Breast 1 Flashcards
what are the two cell types that line the ducts and acini of the breast?
Inner luminal epithelial cells
Outer myoepithelial cells
What do inner luminal epithelial cells do? myoepithelial cells?
Luminal: produce milk during lactation
myoepithelial: contract cells on basement membrane ejecting the milk product.
when do you have the most radiolucent breasts?
when you are old because there is more fat content.
what is usually the first sign of breast pathology?
A palpable mass
what is the second most common sign of breast pathology?
Nipple discharge.
what is the most common cause of nipple discharge?
benign intraductal papilloma
what are microcalcifications?
calcium deposits usually from tumor cells and necrotic tissue within the ducts
T/F Carcinomas are more radiodense than benign breast tissue?
True
What does fat necrosis mimick?
breast carcinoma b/c it can present as a palpable mass and show up as radiodense on mamography
Foamy macrophages are a key finding with what type of breast pathology?
Fat necrosis
What is infection during breastfeeding with erythema and pain and fever called?
mastitis
what are the two most common pathogens that cause mastitis?
S. aureus and many strep species.
what is periductal mastitis?
what ducts near nipple undergo squamous metaplasia and keratin obstructs the ductal system leading to dilatation and rupture. PAINFUL and common in SMOKERS
when do men usually get gynecomastia?
puberty and when old.
what causes gynecomastia? is it unilateral or bilateral?
It is caused by the imbalance of estrogens and androgensn in diseases such as Cirrhosis, Kleinfelters and drugs. It can be both unilateral or bilateral.
Breast mouse means which type of lesion?
fibroadenoma
T/F fibroadenomas are the most commmon benign breast tumor?
True
Fibroadenomas are characterized by proliferation of which tissue types (2)?
stromal and epithelial proliferation
Lumpy bumpy breast refers to which breast pathology?
fibrocystic change AKA (non proliferative change)
What are the 3 histologic findings with fibrocytic change?
fibrosis
cysts
adenosis
Are fibrocytic changes a concern for breast carcinoma?
No, they have no increased risk
what is adenosis?
an increase in anini per lobular unit of the breast.
what breast pathology is described as every cell type proliferates, and each at different stages; there are usually more than 2 cell layers comprising the glands?
proliferative breast disease without atypia
does proliferative breast disease without atypia have an increased risk for carcinoma?
yes, 2x
ductal epithelial hyperplasia without atypia sclerosing adenosis papillomas comples radial scars (these are all part of which grouping?)
Proliferative breast disease without atypia (This is proliferation of the DUCTAL epithelium, and these have more than the usual 2 cell layers)
which disease is described as proliferation of ductal epithelium (more than 2 layers) that has both cytologic heterogeneity and architectural heterogeneity?
Ductal epithelial hyperplasia without atypia
T/F ductal epithelial hyperplasia without atypia usually fills the ductal lumen with cells that are irregular in shape and size?
True
which disease looks like a severely compressed fibrotic stroma but still having only 2 cell layers in the ducts?
sclerosing adenosis
T/F sclerosing adenosis looks just like breast carcinoma on histology?
True
what is the most common cause of unilateral bloody discharge?
intraductal papillomas (specifically large duct papillomas because they occur near the nipple while small duct papillomas occur in the lobules)
Which disease is this describing? [histology: central nidus with fibroelastic stroma containing entrapped glands]
complex sclerosing lesion/radial scar
does proliferative breast disease with atypia have and increased risk of breast carcinoma?
Yes, 5x
Lesions included in the proliferative breast disease with atypia include (2)?
atypical ductal hyperplasia
atypical lobular hyperplasia
what does this describe; punched out regular lumina, cribiform architecture, and monotonous cells?
atypical ductal hyperplasia. (you can also frequently see micorcalicifications with this)
what does this describe; monotonous poorly cohesive cells (loss of E cadherin), looks like lobular carcinoma in situ?
atypical lobular hyperplasia.
what is the lifetime risk of a woman acquiring breast cancer?
1/8
what is the most common malignancy in women?
skin cancer
what is the second most common malignancy in women?
breast cancer
why did the incidence of breast cancer increase during the early 90’s?
better detection (so you just find a higher percentage) Using hormone replacement therapy.
which race has the highest incidence of breast cancer?
caucasians
what are the big risk factors for breast cancer?
AGE Gender early menarchy/late menopause obesity not breastfeeding Family history Gene mutation
what percentage of all breast cancers are attributable to familial breast cancers?
10%
Which gene in autosomal dominant, is involved in DNA repair, and if mutated increases risk for breast cancer risk to 65% by age 70?
BRCA 1
what percentage of all breast cancers are caused from BRACA 1 and BRACA 2 mutations?
3 percent of total
20 percent of familial
