16.2 - Benign tumors and fibrocystic changes of the breast

Question 1

lumpy breast, upper outer quadrant - diagnosis?

Answer 1

fibrocystic change (benign)

Question 2

gross exam reveals a blue dome appearance on the breast - diagnosis?

Answer 2

fibrocystic change

Question 3

what are the different types of fibrocystic change of the breast? which confer an increased risk of invasive carcinoma?

Answer 3

• fibrosis, cysts, apocrine metaplasia - NO RISK
• ductal hyperplasia and sclerosing adenosis - 2X RISK
• atypical hyperplasia - 5x RISK

Question 4

how does intraductal papilloma differ from papillary carcinoma, histologically?

Answer 4

• intraductal papilloma: lined by epithelial (luminal) and myoepithelial cells
• papillary carcinoma: fibrovascular projections lined by epithelial cells WITHOUT underlying myoepithelial cells

Question 5

how does intraductal papilloma present?

Answer 5

bloody nipple discharge in a premenopausal woman (papillary carcinoma also presents this way)

Question 6

what is the most common benign neoplasm of the breast?

Answer 6

fibroadenoma

Question 7

well-circumscribed, mobile marble like mas - diagnosis?

Answer 7

fibroadenoma

Question 8

are fibroadenomas estrogen sensitive or estrogen resistant?

Answer 8

estrogne sensitive

Question 9

what is a phyllodes tumor?

Answer 9

fibroadenoma-like tumor with overgrowth of the fibrous** component, with characteristic “leaf-like” projections

Question 10

what is the hallmark feature of a phyllodes tumor?

Answer 10

leaf-like projections

Question 11

leaf-like projections are seen on biopsy of a breast tumor - diagnosis?

Answer 11

phyllodes tumor

Question 12

do phyllodes tumors typically affect premenopausal women or postmenopausal?

Answer 12

postmenopausal