Benign Tumors and FIbrocystic Changes

Question 1

what is the most common change in the premenopausal breast

Answer 1

fibrocystic change (results from the fluctuation of hormones

Question 2

what is fibrocystic change?

Answer 2

the development of fibrosis and cysts in the breast

Question 3

how does fibrocystic change present

Answer 3

what irregularity of the breast (lumpy) usually in the upper outer quadrants

Question 4

cysts in fibrocystic change have a ___ appearance on gross exam

Answer 4

blue dome appearance

Question 5

is fibrocystic change benign?

Answer 5

yes, but there are some related changes that can lead to an increased risk of invasive carcinoma in BOTH breasts

Question 6

fibrocystic change: fibrosis, cysts, and apocrine metaplasia risk of cancer?

Answer 6

none

Question 7

what is apocrine metaplasia?

Answer 7

increased cytoplasm (pink), larger cysts- no risk of invasive carcinoma

Question 8

fibrocystic change: ductal hyperplasia and sclerosing adenosis risk of cancer?

Answer 8

2x risk

sclerosing adenosis: increase in gland number, scarring, Ca+ deposition

ductal hyperplasia: duct cells increase

Question 9

fibrocystic change: atypical hyperplasia risk of cancer?

Answer 9

5x risk

hyperplasia in the duct and or lobule

Question 10

what is an intraductal papilloma?

Answer 10

this is a papillary growth (finger like projection) that protrudes into a large duct and is lined by both myoepithelial cells and luminal epithelial cells with a vascular corse

Question 11

intraductal papilloma classically presents as _________

Answer 11

bloody nipple discharge

Question 12

intraductal papilloma is seen in what age group

Answer 12

premenopausal women

Question 13

intraductal papilloma must be distinguished from papillary carcinoma, what is the difference

Answer 13

papillary carcinoma also has blood nipple discharge BUT it only has epithelial cells lining it and is seen in older women typically post menopausal

Question 14

what is the most common tumor is premenopausal women of the breast

Answer 14

fibroadenoma

Question 15

how would you describe a fibroadenoma

Answer 15

well circumscribed, marble like, mobile mass

Question 16

what is a fibroadenoma?

Answer 16

tumor of fibrous tissue and glands that is benign

• sensitive to estrogen so it can grow/be painful in pregnancy or during cycle
• can shrink during menopause

Question 17

is there an increased risk of cancer in a fibroadenoma

Answer 17

nooooo

Question 18

what is a phyllodes tumor

Answer 18

this is basically a fibroadenoma with an overgrowth of fibrous tissue which gives it a leaf like appearance on histology

Question 19

phyllodes tumors are seen in what population?

Answer 19

postmenopausal women

Question 20

does a phyllodes tumor have a risk of cancer?

Answer 20

yes, can be malignant in some cases