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Basic Human Pathology 2 > Breast > Flashcards

Breast Flashcards

1
Q

what are the four quadrants of the breast

A

upper inner
lower inner
upper outer
lower outer

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2
Q

at which week does breast development begin

A

week 4 of gestation

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3
Q

what are the milk lines

A

parallel lines of glandular tissue which extend from axilla to peritoneum

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4
Q

what are milk line remnants

A

persistence of epidermal thickenings along the milk lines

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5
Q

define mastalgia

A

breast pain

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6
Q

define mastodynia

A

breast pain

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7
Q

who is most susceptible to a breast malignancy

A

older aged women (older than 50 - chance goes up with age)

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8
Q

define galactorrhea

A

milk discharge not associated with malignancy

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9
Q

which quadrant of the breast is most common for malignancy

A

upper outer quadrent (50%)

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10
Q

what are the two main modalities for breast imaging

A

ultrasound and MRI

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11
Q

what is a fibroadenoma

A

well-circumscribed, benign, proliferating mass of fibrotic tissue

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12
Q

what is acute mastitis

A

bacterial infection during breastfeeding causes inflammation of breast

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13
Q

what is the most common bacteria to cause acute mastitis

A

staph. aureus

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14
Q

what is squamous metaplasia of lactiferous ducts (SMOLD)

A

keratin plug causes abscess to form within duct

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15
Q

what are the three other names for squamous metaplasia of lactiferous ducts (SMOLD)

A

recurrent subareolar abscess
periductal mastitis
zuska disease

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16
Q

which two conditions are most associated with squamous metaplasia of lactiferous ducts (SMOLD)

A

smoking and vitamin A deficiency

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17
Q

what is duct ectasia

A

white nipple secretions that present as a palpable periareolar mass

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18
Q

who is most affected by duct ectasia

A

50-60 year old women who haven’t had children

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19
Q

what are the two most common (50%) causes of fat necrosis of the breast

A

trauma or previous surgery

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20
Q

which two conditions are associated with lymphocytic mastopathy (sclerosing lymphocytic lobulitis)

A

type 1 diabetes and autoimmune thyroid disease

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21
Q

what are the three categories of benign epithelial lesions of the breast

A

non-proliferative breast changes
proliferative breast disease
atypical hyperplasia

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22
Q

what are the three principal morphologic changes seen with non-proliferative breast changes (fibrocystic changes)

A

cystic change
fibrosis
adenosis

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23
Q

are non-proliferative breast changes associated with a risk of cancer

A

no

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24
Q

does proliferative breast disease without atypia increase your risk for cancer

A

yes - small increase

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25
Q

what is epithelial hyperplasia of the breast

A

a type of proliferative breast disease without atypia
increased numbers of luminal and myoepithelial cells within the ducts

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26
Q

what is sclerosing adenosis

A

a type of proliferative breast disease without atypia
increased number of acini

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27
Q

what is a complex sclerosing lesion

A

a type of proliferative breast disease without atypia
hardened area of breast tissue that appears as a scar

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28
Q

what is a radial scar

A

radial sclerosing lesion that has a irregular shape and can closely mimic invasive carcinoma

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29
Q

complex sclerosing lesions have components of what

A

sclerosing adenosis
papillomas
epithelial hyperplasia

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30
Q

what is a papilloma

A

a type of proliferative breast disease without atypia
growth in a dilated duct made of branching fibrovascular cores

