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breast Flashcards

Describe the common developmental abnormalities of the breast Define acute mastitis and list the common causes Describe fibrocystic changes (including important clinical associations) Describe the clinicopathologic features of intraductal papilloma, fibroadenoma, and phyllodes tumor List the risk factors for breast cancer development Describe ductal carcinoma in situ Describe and be able to identify mammary Paget's disease and inflammatory carcinoma Compare and contrast the 2 subtypes of

1
Q

causes of acute mastitis

A

cracks in skin or stasis in milk may allow direct or retrograde ductal spread of bacteria

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2
Q

most common cause of bloody nipple discharge

A

intraductal papilloma

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3
Q

most common tumor in adolescent and young adults

A

fibroadenoma

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4
Q

main risk factor for breast cancer

A

age, 1st degree FMX, estrogen exposure, radiation, obestity

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5
Q

worst BRCA mutation

A

BRCA1

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6
Q

US lifetime risk of breast cancer

A

11%

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7
Q

syndromes that can lead to risk of breast cancer

A

li-fraumeni, cowden (PTEN)

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8
Q

comedo type necrosis

A

grade III carcinoma in situ

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9
Q

100% of pts with this will have DCIS

A

paget’s disease of the nipple

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10
Q

35-50% of pts with this will have invasive carcinoma

A

paget’s dx of the nipple

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11
Q

signs of invasive breast cancer

A

lump
firm, non-movable lump
diffuse thickening in breast texture
eczema like changes

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12
Q

small uniform round of oval nuclei in single file pattern infiltrating the stroma

A

onvasive lobular carcinoma

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13
Q

orange peel skin

A

inflammatory carcinoma

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14
Q

staging with direct extention to chest wall

A

T4

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15
Q

staging of ANY distant mets

A

M1

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16
Q

met to any internal mammary node

A

N3

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17
Q

importance of congenital inversion of the nipple

A

similar changes can be produced by underlining cancer

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18
Q

arises from cystic dilation of an obstructed duct

A

galactocele

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19
Q

benign cyst formation and fibrosis of the breast

A

fibrocystic changes

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20
Q

brown to blue cysts filled with watery fluid

A

fibrocystic changes

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21
Q

duct lumen filled with heterogeneous population of cells of difereing morphology with fenestrations

A

epithelial hyperplasia

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22
Q

benign processes at higher risk for invasive breast carcinoma

A

atypical ductal and lobar hyperplasia

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23
Q

proliferation of lumial spaces lined with epithelial cells and myepithelial cells yielding masses of small glands within a fibrois stroma

A

sclerosing adenosis

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24
Q

swirling pattern of cells with a well-circumscribed border

A

sclerosing adenosis

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25
Q

benign processes with small risk of breast carcinoma

A

fibrosis, cystic changes, apocrine metaplasia

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26
Q

carcinoma risk of sclerosing adenosis

A

slightly higher

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27
Q

bugs causing acute mastitis

A

Staph A, S pyogenes

28
Q

inflamatory breast lesion sometimes preceded by trauma

A

fat necrosis

29
Q

prominent lymphoplasmacytic infiltrate and occasiional granulomas in the periductal stroma

A

mammary duct ectasia

30
Q

solitary discrete mobile mass

A

fibroademoma

31
Q

rubbery well-circumcribed mass

A

fibroadenoma

32
Q

leaf-like epithelium projections in beign tumors

A

phyllodes tumor

33
Q

serous or bloody nipple discharge with a small subareolar tumor in a premenopausal woman

A

intraductal papilloma

34
Q

< 1 cm tumor with delicate branching growths within a dilated duct with double layered epithelium

A

intraductal papilloma

35
Q

histological way to differentiate intraductal papilloma from carcinoma

A

precense of double layered epithelium

36
Q

most common genetic breast cancer mutation

A

HER2/NUE

37
Q

genetic marker in breast cancer associated with poor outcomes

A

HER2/NUE

38
Q

4 types of breast cancer molecular subtypes

A

HER2/NUE + estrogen receptor +
HER2/NUE + estrogen receptor -
HER2/NUE - estrogen receptor +
HER2/NUE - estrogen receptor -

39
Q

common non-breast primary cancer in women with breast cancer

A

ovarian

40
Q

most common location of breast cancer

A

upper outer quadrant

41
Q

calcifications are frequently associated with

A

DCIS

42
Q

two types noninvasive breast cancer

A

ductal/lobular cancer in situ

43
Q

DCIS prognosis

A

excellent

44
Q

extention of DCIS into the nipple

A

paget’s disease of the nipple

45
Q

bland round nuclei occuring in loosely cohesive clusters within lobules

A

LCIS

46
Q

in situ carinoma with the highest risk of invasive disease

A

LCIS

47
Q

marker of increased risk of invasive cancer of either breast

A

LCIS

48
Q

replaces normal breast fat with tumor cells and forms a hard palpaple mass

A

invasive ductal carcinoma

49
Q

single-file chains of tumor cells invading into the stroma

A

invasive lobular carcinoma

50
Q

met to CSF, serosal surfaces, GI, ovary, uterus and bone marrow

A

invasive lobular carcinoma

51
Q

usually hormone +/ HER2/NEU -

A

invasive lobular carcinoma,

52
Q

enlarged, swolled, warm breast usually without palpable mass

A

inflammatory carcinoma

53
Q

reason imflammatory carcinoma looks that was

A

invades dermal lymphatic spaces

54
Q

can often be mistaken for fibroadenomas

A

medullary carcinomas

55
Q

“triple-negative” breast cancer

A

medullary carcinomas

56
Q

first outward sign of breast malinancy

A

retraction or dimpling of the nipple

57
Q

sign of involvement of the breast lymphatics

A

peau d/orange

58
Q

outer quadrants and centrally located cancers spread to

A

axillary nodes

59
Q

inner quadrants cancers spread to

A

nodes along internal mammilary arteries

60
Q

most common mets in breast cancer

A

lungs, bones, liver, adrenals

61
Q

better progress cancer types

A

tubular, medullary, mucinous

62
Q

worst type of breast cancer

A

inflammatory

63
Q

frequent cause of angiosarcoma

A

previous breast radiation therapy

64
Q

expression of estrogen and progesterone is (good/bad)

A

good

65
Q

expression of HER2/NEU is (good/bad)

A

bad

66
Q

drug thats use is based on HER2/NEU profile

A

trastuzumab

67
Q

most important cause of hyperestrtinism in males

A

liver cirrhosis

GU (12 decks)

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