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3 Benign breast disease Flashcards

1
Q

What does fibrocystic change of the breast mean?

A

Describes fibrosis and cysts with reactive and degenerative changes that occur in the breast of older women

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2
Q

What is Atypical Epithelial Hyperplasia?

A

When epithelial hyperplasia becomes multilayered, with atypical nuclear change

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3
Q

What is the most common inflammatory disease of the breast? What is it is caused by?

A

Acute mastitis.

Caused by purulent bacteria such as Staph and Strept

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4
Q

How does bacteria invade the breast in acute mastitis?

A

Thru the dilated milk ducts and thru skin lacerations or injuries during suckling

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5
Q

How does stagnant milk affect acute mastitis?

A

Provides growth medium for the bacteria

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6
Q

Which inflammatory cells infiltrate the entire edematous breast in acute mastitis?

A

PMNs

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7
Q

What is the cause of chronic mastitis?

A

It is unknown

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8
Q

What can chronic mastitis mimic b/c it produces small lumps?

A

Cancer, so a biopsy is needed to rule out

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9
Q

When extensive necrosis occurs from acute mastitis, what tissue may replace the destroyed breast tissue?

A

Fibrous scar tissue, nipple may retract and can be mistaken for carcinoma of the breast

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10
Q

What is fat necrosis of the breast?

A

Grossly, there is hemorrhage with central fat necrosis which later forms a nodule of gray-white tissue with foci of chalk-white debris

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11
Q

Where does fat necrosis of the breast occur?

A

Tends to occur in one breast as a solitary, sharply localized process in one breast. Almost all patients give a prior history of trauma, prior surgical intervention, or radiation therapy

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12
Q

What is a Fibrocystic change of the breast?

A

Fibrosis and cysts with reactive and degenerative changes that occur in the breast of older women

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13
Q

What does Fibrocystic change of the breast produce?

A

Palpable lumps in the breast substance, and histologic signs are found in approximately 50% of all women whose breasts are examined in autopsy or biopsy

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14
Q

When does Fibrocystic change of the breast occur?

A

Does not occur before puberty, and is unusual to be diagnosed with a clinical onset in postmenopausal women

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15
Q

What percentage of women b/w 20-50 years of age have symptoms pertaining to Fibrocystic change of the breast?

A

Only 10-15% have symptoms it is estimated

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16
Q

T/F Women who have symptoms related to Fibrocystic change of the breast show improvement after menopause

A

T

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17
Q

What hormones are related to the pathogenesis of Fibrocystic change of the breast?

A

Sex hormones - estrogen, progesterone, which stimulate the proliferation of cells in the excretory ducts of the breast and the intralobular stroma

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18
Q

What is the etiology of Fibrocystic change of the breast?

A

Imbalances in estrogen/progestrone that produce changes not only in the ducts and lobules but also in the stroma

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19
Q

What are some of the changes included in Fibrocystic change of the breast?

A

Dense fibrosis, cystic dilation of ducts, and various ductal proliferative changes

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20
Q

What is the most common feature of Fibrocystic change of the breast?

A

Fibrosis

21
Q

What is the normal loose intralobular CT replaced with in Fibrocystic change of the breast?

A

Dense CT rich in collagen, but unresponsive to hormones

22
Q

Why does the ductal epithelium continue to proliferate in Fibrocystic change of the breast?

A

B/c it retains its responsiveness to hormones

23
Q

How may cysts form in Fibrocystic change of the breast?

A

The dilated ducts may become entrapped in the dense ct stroma, leading to formation of cysts

24
Q

What are the most common alterations in Fibrocystic change of the breast? Besides this, what is also always present?

A

Formation of Blue-Domed cysts.

Epithelial hyperplasia is always present

25
Q

What is the term for epithelial hyperplasia that becomes multilayered in Fibrocystic change of the breast?

A

Atypical epithelial hyperplasia

26
Q

What is the only change related to the development of carcinoma in Fibrocystic change of the breast?

A

evidence of Atypical epithelial hyperplasia

27
Q

What indicates a greater risk of developing carcinoma in Fibrocystic change of the breast? Are any other changes associated with increased risk for carcinoma?

A

The more severe and atypical the hyperplasia, the greater the risk. All other changes are NOT associated

28
Q

T/F Clinically, fibrocystic changes usually affect both breasts, and b/c the changes are symmetrical, pts may complain mostly of pain, nodularity, and sensitivity on palpation

A

T

29
Q

What does the fluctuation of small lumps correspond to in Fibrocystic change of the breast?

A

They would correspond to the fluid filled cysts and are easily palpatable

30
Q

What may mammography reveal in Fibrocystic change of the breast? What is the surest way to establish diagnosis and why?

A

Condensed areas, cysts, and even areas of calcification.
Calcifications are indistinguishable from those seen in cancer and biopsy is the surest way to establish a definitive diagnosis

31
Q

Does typical fibrocystic change require treatment in Fibrocystic change of the breast?

A

Not unless premalignant changes from atypical epithelial hyperplasia are found, if found then additional surgical resection is recommended

32
Q

What do most surgeons perform in Fibrocystic change of the breast? What is the prognosis?

A

An extended lumpectomy - remove the indurated glandular part of the breast parenchyma. Excellent overall

33
Q

What is the most common of benign tumors of the breast?

A

Fibroadenomas

34
Q

What are the typical characteristics of fibroadenomas?

A

Typically measure 2-5 cm in diameter.
Well incapsulated spherical nodules, usually well-circumscribed from the breast parenchyma and are freely moveable from the surrounding breast substance

35
Q

What two components make up fibroadenomas?

A

Fibrous stroma and glandular epithelium

36
Q

What does the fibroblastic component of fibroadenomas resemble?

A

Normal intralobular stroma enclosing glandular and cystic spaces lined by epithelium

37
Q

Where do fibroadenomas most commonly occur? What demographic?

A

Most commonly occur in the upper outer quadrant.

In young women

38
Q

T/F Adenomas are well-encapsulated, gray-white tumors that are easily removed w/o consequences

A

T

39
Q

Do adenomas recur or undergo malignant change?

A

No, they have an excellent prognosis

40
Q

What is intraductal papilloma?

A

A neoplastic papillary growth w/in a duct

41
Q

Where are most intraductal papillomas found?

A

Most are solitary and found w/in the principle lactiferous ducts or sinuses.

42
Q

What is the clinical presentation of intraductal papilloma?

A

Serous or bloody discharge from the nipple, a small sub-areolar mass and rarely nipple retraction

43
Q

What would be performed to avoid local recurrence of intraductal papilloma?

A

Complete excision

44
Q

What are multiple papillomas associated with?

A

Increased risk of papillary carcinomas. Solitary ones are benign.

45
Q

What is gynecomastia?

A

Male breast enlargement associated with hormonal changes in puberty.

46
Q

What is gynecomastia secondary to?

A

inordinte proliferation of the excretory ducts and the surrounding CT.

47
Q

What is an additional reason for gynecomastia in adulthood?

A

Excess estrogens, as from cirrhosis or tumors

48
Q

What does gynecomastia present as clinically?

A

Fibrous cap of tissue directly under the areolar area

49
Q

What is the likelihood of gynecomastia becoming a carcinoma in males compared to females?

A

100 times less likely in males than females, are ductal in origin and invades more rapidly

Reproduction (10 decks)

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