Breast

Question 2

Acute Mastitis

Answer 2

breast-feeding -> Staphylococcus aureus infection -> intramammary abscess

Question 3

Periductal Mastitis

Answer 3

Smoker, reproductive age, painful mass, Squamous Metaplasia from nipple into ducts, keratin blocks ducts -> Granulomatous inflammatory reaction

Question 4

Mammary Duct Ectasia Clinical Presenation

Answer 4

50-60 y/o, non-smoker, multiparous, cheesy nipple discharge, painless mass

Question 5

Mammary Duct Ectasia Histological Presentation

Answer 5

Mucin-plug causing dilation of ducts filled with lipid-laden macrophages + granulomatous inflammation w/ infiltrate of lymphocytes, macrophages and plasma cells

Question 6

Fat Necrosis

Answer 6

Trauma, lipid-laden macrophages, granulomatous inflammation, calcifications + crystallized lipid

Question 7

Granulomatous Mastitis

Answer 7

Secondary to disease, infection, foreign body

Question 8

Cyst Formation

Answer 8

PURE fibrocystic change; blue dome cysts, calcification, apocrine metaplasia

Question 9

Fibrosis

Answer 9

PURE fibrocystic change; Cyst rupture -> overproduction of collagen -> fibrosis

Question 10

Adenosis

Answer 10

PURE fibrocystic change; Fibrosis + aggregated glands w/ increased acini -> calcifications

Question 11

Usual Ductal Epithelium Hyperplasia

Answer 11

Proliferation of ductal epithelium w/ no cytological changes, 2 cell types present

Question 12

Atypical Ductal Epithelium Hyperplasia

Answer 12

Proliferation of ductal epithelium w/ cytological changes: mitotic figures, hyperchromia; Microcalcifications lining ducts (much like DCIS); Increased risk for cancer

Question 13

Non-Complex Sclerosing Adenosis

Answer 13

Swirling fibrous tissue + increased acini + duct compression into cords

Question 14

Complex Sclerosing Adenosis

Answer 14

Abundant central fibrosis / elastosis, Few, tiny glands separated by extensive bands of collagen

Question 15

Atypical Lobular Epithelium Hyperplasia:

Answer 15

Proliferation of lobular epithelium w/ cytological changes: mitotic figures, hyperchromia

Question 16

Sclerosing Papillomas

Answer 16

Typical sclerosing adenosis features + Papillary projections into lumen

Question 17

Small Duct Papillomas

Answer 17

Occur deep w/in breast; Papilloma (arise from epithelium) in small ducts

Question 18

Fibroadenoma

Answer 18

Most common neoplasm

Question 19

Phyllodes

Answer 19

>60 y/o, large, low-grade tumor, less-defined, more cellular w/ few mitotic figures, SCALLOPED clefts

Question 20

Cystosarcoma phyllodes

Answer 20

Highly CELLULAR, a lot of ATYPIA, less stromal tissue

Question 21

Stewart-Trevis Syndrome

Answer 21

Lymphangiosarcoma may develop outside the breast in patients who have had mastectomy - lymphedema in unilateral UE

Question 22

Large Duct Papilloma

Answer 22

Serous or bloody nipple discharge; ductal papilloma in a large duct

Question 23

Ductal Carcinoma In Situ – Comedo

Answer 23

High-grade, high risk for IDC, solid sheets of tumor cells + central area of necrosis and microcalcifications

Question 24

Ductal Carcinoma In Situ – Comedo on mammogram

Answer 24

microcalcifications lining ducts

Question 25

Ductal Carcinoma In Situ – Non-Comedo

Answer 25

Low-grade, less atypia, characterized by the way cells grow in ducts (cribriform, papillary, etc)

Question 26

Paget Disease of the Nipple

Answer 26

Nipple is fissures, ulcerating, oozing; DCIS extends from nipple ducts into contiguous epithelium of nipple and areola

Question 27

Lobular Carcinoma In Situ

Answer 27

does not calcify or show up on mammogram, hard to detect, high incidence of BILATERALITY

Question 28

Invasive Ductal Carcinoma

Answer 28

Hard, gritty, chalky-like mass; • Cords, solid nests, anastomosing sheets of malignant cells

Question 29

African Americans tend to have

Answer 29

Triple negative IDC

Question 30

Medullary Carcinoma

Answer 30

IDC, 20-30y/o, BRCA1 mutation, HIGH-GRADE w/ LOW-GRADE BEHAVIOR; circumscribed, marked anaplasia + lymphocytic infiltrate

Question 31

Colloid/Mucinous Carcinoma

Answer 31

IDC, Elderly, well-circumscribed, mucin-lakes w/ malignant cell islands (PALE BLUE, gelatinous)

Question 32

Tubular Carcinoma

Answer 32

IDC, Low-grade, well-formed tubules, but lack myoepithelial cell layer, appears similar to Sclerosing Adenosis

Question 33

Invasive Papillary Carcinoma

Answer 33

IDC, rare, DCIS + papillary architecture

Question 34

Invasive Lobular Carcinoma

Answer 34

BILATERAL 20%, RUBBERY/scorrhous stroma, SINGLE-FILE Invasion; no tubules w/ rings about normal ducts

Question 35

cheesy discharge

Answer 35

Mammary Duct Ectasia

Question 36

blue dome cysts

Answer 36

Cyst Formation - fibrocystic change

Question 37

fibrous area b/w cysts that shows an aggregation of glands w/ enlarged lumens

Answer 37

Adenosis

Question 38

Proliferation of ductal epithelium + cytological changes

Answer 38

Atypical Ductal Epithelium Hyperplasia (DCIS)

Question 39

Swirling fibrous tissue, compression of ducts into cords + aggravated small glands

Answer 39

Sclerosing Adenosis

Question 40

Most COMMON neoplasm

Answer 40

Fibroadenoma

Question 41

glands forming flattened elongated /cleft-like spaces

Answer 41

Fibroadenoma

Question 42

GLAND spaces are more scalloped and may have breakdown of the epithelia

Answer 42

Phyllodes

Question 43

Serous or bloody nipple discharge

Answer 43

Large Duct Papilloma

Question 44

Nipple is fissured, ulcerating or oozing

Answer 44

Paget's

Question 45

Hard, gritty, chalky-like mass

Answer 45

Invasive Ductal Carcinoma

Question 46

solid sheets of cancer cells

Answer 46

Invasive Ductal Carcinoma

Question 47

High-grade features w/ LOW-GRADE BEHAVIOR

Answer 47

Medullary Carcinoma

Question 48

Mucin lakes with malignant cell islands.

Answer 48

Colloid Carcinoma

Question 49

similar to Sclerosing Adenosis, tubules w/o myoepithelial cell

Answer 49

Tubular Carcinoma

Question 50

Rubbery, single-file

Answer 50

Invasive Lobular Carcinoma

Question 51

BILATERAL

Answer 51

Invasive Lobular Carcinoma