Breast Flashcards

1
Q

What is the embryology of breast tissue?

A

The breast develops from the skin- it is a modified sweat gland

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2
Q

Where do third nipples develop?

A

Along the milk line (in both men and women)

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3
Q

What are the two layers of epithelial cells in the breast?

A

Luminal cells
Myoepithelial cells

Both layers must be present in order for the breast tissue to be normal (non-cancerous)

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4
Q

What are the two most likely causative agents of acute mastitis?

A

Staph

Strep

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5
Q

What is the clinical relevance of fat necrosis?

A

Fat necrosis can appear as calcification, which is an ominous sign for potential cancer. A biopsy is required to differentiate the two

Fat necrosis can appear as a palpable mass, or calcification on mammography

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6
Q

What is the single most common breast disorder?

A

Non-proliferative fibrocystic change

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7
Q

Why are fibrocystic changes clinically relevant?

A

They can give you a mass, calcifications, or even nipple discharge (which could indicate cancer)

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8
Q

What is the increase in cancer risk associated with fibrocystic changes with apocrine metaplasia?

A

No increased risk

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9
Q

What is adenosis?

A

Increase in the number of acini/lobule

Lots of glands with little intervening stroma

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10
Q

What are the three main features of fibrocystic change?

A

Fibrosis
Adenosis
Cystic change with apocrine metaplasia

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11
Q

When is adenosis a normal physiologic process?

A

Pregnancy

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12
Q

A fibroadenoma is a benign tumor of what part of the breast?

A

Stroma

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13
Q

Are fibroadenomas hormone sensitive?

A

Yes- to estrogen

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14
Q

Describe the appearance of a fibroadenoma

A

well demarcated, smooth, mobile mass

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15
Q

Phyllodes tumors are an overgrowth of what part of the breast?

A

Stroma

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16
Q

Describe the growth of phyllodes tumors

A

They are leaf-like, large overgrowths of stroma

17
Q

Who generally gets phyllodes tumors?

A

Post-menopausal women

18
Q

Are phyllodes tumors benign or malignant?

A

Most are benign, a few can be malignant

19
Q

What is the most common cause of bloody nipple discharge in younger women?

A

Intraductal papilloma

Must rule out papillary carcinoma

20
Q

What is the relative risk of developing carcinoma with intraductal papilloma?

A

1.5-2x

21
Q

What is the relative increased risk of cancer in the presence of atypical hyperplasia?

A

Atypical hyperplasia

22
Q

Atypical hyperplasia can advance to which carcinoma?

A

Lobular carcinoma in situ (LCIS)

23
Q

What is the etiology of Paget’s Disease?

A

DCIS in the ductal system works its way up to the nipple skin without crossing the basement membrane.

Paget’s disease indicates there is DCIS below it.

24
Q

What is the role of BRCA1 and BRCA2?

A

They are both tumor suppressors

25
Q

What are the markers for luminal A breast cancer?

A

ER+, PR+, HER2/Nu -

26
Q

What are the markers for luminal B breast cancer?

A

ER+
PR+
Her2/Nu +

27
Q

What are the markers for Basal like breast cancer?

A

Triple negative

28
Q

WHat causes gynecomastia?

A

Hyperestrogenism

29
Q

Which gene mutation is associated with male breast cancer?

A

BRCA2