192b histo and path of the breast

Question 1

breast anatomy

Answer 1

lobes –> lactiferous duct –> lactiferous sinuses (dilations below the nipple)

Question 2

NAC

Answer 2

nipple-areola complex

smooth muscle between ducts - erection and milk ejection

areola has montgomery’s glands, smooth muscle

Question 3

duct histo

Answer 3

dual cell layer

Question 4

breast histo

Answer 4

in flux

epithelial (duct) cells + myoepithelial cells

cancers from TDLU (terminal ductal lobular unit)

Question 5

3 big parts

Answer 5

white - fat
pink - stroma (esoin stains protein pink)
putple - epithlelaim (nucles stains dark)

Question 6

lobular unit

Answer 6

2 layers of cell

inner ductal/epithelial - makes milk

outer myoepithelial - contractile

Question 7

inactive mammary gland

Answer 7

all duct (no secrety end pieces/lobules)

still has 2 layers

dense ct common

Question 8

proliferative phase

Answer 8

TDLU formation from Estrogen (ducts) and Progesterone (TDLU)

small changes during menstrual cycle - late increased vaculation of myoepi cells

Question 9

lactation

Answer 9

milk accumulats in acini
ct replaced - no stroma
nuceli protrude

Question 10

milk secretion

Answer 10

myoepi in response to oxytocin

Question 11

inner cells

Answer 11

make milk - protein, lipid, lactose

Question 12

post menopuase breast

Answer 12

mostly stroma and fat

loss of TDLU

Question 13

begign breast path - inflammatory

Answer 13

acute mastitis - enlarged, red, painful breast during lactation from Staph Aureus entering via nipple cracks; PMNs on histo

duct ectasia - poorly defined mass; dilation of ducts; old women; secretions and foamy chronic macrophages –> squamous metaplasia

Question 14

benign breast - fibrocystic; non-proliferation

Answer 14

non-proliferative
-cysts - low cubodial epi lining void of cells

• apocrine metaplasia - hyperplasia from low cubodial to eosinophilic with apical snouts; can form micropapilla
• fibroadedoma - mass lesion in women < 30 y/o; ruvvery and mobile; mobile; stroma and epithelial component –> compresses duct system

Question 15

benign proliferation without atypia

Answer 15

usual ductal hyperplasia - more layers than typical 2 layers - cells fill space; increase number of cells, but normal cell types; jumbled look of cells

atypical ductal hyperplasia - surigcal excision; epi cells only – monotony of cells; very round cells with organized look

atypical lobular hyperplasia - uniform, small cells that fall apart from each other - spaces between each other

sclerosing adenosis - microscopic finding; calcifications; lobule proliferation that are distrorted;

radial scar - looks like cancer; stellate appearance; central nidus with fibrosis (pink) w/out glands; dilation at periphery

intraductual papilloma - thicl fibrovascular core near nipple- can cause discharge; finger like projections; solitary

Question 16

calcium oxolate

Answer 16

benign processes