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MJ- Patho Exam 3 > Breast > Flashcards

Breast Flashcards

1
Q

Do men have lobules?

A

No

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2
Q

What is Amastia? Polymastia?

A

congenital absence of a breast. Multiple breasts dont develop.

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3
Q

how do breasts (and the pancreas) repair?

A

Fat necrosis

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4
Q

Besides the anterior torso, where else is breast tissue located?

A

the Axilla: use 4 quadrants for the physical exam

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5
Q

What is the most benign breast cancer?

A

Fibroadenoma found in upper outer quadrent.

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6
Q

What breast tissue is given to pathologist?

A

Anterior mid and deep axillary

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7
Q

What is the most common inflammatory breast condition?

A

Acute mastitis - lactating women, caused by Staph or Strep

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8
Q

How do bacteria invade breast tissue?

A

via dilated milk ducts or skin lacerations or suckling

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9
Q

What is a good growth median for bacteria?

A

stagnant breast milk. It can spread and cause localized or diffused breast swelling that in red and painful

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10
Q

What immune cells are seen in Acute Mastitis?

A

PMNs, if persistant = Incision and Drain

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11
Q

What breast disease is rare and mimics breast cancer (small lumps + retracted nipple)?

A

Chronic Mastitis - biopsy needed

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12
Q

Why would there be fibrous scars in breast tissue?

A

due to destroyed breast tissue from acute insult.

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13
Q

Previous breast trauma, proir surgery, or radiation can lead to ___ _______. this is sharply localized, solitary, and in 1 breast

A

Fat necrosis - hemorrhage with fat center that forms a chalk white foci.

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14
Q

What breast disease is characterized by a family history of heavy boggy breasts?

A

Fibrocystic Breast changes

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15
Q

What breast disease has palpable lumps that appear blue on autopsy or biopsy and create post puberty?

A

Fibrocystic Breast changes

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16
Q

When do women with fibrocystic breast changes get relief? What hormones regulate the relief?

A

after menopause.

reduction in estrogen and progesterone from excretory ducts in the intralobular stroma

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17
Q

what causes fibrocystic breast changes that leads to fibrosis?

A

an imbalance of hormones in the ducts, lobules, or stroma

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18
Q

In Fibrocystic breast changes what is the loose intralobular connective tissue changed into?

A

Dense connective tissue rich in collagen and non-responsive to hormones

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19
Q

In Fibrocystic breast changes, cysts are formed because the ductal epithelium grows in the dense connective tissue. Why does the epithelium grow?

A

because it is still responsive to hormones. Becomes and trapped and creasts the cysts.

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20
Q

What is a blue-domed cyst?

A

Fibrocystic breast changes

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21
Q

What is the most common type of alteration in breasts?

A

Fibrocystic breast changes

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22
Q

Is there hyperplasia in the epithelium in Fibrocystic breast changes?

A

Yes

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23
Q

(ON THE TEST) Hyperplasia is always present in Fibrocystic breast changes. what else is this called?

A

Atypical Epithelial Hyperplasia = multilayered hyperplasia. this

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24
Q

Does Atypical Epithelial Hyperplasia mean cancer?

A

No, only a SLIGHT risk increase (5%)

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25
Q

If you see roman arches, what is it?

A

Fibrocystic changes, Atypical Epithelial Hyperplasia

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26
Q

Does Fibrocystic breast changes affect both breasts?

A

Yes, changes are symmetrical. Patients complain of pain, nodularity and sensitive on palpation

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27
Q

Describe the lumps in Fibrocystic breast changes

A

Small, fluctuating lumps which are fluid filled, & easily palpated ( may be calcified)

28
Q

In Fibrocystic breast changes why do you biopsy the breast?

A

to distingish FCB from cancer

29
Q

What is the treatment for Fibrocystic Breast changes?

A

Usually not required. if premalignant = resection recommended

30
Q

What is the prognosis of Atypical Epithelial Hyperplasia?

A

Excellent. Surgeons prefer an extended lumpectomy - remove breast parenchyma

31
Q

What benign breast cancer is well-encapsulated, 2-5 cm, spherical, and FREE MOVEABLE?

A

Fibroademonas = fibrous stroma and glandular epithelium

32
Q

What benign breast cancer has SOLID SHARP margins?

A

Fibroadenoma

33
Q

Which breast cancer originates from the papillary growth within a duct?

A

Intraductal Papilloma, solitary found in duct or sinuses.

34
Q

What breast cancer presents with serous or bloody nipple discharge with sub-areolar mass but rarely with nipple retrations?

