Benign Tumors And Fibrocystic Tumors Of The Breast

Question 1

What is the most common change in the pre menopausal breast and what do they think causes it? How do we best characterize the change?

Answer 1

Fibrocystic change due to hormones.

Essentially the lobules becomes cystic and fibrosis occurs in between them.

Question 2

Classic presentation on physical exam is what?

Answer 2

Lumpy breast

Question 3

On gross exam what does the breast look like?

Answer 3

Each cysts looks like a blue dome

Question 4

Talk about the risk fibrocystic change of the breast has for carcinoma?

Answer 4

None

Question 5

But what is the caveat?

Answer 5

When you do a biopsy, sometimes you can see associated changes that do carry a risk for cancer in the future.

Question 6

What is the risk factor for apocrine metaplasia and why is it a big deal?

Answer 6

No risk, which is a big deal because usually metaplasia carries risk for carcinoma.

Question 7

What are three associated changes that carry risk?

Answer 7

Duct all hyperplasia
Sclerosing adenosis, more lobule glands and sclerosis
Atypical hyperplasia

Question 8

What is high yield about sclerosing adenosis?

Answer 8

Can be calcified and seen on mammogram

Question 9

When we say increased risk, what are we saying the risk is for and which breast?

Answer 9

Invasive carcinoma of both breast

Question 10

Quickly characterize a papillary growth?

Answer 10

Finger like projection, covered with a layer of epithelium, with a fibrovascular core.

Question 11

What is a classic complication of a papillary structure, which means what will be the classic symptom/sign in a woman with an introduction papilloma?

Answer 11

Bleed

Bleeding discharge from the nipple

Question 12

2 big differences between an intraductal papilloma and a papillary carcinoma in the same spot?

Answer 12

1. Papillary carcinoma would be more common in a postmenopausal women and the papilloma is in a premenopausal women.
2. Because the papilloma is benign, it will still have the two layers of epithelium, luminal and myo. Pap carcinoma does not have the myoepithelial layer.

Question 13

How do we characterize a fibroadenoma?

Answer 13

Tumor of fibrous tissue and glands.

Question 14

Fibroadenoma is the most common what? What is the typical presenting patient?

Answer 14

Benign tumor of the breast

Premenopausal

Question 15

Fibroadenomas are very sensitive to what, which means?

Answer 15

Estrogen, so they grow during pregnancy and menstrual cycles

Question 16

Relationship between fibroadenoma and cancer?

Answer 16

No increased risk

Question 17

How do we distinguish phyllodes tumor from a fibroadenoma? What is the classic histo of a phyllodes?

Answer 17

There is overgrowth of the fibrous part which makes the tumor leak life

Question 18

2 main differences between fibroadenoma and phyllodes tumor?

Answer 18

Phyllodes can be malignant

Tumor of postmenopasual women