Breast Flashcards
1
Q
result from the persistence of epidermal thickenings along the milk line
A
supernumerary nipples or breasts
2
Q
failure of nipple to evert during development
A
congenital nipple inversion
3
Q
may indicate the presence of an invasive cancer or inflammatory nipple disease
A
acquired nipple retraction
4
Q
normal ductal system extends into the subcutaneous tissue of the chest wall or axillary fossa
A
accessory axillary breast tissue
5
Q
these markedly reduce the risk of breast cancer in patients with an accessory axillary breast
A
prophylactic mastectomies
6
Q
breast pain (2)
A
mastalgia or mastodynia
7
Q
only __% of breast cancers present with pain
A
10
8
Q
most common palpable lesions of the breast (3)
A
-cysts
-fibroadenomas
-invasive carcinomas
9
Q
palpable masses most common in premenopausal women
A
benign
10
Q
4 clinical presentations with breast disease
A
-pain
-palpable mass
-nipple discharge
-lumpiness
11
Q
milky discharge not associated with malignancy
A
galactorrhea
12
Q
nipple discharge that is most commonly due to large duct papillomas and cysts
A
bloody or serous
13
Q
50% of breast cancer is located in this site
A
upper outer quadrant
14
Q
dense breasts are present in
A
younger women
15
Q
fatty breasts are present in
A
older women
16
Q
macrocalcifications are typically
A
benign
17
Q
microcalcifications are typically
A
malignant/DCIS
18
Q
cysts have this pattern on breast imaging
A
anechoic
19
Q
fibroadenomas have this pattern on breast imaging
A
hypoechoic
20
Q
cancer has this pattern on breast imaging
A
hypoechoic
21
Q
glandular tissue has this pattern on breast imaging
A
hyperechoic
22
Q
particularly useful in distinguishing a cyst from a mass
A
ultrasound
23
Q
particularly useful in detecting cancer because tumors have increased vascularity and rapidly take up contrast agents
A
MRI
24
Q
typically benign well circumscribed densities (2)
A
-fibroadenomas
-cysts
25
typically malignant irregular density
invasive carcinoma
26
multiple fibroadenomas or a complex fibroadenoma present with 2x the risk of
carcinoma
27
mimics inflammation by obstructing dermal vasculature with tumor emboli
inflammatory breast cancer
28
this should be considered whenever there is an erythematous swollen breast
inflammatory breast cancer
29
typically caused by a bacterial infection the first month of breastfeeding due to cracks and fissures in the nipples
acute mastitis
30
most common cause of acute mastitis that form solitary or multiple abscesses
staph aureus
31
strep infections spread as
cellulitis
32
3 different names for squamous metaplasia of lactiferous ducts (SMOLD)
-recurrent subareolar abscess
-periductal mastitis
-Zuska disease
33
presents as a subareolar mass that appears clinically as an abscess; may cause inverted nipple or fissure
SMOLD
34
90% of patients with SMOLD are
smokers
35
presents as a palpable periareolar mass with thick, white nipple secretions and occasionally with skin retraction
duct ectasia
36
dilated ductal architecture
duct ectasia
37
50% of people with breast fat necrosis have this clinical history (2)
-breast trauma
-surgery
38
fat necrosis can cause the skin to thicken and retract, resembling
cancer
39
single or multiple hard palpable masses/mammographic densities that are most common in women with T1D or AI thyroid disease
lymphocytic mastopathy
40
another name for lymphocytic mastopathy
sclerosing lymphocytic lobulitis
41
this condition is difficult to biopsy and distinguish from cancer
lymphocytic mastopathy
42
uncommon inflammatory disorder that only occurs in parous women
granulomatous inflammation
43
can be localized to breast or manifestation of systemic granulomatous disease
granulomatous inflammation
44
inflammatory disease closely associated with the lobules
granulomatous inflammation
45
three groups of benign epithelial lesioons
-non-proliferative breast changes
-proliferative breast disease
-atypical hyperplasia
46
most present on mammography or incidentally in surgical specimens
benign epithelial lesions
47
type of change in nonproliferative breast change