A

Intraductal papilloma

35
Q

If solitary papillomas are benign, multiple papillomas are associated with an increased risk of?

A

Papillary carcinoma

36
Q

What is the second most common cancer in women (behind lung cancer)?

A

Carcinoma of the Breast. 1/14 develop CB

37
Q

What causes Carcinoma of the Breast?

A

Unknown, Risk factors include: hormonal and genetic etiologies (some viruses) ERB-B genetic marker

38
Q

When does Carcinoma of the Breast occur?

A
  1. Female 100x vs Men
    2) after 35 and peak in postmenopause (60).
    3) Rare in men, Japanese, Chinese. Most common in Caucasians and Jews
    4) Genetics: maternal inheritance
    5) Hormonal factors: prolonged exposure to estrogen - early menarch and late pregnancy (Nullparous = no preg)
    6) Presence of other cancers (ovarian, endometrial)
    7) Pre-malignant Firbocystic changes and multiple intraductal papillomastosis
    8) Obesity, Alcohol, Fatty diet
39
Q

Most malignant breast cancers are from what tissue?

A

epithelium

40
Q

what percent of BC are in the upper outer quadrent?

A

45%, 25% are under the areola

41
Q

What prevents adenocarcinomas from invading?

A

the basement membrane

42
Q

Ductal Carcinomoa in-situ is also called a

A

comedocarcinoma

43
Q

Lobular in-situ carcinomas proliferate from the…

A

Terminal duct (acini)

44
Q

Ductal carcinomas are seen in ___ breast, while Lobular carcinomans are seen in _____ breast

A

One, both

45
Q

What is Desmoplastic?

A

Seen with Ductal (D and D)

occurs during the last days of menses, where connective tissue surrounds the invasive ductal carcinoma

46
Q

Invasive ductal carcinomas does what to the skin and nipple?

A

Dimple (Keep the Ds together)

Dimple the nipple and skin

47
Q

Invasive ductal carcinomas have sharp or not sharp edges?

A

Sharp

48
Q

Invasive lobular carcinomas can be in how many breasts? with or without a Desmoplasia?

A

many breasts, without desmopasia

49
Q

Are Invasive lobular carcinomas formed in single fill cells with little pleomorphism or not?

A 
Single line (lobular = Line)
and form a Targetoid pattern.
50
Q

Medullary carcinomas large fleshy tumors. DO they have Desmoplasia?

A

No, only Ductal has Desmoplasia

51
Q

Do Medullary carcinomas have necrosis and hemorrhage?

A

Yes

52
Q

Do Medullary carcinomas invade the lymphatics?

A

Yes

53
Q

Colloid or Mucinous Carcinoma are slow growing (Colloid = cripple growth). what is the popcorn term for these cancers?

A

Gelatinous grossly large grey-blue lakes of mucin with neoplastic floaters.

54
Q

Paget’s disease affects the ____ of the breasts

A

Ductals around the nipple and areolar = oozing and edema around nipple

55
Q

What do Paget cells look like?

A

Abundant clear cytoplams with keratine

56
Q

BC metastesizes via lymphatics?

A

Yes

57
Q

Where can central or medial tumors spread to?

A

internal mammary lymph

58
Q

What are the main Mets sites for BC?

A

Bones, brain, liver, lungs, adrenals

59
Q

90% of BC are found by

A

self exam

60
Q

What is peau d’ orange skin?

A

Carcinoma that locks a lymph = lymphedema

61
Q

If a lump is found on self-exam, always do a …

A

Breast biopsy

62
Q

How can you do a breast biopsy?

A

FNA or incision biopsy (basement membrane)

63
Q

What is Tamoxifen used for?

A

estrogen expressing tumors treatment

64
Q

What is a lumpectomy vs mastectomy?

A 
L = conservative resection of tummor and surrounding fat
M = entire breast and axillary lymph
65
Q

what is Stage 1
Stage 2
Stage 3
Stage 4 BC?

A

Stage 1= <2.5cm 80% survival
Stage 2= 2.5-5cm 65% survival
Stage 3= >5cm and local lymph spead. survival = 40%
Stage 4= any size and distant spread Mets, survival = 10%

66
Q

What is gynecomastia?

A

enlarged male breasts due to liver or tumor problem. Liver can’t convert estrogens, so estrogens build up in men.

67
Q

Why does Gynecomastia happen?

A

excess in excretory ducts due to excess estrogen

MJ- Patho Exam 3 (15 decks)

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