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Pathology III > ALL THINGS BREAST- FINAL > Flashcards

ALL THINGS BREAST- FINAL Flashcards

1
Q

Amastia

A

breast tissue, nipple and aureola are absent

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2
Q

Amazia

A

mammary gland tissue is absent but the nipple and aureola remain present

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3
Q

Athelia

A

presence of breast glandular tissue but no nipple or areola

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4
Q

Supernumerary nipple

A

more than one nipple

occurs most often along the milk line (extends from the axilla to the groin)

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5
Q

Supernumerary breast tissue

A

presence of breast tissue in an ectopic location

occurs most often along the milk line (extends from the axilla to the groin)

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6
Q

Can ectopic breast tissue be pathologic?

A

Yes. This supernumerary breast tissue can undergo the same pathologic changes as normal breast tissue (benign cystic changes, benign breast tumors, and breast cancer)

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7
Q

Inverted nipple

A

The new onset of nipple inversion is a sign that requires a work-up to rule out underlying breast cancer

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8
Q

Inverted nipple is usu caused by_______

A

fibrous bands of tissue that tether the nipple in an inverted position

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9
Q

Galactorrhea is__________

A

the spontaneous flow of milky nipple d/c that occurs in the absence of childbirth or lactation

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10
Q

Galactorrhea is commonly due to

A

hormonal dysregulation or as a side effect of several medications such as oral contraceptives

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11
Q

The presence of galactorrhea is the most disconcerting when____________

A

the d/c is unilateral, bloody or when there is an associated mass

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12
Q

Mastitis is___________

A

the non-infectious inflammation of the parenchyma of the mammary gland

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13
Q

If mastitis occurs in lactating women (as it most often does), then condition is called__________

A

puerperal mastitis

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14
Q

If mastitis occurs in non-lactating women or if it occurs in men it’s called_________

A

non-puerperal mastitis

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15
Q

If the cause of mastitis is infectious (less common), it is most likely due to________

A

Staph aureus or Strep epidermitis

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16
Q

Where does peri-ductal mastitis usually occur?

A

sub-areolar area with overlying skin erythema

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17
Q

What population does peri-ductal mastitis usually occur in?

A

smokers (90%)

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18
Q

The microscopic morphology of peri–ductal mastitis usually reveals_________

A

keratinizing squamous epithelium in the duct system of the nipple which often extends to an abnormal depth

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19
Q

A chronic _________ response is characteristically noted in peri-ductal mastitis?

A

granulomatous inflammatory

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20
Q

condition that is characterized by the dilatation of the sub-areolar ducts is called_____________

A

Mammary duct ectasia

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21
Q

Mammary duct ectasia is more often see in__________

A

multiparous women

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22
Q

What sequelae is seen in 30-40% of cases of mammary duct ectasia?

A

nipple inversion

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23
Q

In mammary duct ectasia, microscopically one sees_________

A

dilated lactiferous ducts that are filled with granular debris including lipid laden macrophages.
Peri-ductal and interductal inflammation is notable as characterized by infiltrates of lymphocytes and macrophages with an increased number of plasma cells

24
Q

early lesion of mammary duct ectasia is characterized by

A

the accumulation of foamy macrophages beneath the luminal duct epithelium

25
Q

Fibrocystic breast disease is a condition characterized by____

A

fibrous lumps and cords in the breast tissue that are non-cancerous
fibrocystic breast changes may be asx or they may cause discomfort

26
Q

What disease represents the singe most common disorder of the breast?

A

Fibrocystic breast disease!

It accounts for more than half of all surgical operations that are performed on the female breast

27
Q

Where are fibrocystic breast changes most often found?

A

upper outer quadrant!

28
Q

Microscopic appearance of fibrocystic breast disease

A

multi-layering of the ductal cells or noting the in-growth of these cells towards the center of the duct (layering starts to compromise the ductal space)

29
Q

Fat necrosis results from____________

A

the rupture of adipocytes and hemorrhage from broken blood vessels into the traumatized area
calcification and hemosiderin deposition occurs within the affected area

30
Q

Mammography (or US) of an area of fat necrosis often reveals

A

a central radiolucent area of fat with increased density and/or presence of calcifications at the fat periphery

31
Q

Microscopically fat necrosis is characterized by

A

irregular fatty spaces which are surrounded by foamy histiocytes and multinucleated giant cells

32
Q

microscopic examination of lymphocytic mastophathy reveals

A

a thickening and fibrosis of stromal tissue and lymphocytic infiltrates that surrounds the epithelium and blood vessels

33
Q

Lymphocytic mastopathy is most commonly associated with

A

women with type 1 diabetes mellitus and in women with autoimmune thyroiditis (AI diseases!)

