Breast

Question 1

what is the most common non-skin malignancy in women and the second most common cause of cancer deaths in the US

Answer 1

breast cancer

Question 2

which two genes cause 80-90% of breast cancers

Answer 2

BRCA1 and 2

Question 3

most breast malignancies are what type

Answer 3

adenocarcinoma

Question 4

what is the most common benign tumor of the breast

Answer 4

fibroadenoma

Question 5

which breast lesion has a radial scar and grossly resembles carcinoma

Answer 5

complex radial sclerosing lesion

Question 6

which breast tumor is greek for “leaf-like”

Answer 6

phyllodes tumor

Question 7

what is PASH

Answer 7

pseudoangiomatous stroma hyperplasia

shows anastomosing slit-like spaces

Question 8

what is the appearance of ductal carcinoma

Answer 8

firm, pink-gray stellate mass

Question 9

which condition is Peau D-Orange related to

Answer 9

inflammatory carcinoma

Question 10

what is the appearance of medullary breast carcinoma

Answer 10

soft, fleshy mass

Question 11

which type of DCIS causes unilateral erythematous eruption with a scale crust

Answer 11

Paget disease

Question 12

what is the most common mammary sarcoma

Answer 12

angiosarcoma - often radiation induced

Question 13

which hormone receptors are involved in 50-65% of breast cancer cases

Answer 13

luminal - ER+, HER2-

Question 14

according to ASCO, how long should breast biopsies fix

Answer 14

6-72 hours in 10% NBF

Question 15

what is a Biozorb

Answer 15

breast lesion localization tool - ensures correct locating of lesion

Question 16

what is an important clinical history grossing consideration of a breast specimen

Answer 16

neoadjuvant therapy

Question 17

T/F: you do not need to weigh breast reductions

Answer 17

false: it is important to weigh all breast specimens as it can be important for insurance reimbursement

Question 18

T/F: you should dry specimens before inking

Answer 18

true: this prevents the ink from spreading to areas it doesn’t belong and creating a false margin - pat dry with a paper towel

Question 19

T/F: if you need to further section a large piece to submit it entirely, you should section through the lesion

Answer 19

false: avoid sectioning through middle of lesion - cut into more pieces if need be

Question 20

what is the first section to take on a mastectomy case

Answer 20

nipple

Question 21

how should you section a mammary case of Paget’s disease

Answer 21

amputate the nipple parallel to the skin’s surface

perpendicularly section the nipple

Question 22

T/F: cut a mastectomy specimen skin up

Answer 22

false: always cut a mastectomy section face down to allow the skin to act as a book spine

Question 23

which stain can be used on breast lymph nodes to look for metastasis and isolated tumor cells

Answer 23

CK7 (cytokeratin stain)

Question 24

what is important to note about the staging of invasive breast carcinoma

Answer 24

based on tumor size and involvement of skin/chest wall

Question 25

what is the main scoring system used for breast

Answer 25

nottingham

Question 26

involvement of skin in an invasive breast carcinoma stages it at what

Answer 26

T4b

Question 27

T/F: submit at least 12 lymph nodes for breast specimens

Answer 27

false: evaluation of ALL lymph nodes is critical for staging

Question 28

what is this condition of the breast capsule

Answer 28

breast implant associated anaplastic large cell lymphoma

Question 29

what is the CPT code for a breast biopsy

Answer 29

88305

Question 30

what is the CPT code for a breast reduction

Answer 30

88305

Question 31

what is the CPT code for a simple mastectomy

Answer 31

88307

Question 32

what is the CPT code for a mastectomy with regional lymph nodes

Answer 32

88309

Question 33

what is the CPT code for a sentinel lymph node

Answer 33

88307