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31
Q

where is the most common location for a large duct papilloma

A

lactiferous sinuses of the nipple

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32
Q

where is the most common location for a small duct papilloma

A

deeper within the duct system

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33
Q

a fibrovascular core is a key distinctive feature in which condition

A

breast papilloma

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34
Q

define gynecomastia

A

enlargement of male breast

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35
Q

what are the two main forms of atypical hyperplasia of the breast

A

atypical ductal hyperplasia
atypical lobular hyperplasia

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36
Q

what is the most common non-skin malignancy in women

A

breast carcinoma

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37
Q

what is the ratio for women getting breast cancer

A

1 in 8

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38
Q

in which breast is cancer more common

A

left

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39
Q

what are the three main types of breast carcinoma, hormonally speaking

A

luminal
HER2+
triple negative

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40
Q

which receptors are involved in luminal breast carcinoma

A

ER+
HER2-

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41
Q

which receptors are involved in HER2+ breast carcinoma

A

overexpression of HER2

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42
Q

which receptors are involved in triple negative breast carcinoma

A

ER-
PR-
HER2-

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43
Q

what is the most common type of breast cancer in terms of hormone receptors

A

ER+

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44
Q

what is the least common type of breast cancer in terms of hormone receptors

A

HER2+

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45
Q

what should a positive hormone receptor IHC look like

A

brown (right) - indicates update

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46
Q

in which year was mammographic screening introduced

47
Q

what is the average age of breast cancer diagnosis in those who are white

48
Q

what is the average age of breast cancer diagnosis in those who are hispanic

49
Q

what is the average age of breast cancer diagnosis in those who are African American

50
Q

ER- breast carcinomas are most common in which ethnicity

A

white women

51
Q

what is tamoxifen

A

a hormone therapy for ER/PR+ tumors
blocks the hormone receptors and thus stops the hormone stimulation

52
Q

what are aromatase inhibitors

A

hormone therapy for ER/PR+ tumors
stops estrogen production

53
Q

which drug can be used to treat HER2+ breast carcinomas

A

Herceptin - reduces recurrence rates

54
Q

what are the two main consequences of Herceptin use

A

heart and lung damage

55
Q

what is the most aggressive type of breast carcinoma hormonally speaking

A

triple-negative breast cancer
aggressive but respond well to chemo and radiation

56
Q

what is a stage 1 breast tumor

A

less than 2 cm
usually treated conservatively

57
Q

what is a stage 2 breast tumor

A

between 2 and 5 cm
surgery and radiation

58
Q

what is a stage 3 breast tumor

A

greater than 5 m
neoadjuvant therapy - more aggressive treatment

59
Q

which ethnicity has the highest mortality rate for breast cancer

A

African Americans

60
Q

which three lifestyle aspects can increase the risk for breast cancer

A

delayed pregnancies
fewer pregnancies
decreased breastfeeding

61
Q

what is one of the biggest risks of developing breast cancer

A

exposure to extrogen

62
Q

having a first-degree relative with breast cancer increases your risk by which percentage

63
Q

what are the four major known susceptible genes for familiar breast cancer

A

BRCA1
BRCA2
TP53
CHEK2

64
Q

mutations in which two genes are responsible for 80-90% of single gene breast cancers

A

BRCA1 and 2

65
Q

BRCA1 gene mutation increases your risk for what

A

breast, ovarian, and other epithelial cancers

66
Q

BRCA2 gene mutation increases your risk for what

A

breast (male and female) cancer

67
Q

where is the BRCA1 gene mutation located

A

17q21 chromosome

68
Q

where is the BRCA2 gene mutation located

A

13q12-13 chromosome

69
Q

how do ER+, HER2- cancers develop

A

due to a BRCA2 mutation

70
Q

how do HER2+ cancers develop

A

due to TP53 mutations

71
Q

how do ER-, HER2- cancers develop

A

due to BRCA1 mutations

72
Q

why is fibrous stroma important in terms of developing breast cancer

A

cancers occur in the areas of greatest density, so more fibrous stroma can increase your risk for cancer

73
Q

what are the four main types of breast carcinoma

A

ductal carcinoma in-situ
lobular carcinoma in-situ
invasive ductal carcinoma
invasive lobular carcinoma

74
Q

what is the most common type of breast cancer

A

adenocarcinoma

75
Q

what is seen on mammography for ductal carcinoma in-situ

A

calcifications
periductal fibrosis

76
Q

which two types of ductal carcinoma in-situ can produced nipple discharge

A

micropapillary and papillary

77
Q

what are the two main categories of ductal carcinoma in-situ

A

comedo
non-comedo

78
Q

what are the four types of non-comedo ductal carcinoma in-situ

A

cribriform
micropapillary
papillary
solid

79
Q

what are the two main microscopic features of comedo ductal carcinoma in-situ

A

pleomorphic, high grade nuclei
central necrosis

80
Q

what is the other name for large cell ductal carcinoma in-situ

A

comedocarcinoma

81
Q

which, comedo or non-comedo ductal carcinoma in-situ, is more likely to progress to carcinoma