fibrocystic change
48
three principal morphologic changes in nonproliferative breast change
-cystic change
-fibrosis
-adenosis
49
blue dome cysts are present in
nonproliferative breast change
50
increased acini per lobule
adenosis
51
these can also arise in nonproliferative breast change in lactating women
lactational adenoma
52
4 morphologic patterns of proliferative breast disease without atypia
-epithelial hyperplasia
-sclerosing adenosis
-complex sclerosing lesion
-papilloma
53
increased numbers of both luminal and myoepithelial cell types fill and distend ducts and lobules
epithelial hyperplasia
54
increased number of acini that are compressed and distorted in the central portion of the lesion
sclerosing adenosis
55
a complex sclerosing lesion has components of these three things
-epithelial hyperplasia
-sclerosing adenosis
-papilloma
56
a complex sclerosing lesion has this scar that can closely mimic invasive ductal carcinoma radiologically, grossly, and histologically
radial scar
57
growth within a dilated duct and composed of multiple branching fibrovascular cores with epithelial hyperplasia and apocrine metaplasia
papilloma
58
usually solitary in the lactiferous sinuses of the nipple
large duct papilloma
59
commonly multiple and located deeper within the ductal system
small duct papilloma
60
common cause of clear or bloody nipple discharge especially when it comes from only one breast
papilloma
61
enlargement of male breast
gynecomastia
62
commonly caused by male estrogen levels that are too high or out of balance with testosterone
gynecomastia
63
proliferative breast disease with atypia associated with a moderately increased risk of carcinoma
atypical hyperplasia
64
two forms of atypical hyperplasia
atypical ductal hyperplasia, atypical lobular hyperplasia
65
most common non-skin malignancy in women
breast carcinoma
66
second to lung cancer in causing death
breast carcinoma
67
breast cancer is 5-10% more common in the
left breast
68
ER+ and HER2- breast cancer
luminal breast cancer
69
most common type of breast cancer
ER+
70
worst kind of breast cancer
triple negative
71
ER-, PR-, HER2- breast cancer
triple negative
72
80% of breast cancers are ___ positive
ER
73
65% of breast cancers are ____ positive
PR
74
20% of breast cancers are ____ positive
HER2
75
breast cells grow and divide in uncontrolled way in this type of breast cancer
HER2 positive
76
DCIS only tests for these two receptors
ER, PR
77
type of breast cancer lower in non-white women
ER positive cancers
78
invasive cancer is less common overall in
nonwhite older women
79
are much more likely to respond therapy than negative tumors
ER/PR positive tumors
80
blocks hormone receptors, preventing hormones from binding to them
tamoxifen
81
therapy only used after menopause to stop estrogen production
aromatase inhibitors
82
systemic chemo before surgery
neoadjuvant therapy
83
systemic chemo treatment after surgery
adjuvant therapy
84
4 major known susceptibility genes for familial breast cancer
BRCA1, BRCA2, TP53, CHEK2
85
germline BRCA2 mutations can cause what type of breast cancer
ER+, HER2- cancer
86
germline TP53 mutations can cause what type of breast cancer
HER2+ cancer
87
germline BRCA1 mutations can cause what type of breast cancer
triple negative cancer
88
syndrome implicated in HER2+ breast cancer
Li-Fraumeni syndrome
89
>95% of breast cancer are
adenocarcinomas
90
which breast cancer is more common, ductal or lobular
ductal
91
two main categories of ductal carcinoma in situ
comedo, noncomedo
92
two features that define comedo
-tumor cells with pleomorphic, high grade nuclear
-areas of central necrosis
93
most aggressive form of DCIS that is also referred to as comedocarcinoma
large cell
94
unilateral erythematous eruption with a scale crust on the nipple that results from a rare manifestation of breast cancer
Paget disease
95
masectomy is curative in 99% of cases of this breast cancer
DCIS
96
3 major risk factors for recurrence
-high nuclear grade and necrosis
-extent of disease
-positive margins
97
