Benign Breast Disease

Question 1

What are the procedures for a Palpable mass?

Answer 1

Diagnostic imaging prior to biopsy. Biopsy can alter mammographic/sonographic appearance

Question 2

What is Duct Ectasia?

Answer 2

Dilated duct that widens and the duct walls thicken, and ducts fill with fluid
Duct gets clogged with a thick sticky substance
Periductal mastitis can result

Question 3

What are the imaging charicteristics of Breast Cysts?

Answer 3

Thick walled septa
Cont cystic and solid components
Anechoic and echoic components

Question 4

What are the FNA/Biopsy charicteristics of Breast Cysts?

Answer 4

Cystic or solid?

No fluid? Biopsy!

Question 5

What are the features of a Fibroadenoma of the breast?

Answer 5

Pseudoencapsulated, sharply delineated

Firm and rubbery

Question 6

What is a Giant vs Juvenile Fibroadenoma?

Answer 6

Giant: Histo typical, rapid growth
Juvin: Adolescents and YA, Histo typical, rapid growth and causes overlying skin changes

Question 7

What ar the features of Intraductal pappilloma?

Answer 7

Bloody nipple discharge
Small, non-palp, close to nipple
NOT premalignant

Question 8

What is Atypical Ductal Hyperplasia

Answer 8

On the spectrum between normal and DCIS

Needs Excisional biopsy

Question 9

What is Atypical Lobular Hyperplasia and Lobular CA in Situ?

Answer 9

Devt into invasive ductal Ca

Question 10

What Are the components of “Gail” risk assesment for Breast cancer?

Answer 10

# of First degree relatives with Br CA
Age at menarche
Age at first live birth
# previous biopsies
Race/ethnicity

Question 11

What are the Tumor Size staging Parameters in Br Cancer?

Answer 11

TX tumor cannot be assessed
T0 no evidence of primary tumor
Tis Carcinoma in Situ
T1 2cm or less 
T2 >2cm but no more than 5 cm
T3 >5cm
T4 Tumor of any size growing into the chest wall or skin

Question 12

What are the LN spread staging Parameters in Br Cancer?

Answer 12

N1 1-3 axillary LN
N2: 4-9 axillary LN
N3: Spread to axillary AND internal mammary nodes or above tha clavicle or > 10 Axillary nodes involved

Question 13

What are the steps of Br CA progression to invasion?

Answer 13

Normal
Ductal Hyperplasia
Atypical Hyperplaia
DCIS
Invasive ductal CA

Question 14

What is Invasive Lobular CA?

Answer 14

Starts in milk producing glands

it can spread like IDC

Question 15

What is invasive Ductal CA?

Answer 15

Most common type of Br CA
Starts in Milk duct epithelium
Breaks through wall of the duct

Question 16

What are the effects of Est and Progest receptors on Br CA?

Answer 16

Fueled by Hormones

CA may be + for one, both or neither receptor

Question 17

What drugs target HER2/neu protein?

Answer 17

Trastuzumab and Lapidinib

Question 18

What is Triple negative Br Cancer?

Answer 18

Faster growing and more aggressive CA

Doesn’t express Estrogen rec, Progesterone rec, or Her2-neu rec.

Question 19

What are the screenign guidelines ofr Br CA?

Answer 19

Age >25

Question 20

What are the Options for Breast imaging?

Answer 20

Mammography
Ultrasound
MRI

Question 21

What are the Categories of Breast imaging reporting data?

Answer 21

BI-RADS1: normal
BI-RADS2: benign
BI-RADS3: Prob benign (Follow up)
BI-RADS4 Suspicious
BI-RADS5 Strongly suggestive
BI-RADS6 Imaging Pt with Known Malignancy

Question 22

What is the role of LN status in Br Cancer?

Answer 22

Most important Prognostic indicator