82
Q

what is the histologic appearance of cribriform non-comedo ductal carcinoma in-situ

A

rounded (cookie cutter like) spaces filled with calcified material

83
Q

a rounded, cookie cutter link appearance histologically is indicative of what

A

cribriform non-comedo ductal carcinoma in situ

84
Q

what is important to note about the papillary projections in papillary and micropapillary non-comedo ductal carcinoma in-situ

A

the projections lack fibrovascular cores

85
Q

what is Paget disease

A

a type of ductal carcinoma in-situ
Paget cells extend within the ductal system to the nipple causing an unilateral eruption with a scale crust

86
Q

what is the radiologic appearance of Paget disease

A

rod-like micro calcifications

87
Q

what is the histologic appearance of Paget disease

A

basal cells with clear cytoplasm containing mucin

88
Q

what are the three major risk factors for recurrence in ductal carcinoma in-situ cases

A

high nuclear grade and necrosis
extent of disease
positive surgical margins

89
Q

which gene mutation is most common in lobular carcinoma in-situ

A

E-cadherin (CDH1) mutation

90
Q

what is unique about lobular carcinoma in-situ

A

no calcifications

91
Q

what are the two main treatment options for lobular carcinoma in-situ

A

bilateral prophylactic mastectomy
tamoxifen

92
Q

what is the radiographic appearance of invasive (infiltrating) carcinoma of the breast

A

well-defined stellate

93
Q

what is the main grading system for invasive (infiltrating) breast carcinoma

A

(scarff) Bloom-Richard grading system

94
Q

what is a mucinous (colloid) breast carcinoma

A

variant of invasive (infiltrating) carcinoma
shows clusters of tumor cells with mucin

95
Q

what is an apocrine breast carcinoma

A

variant of invasive (infiltrating) carcinoma
shows punctate nucleoli

96
Q

what are the two types of metaplastic breast carcinoma

A

spindle cell carcinoma
matrix-producing carcinoma

97
Q

what is inflammatory breast carcinoma

A

variant of invasive (infiltrating) carcinoma
tumor cells are in the dermal lymphovascular space leading to a Peau d-orange appearance

98
Q

Peau d-orange is seen with which condition

A

inflammatory breast carcinoma

99
Q

what is the hallmark of the lobular variant of invasive (infiltrating) breast carcinoma

A

dyscohesive infiltration tumor cells with no tubular formation

100
Q

what are the 7 variants of invasive (infiltrating) breast carcinoma

A

mucinous (colloid)
tubular
apocrine
papillary
metaplastic
inflammatory
lobular

101
Q

which gene mutation puts males most at risk for breast cancer

102
Q

which syndrome can be associated with male breast cancer

A

Klinefelter syndrome

103
Q

which type of male breast cancer is most common (hormonally speaking)

104
Q

what is the most important prognostic factor in the absence of distant metastasis in male breast cancer cases

A

axillary lymph node metastasis

105
Q

what is a sentinel lymph node

A

first one or two nodules that a tumor’s lymphatics drain into - found using radiotracers and color dyes

106
Q

what is the most common benign breast tumor

A

fibroadenoma

107
Q

what is the most common gross and microscopic feature of a breast fibroadenoma

A

slit-like spaces both grossly and histologically

108
Q

what is a phyllodes tumor (cystosarcoma phyllodes)

A

stromal tumor of the breast
benign, “leaf-like” tumors that can become malignant as a type of sarcoma

109
Q

what is fibromatosis

A

stromal tumor of the breast
proliferation of fibroblasts that does not metastasize
associated with FAP, hereditary desmoid syndrome, and Gardner syndrome

110
Q

what is a myofibroblastoma

A

interlobular stromal lesion of the breast
made mainly of myofibroblasts

111
Q

what is the most common sarcoma in the breast

A

angiosarcoma

112
Q

what is the gross appearance of a breast angiosarcoma

A

very hemorrhagic

113
Q

the most common metastatic tumors of the breast are from which two locations

A

melanoma
ovarian cancers

114
Q

what is this

A

breast implant associated anaplastic large cell lymphoma

Basic Human Pathology 2 (14 decks)

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