors that we have discussed.

02:17 Fibroadenoma, how old is your patient? Young, estrogen-responsive, and with fibroadenoma, you’re thinking about fibrous change.

02:28 Is it small or big, fibroadenoma? A small tumor.

02:33 Phyllodes tumor.

02:35 Age range? Elderly, postmenopausal. Commonly sixth decade.

02:40 In terms of the size of the tumor, small or large? Large.

02:44 What about it’s increased risk of cancer? Much greater than fibroadenoma.

02:50 I asked you kindly to make sure that you compare and contrast phyllodes and fibroadenoma.

02:54 I’ve just given you brief little points.

02:56 Let’s continue, please.

02:58 Spend a little bit time make sure that you’re completely comfortable up and down the breast apparatus.