BRANT: Chapter 18: #Pathologic (Normal Anatomy and Histopathology)

Question 1

Paget disease of the NAC is characterized by malignant cells in the epidermis of the nipple. It is most commonly seen in what type of breast cancer?

Answer 1

Ductal carcinoma in situ (DCIS)

Question 2

Diagnosis

Answer 2

Sebaceous cyst

A dermal tract is seen extending to the skin surface (arrow) which is characteristic.

Question 3

Distribution of microcalifications that are most worrisome for DCIS:
a. Linear
b. Segmental
c. Both
d. None of the above

Answer 3

c. Both

Question 4

Description for this finding highly suspicious for malignancy

Answer 4

Architectural distortion

Question 5

T/F: Lymph node metastasis is one of the strongest prognostic features for patients with breast cancer.

Answer 5

True

Question 6

Name the two strongest predictors of lymph node metastasis

Answer 6

1. Morphology
2. Cortical thickness

Question 7

Maximum normal cortical thickness
a. In a patient with breast cancer
b. In a patient without breast cancer

Answer 7

a. 2.3 mm
b. 3.0 mm

Question 8

Part of the lymph node into which metastasis is first deposited
a. Cortex
b. Subcortical region
c. Hilum
d. Medulla

Answer 8

b. Subcortical region

Question 9

The following are features of suspicious lymph nodes, except:
a. Cortical thickness of >2.3 mm
b. Loss of fatty hilum
c. Focal cortical thickening
d. Indistinct margin
e. Increased hilar flow
f. Increasing size over time
d. All of the above are suspicious features

Answer 9

e. Increased hilar flow

EXTRA-hilar

Question 10

T/F: The presence or absence of intramammary nodes may fluctuate

Answer 10

False

The presence or absence of intramammary nodes does not fluctuate. Thus, a new mass should not be classified as a normal intramammary node. It may have been previously obscured or not included on the films.

Question 11

Thrombophlebitis of a superficial vein of the breast is called ____. It has many etiologies including prior surgery, trauma, dehydration, pregnancy, or other thrombogenic conditions. Patients usually present with a tender palpable cord and a linear area of skin erythema

Answer 11

Mondor disease

Question 12

28/F, G1P0 with tender palpable cord and a linear area of skin erthema in the breast.

Diagnosis

Answer 12

Mondor disease

Question 13

Incomplete regression of the this entity can lead to the formation of accessory nipples or breast tissue.

Answer 13

Milk streak

Question 14

Developmental anomalies of the breast:
a. The presence of accessory nipples is called ____
b. The presence of accessory breast tissue is termed ____
c. Congenital absence of the breast is termed ____
d. When a nipple is present without underlying breast tissue, it is known ____

Answer 14

a. Polythelia
b. Polymastia
c. Amastia
d. Asamazia

Question 15

Diagnosis

Answer 15

Polymastia

Question 16

It was first described in 1841 and is the association of absence of the pectoral muscle, chest wall deformity, breast anomalies, and symbrachydactyly, with hypoplasia of the middle phalanges and central skin webbing

Answer 16

Poland syndrome

Question 17

Most common nondermatologic malignancy in women and and the second most common cause of cancer deaths (American Cancer Society).

Answer 17

Breast cancer

Most breast cancers arise from ductal cells in the TDLU.

Question 18

Most common form of breast cancer

Answer 18

Invasive ductal carcinoma (IDC)

It begins in the milk duct and spreads beyond the basement membrane to invade the stroma

Question 19

The cancer cells of invasive lobular carcinoma lack ____. Thus, the cells do not “stick” together, but rather form a web of infiltrative cells.

Answer 19

E-cadherin

Question 20

Which is notcategorized as breast cancer?
a. DCIS
b. LCIS
c. IDC
d. ILC

Answer 20

b. LCIS

In contrast to DCIS, lobular carcinoma in situ (LCIS) is not considered breast cancer. It is a high-risk lesion that increases breast cancer risk.