34
Q

Granulomatous mastopathy is an uncommon form of mastitis that is characterized by

A

the presence of granulomas (formed by epithelioid cells and giant cells)
thought to be due to conditions such as tuberculosis, sarcoidosis, and Wegener’s granulomatosis

35
Q

what is the most common benign tumor of the breast?

A

fibroadenoma

36
Q

the appearance of fibroadenoma microscopically________

A

hyperplasia of intraductal epithelial cells
These hyperplastic cells have no abnormalities in nuclear size and in the normal nucleus to cytoplasm ration.
called lactating adenoma if occurs during pregnancy

37
Q

Hormonally responsive, what commonly increases in size during pregnancy?

A

Fibroadenomas

they often regress after menopause

38
Q

Fibroadenomas are benign, but are associated with a minimally increased risk for_____________

A

development of carcinoma (therefore routinely removed and bx)

39
Q

Microscopy of intraductal papillomas characteristically shows

A

myoepithelial cells and multilayered ductal cells. These multi-layered ductal cells become flattened and the nuclei of the cells usually appear next to the luminal surface

40
Q

the vast majority of breast cancer originates where?

A

in the glandular tissues of the breast and are classified as adenocarcinomas
both the lobular tissues (which produce milk) and the ductal tissue (which are involved in the transfer of milk to the nipple) are considered glandular

41
Q

Risk factors rated as high for breast cancer

A

Female /advancing age
Prior personal history of cancer in one breast.
Family history of both mother and a sister with breast cancer.
Daily ETOH intake > 2 glasses.
High premenopausal blood insulin-like growth factor (IGF)–1 levels.
High post-menopausal blood estrogen levels.

42
Q

Protective role against breast cancer

A 
Age at first period older than 15 years
Breastfeeding for longer than 1 year
Physical activity 
Minimal ETOH consumption
No tobacco use
Monounsaturated fat–rich diet
43
Q

The most common denominator to many of the breast cancer risk factors is__________

A

the level and duration of exposure to endogenous estrogenic stimulation
Estrogens, by their cell proliferating effect on the breast epithelium, increase the chance of DNA replication errors leading to greater chance for mutations.

44
Q

BRCA1 and BRCA2 appear to be responsible for

A

30-40% of all inherited breast cancers

45
Q

_________ are tumor suppressor genes

A

BRCA1 and BRCA2

46
Q

In the general population, prevalence of BRCA1 mutation is _________, compared with _______ prevalence in the Ashkenazi Jewish population

A

0.1%, 20%

47
Q

Another genetic risk factor for breast cancer is

A

HER2/neu gene (a proto-oncogene)

48
Q

Peau de organge

A

increased dimpling of the skin of a breast with cancer

49
Q

The three main types of breast cancer are

A

Ductal, lobular and nipple (or Paget’s disease)

of these three, ductal carcinoma is the most common

50
Q

what is the term used to describe low grade cancerous or precancerous cells in a particular tissue area such as the mammary duct, in the absence of invasion of the surrounding tissue?

A

Carcinoma in situ
In contrast, invasive carcinoma does not confine itself to the initial tissue compartment and invades the surrounding tissue

51
Q

Infiltrating ductal carcinoma (or just ductal carcinoma) manifests as

A

a single hard mass with irregular borders

comprises nearly 80% of all breast cancers

52
Q

The second most common histologic type after ductal carcinoma is___________

A

lobular carcinoma

associated with a multiple loci in the affected breast as well as increased risk for both breast to be involved

53
Q

microscopic appearance of lobular carcinoma is___________

A

single file phenomenon (line up and look like they are in a single file line)
“signet ring” appearance

54
Q

________ disease of the breast is relatively uncommon compared to ductal and lobular forms of breast cancer

A

Paget’s disease

Involves the nipple and areolar area, often associated with an underlying in-situ or invasive carcinoma

55
Q

Histologic dx of Paget’s is confirmed by the finding of_____________

A

large round cells with pale cytoplasm and pleomorphic nuclei (nuclei that are varying sizes)

56
Q

Inflammatory breast cancer (IBC) is a form of __________ that is distinguished by the markedly inflamed appearance of the affected breast

A

ductal carcinoma

inflammatory breast cancer is esp aggressive because of the lack of symptoms (often presents without a palpable lump)

Pathology III (5 decks)

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