proliferation of cells within ducts and lobules that growth in a discohesive fashion
lobular carcinoma insitu
98
LCIS is usually due to an acquired loss of the tumor suppressor adhesion protein
E-cadherin (CDH1 mutation)
99
this type of breast cancer is always an incidental biopsy finding
LCIS
100
this type of carcinoma expresses ER/PR but is HER2-
LCIS
101
almost all types of this have an underlying invasive carcinoma that is poorly differentiated, ER-, HER2+
paget's disease
102
risk of developing invasive lobular carcinoma is the same for the ___________ breast
contralateral
103
one of the most important prognostic indicators of invasive ductal carcinoma
tumor size
104
well defined stellate scar in this type of breast cancer
invasive ductal carcinoma
105
histologic variant of invasive carcinoma with clusters of invasive tumor cells in pools of abundant extracellular mucin
mucinous colloid carcinoma
106
histologic variant of invasive carcinoma with abundant densely eosinophilic cytoplasm, enlarged nuclei, and one or more punctate nuclei
apocrine carcinoma
107
histologic variant of invasive carcinoma with irregular proliferation of small glands and tubules lined by a single layer of cuboidal or columnar epithelium
tubular carcinoma
108
histologic variant of invasive carcinoma that can cause spindle cell and matrix producing carcinoma
metaplastic carcinoma
109
external appearance of breast in inflammatory invasive carcinoma
peau d'orange
110
histologic variant of invasive cancer with dyscohesive infiltrating tumor cells
lobular carcinoma
111
stage 1 tumors are less than
2cm
112
stage 2 tumors are _ cm or less than _ cm
2, 5
113
stage 3 tumors are greater than _ cm
5
114
BRCA1 gene mutation also has increased risk of
ovarian carcinoma
115
gene located on the 17q21 chromosome
BRCA1
116
gene located on the 13q12-13 chromosome
BRCA2
117
BRCA2 gene mutation has less risk for ______ but increased risk of ________
ovarian carcinoma, male breast cancer
118
BRCA1 and BRCA2 gene mutation increases risk for epithelial cancers: ______ and _______ carcinomas
prostatic and pancreatic
119
larger more pleomorphic cells that are mroe likely to progress to carcinoma
comedo
120
histology of comedo shows (2)
-central necrosis
-pleomorphic, high grade nuclei
121
rounded cookie cutter-like spaces that are often filled with calcified secretory material are found histologically in this type of DCIS
cribriform
122
these types of DCIS lack fibrovascular cores
papillary and micropapillary
123
cells fill and expand the duct lamina but are still confined by the basement membrane in this form of DCIS
solid
124
grading system for breast cancer
Nottingham
125
three characteristics for the nottingham grading system
-tubule formation
-nuclear pleomorphism
-mitotic figures
126
this type of breast cancer is more common in men
ER+
127
the most common benign breast tumor
fibroadenoma
128
50% of invasive carcinoma tumor cells have
lymphovascular invasion
129
stromal tumor less common than a fibroadenoma
phyllodes tumors
130
associated with clonal acquired chromosomal changes with gain in chromosome 1q
phyllodes tumors
131
higher tumor grade and more aggressive clinical behavior of phyllodes tumor is associated with increased numbers of chromosomal abnormalities and overexpression of
HOXB13
132
these stromal tumors are more likely to be malignant in older patients
phyllodes tumor
133
other term for phyllodes tumor
cystosarcoma phyllodes
134
tumor composed of stromal cells with epithelium
intralobular stromal tumor
135
tumor composed of stromal cells without an epithelial component
interlobular stromal tumor
136
consists of myofibroblasts and is equally common in males
myofibroblastoma
137
important to distinguish this interlobular stromal tumor from malignancies
lipoma
138
clonal proliferation of fibroblasts and myofibroblasts
fibromatosis
139
breast implant associated lymphoma
anaplastic large cell
140
only sarcoma that occurs with any frequency in the breast
angiosarcoma
141
plural for os
ora
142
primary lymphoma of the breast
B cell lymphoma
143
