37. Breast Path II

Question 1

A 42 year old woman comes to the doctor with complaints of breast pain. During the examination the doctor notes that the skin is thick around the hair follicles and takes a biopsy. The histological presentation is notable for single file line appearance of cells. What area least concern of of metastasis?

A. Leptomeninges 
B. Ovaries
C. Uterus 
D. Peritoneum 
E. Brain

RFA

Answer 1

Ans. E Brain- the patient has Lobular Carcinoma( single file appearance of cells)

Brain metastasis is associated with Ductal Carcinoma

Question 2

A 25 year old African American female is recommended for a baseline mammography due to her family history of breast cancer. The mammogram shows some vague densities in both breasts and the physician refers her to a specialist. The suspicious areas are biopsied, and histological review shows distended lobules with oval noncohesive cells that do not penetrate the basement membrane. If further biochemical testing is done on the biopsy specimen, what would you find? (MG)

A. Microcalcifications
B. The presence of a core made of fibrous material and is vascularized
C. Lymphoplasmacytic immune response
D. Extensive fibrosis
E. Lack of e-cadherin

Answer 2

E. Lack of e-cadherin
Dx is LCIS

A. Not in LCIS, in lots of other types though like DCIS
B. Intraductal papilloma
C. Medullary carcinoma
D. Similar to Invasive ductal carcinoma- lots of fibrosis makes the lump very hard

Question 3

A 36 year old woman arrives to the hospital with complaints of a palpable mass on her breast. A clinical breast exam, mammogram, and biopsy were taken. Under examination, linear cord cells were found beneath the basement membrane. What type of cancer does she most likely have? (MG)

A. Invasive ductal carcinoma
B. Lobular Carcinoma In situ
C. Ductal Carcinoma in Situ
D. Invasive lobular Carcinoma

Answer 3

D. Invasive lobular Carcinoma