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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
If you see roman arches, what is it?
Fibrocystic changes, Atypical Epithelial Hyperplasia
26
Does Fibrocystic breast changes affect both breasts?
Yes, changes are symmetrical. Patients complain of pain, nodularity and sensitive on palpation
27
Describe the lumps in Fibrocystic breast changes
Small, fluctuating lumps which are fluid filled, & easily palpated ( may be calcified)
28
In Fibrocystic breast changes why do you biopsy the breast?
to distingish FCB from cancer
29
What is the treatment for Fibrocystic Breast changes?
Usually not required. if premalignant = resection recommended
30
What is the prognosis of Atypical Epithelial Hyperplasia?
Excellent. Surgeons prefer an extended lumpectomy - remove breast parenchyma
31
What benign breast cancer is well-encapsulated, 2-5 cm, spherical, and FREE MOVEABLE?
Fibroademonas = fibrous stroma and glandular epithelium
32
What benign breast cancer has SOLID SHARP margins?
Fibroadenoma
33
Which breast cancer originates from the papillary growth within a duct?
Intraductal Papilloma, solitary found in duct or sinuses.
34
What breast cancer presents with serous or bloody nipple discharge with sub-areolar mass but rarely with nipple retrations?
Intraductal papilloma
35
If solitary papillomas are benign, multiple papillomas are associated with an increased risk of?
Papillary carcinoma
36
What is the second most common cancer in women (behind lung cancer)?
Carcinoma of the Breast. 1/14 develop CB
37
What causes Carcinoma of the Breast?
Unknown, Risk factors include: hormonal and genetic etiologies (some viruses) ERB-B genetic marker
38
When does Carcinoma of the Breast occur?
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
Most malignant breast cancers are from what tissue?
epithelium
40
what percent of BC are in the upper outer quadrent?
45%, 25% are under the areola
41
What prevents adenocarcinomas from invading?
the basement membrane
42
Ductal Carcinomoa in-situ is also called a
comedocarcinoma
43
Lobular in-situ carcinomas proliferate from the...
Terminal duct (acini)
44
Ductal carcinomas are seen in ___ breast, while Lobular carcinomans are seen in _____ breast
One, both
45
What is Desmoplastic?
Seen with Ductal (D and D) | occurs during the last days of menses, where connective tissue surrounds the invasive ductal carcinoma
46
Invasive ductal carcinomas does what to the skin and nipple?
Dimple (Keep the Ds together) | Dimple the nipple and skin
47
Invasive ductal carcinomas have sharp or not sharp edges?
Sharp
48
Invasive lobular carcinomas can be in how many breasts? with or without a Desmoplasia?
many breasts, without desmopasia
49
Are Invasive lobular carcinomas formed in single fill cells with little pleomorphism or not?
``` Single line (lobular = Line) and form a Targetoid pattern. ```
50
Medullary carcinomas large fleshy tumors. DO they have Desmoplasia?
No, only Ductal has Desmoplasia
51
Do Medullary carcinomas have necrosis and hemorrhage?
Yes
52
Do Medullary carcinomas invade the lymphatics?
Yes
53
Colloid or Mucinous Carcinoma are slow growing (Colloid = cripple growth). what is the popcorn term for these cancers?
Gelatinous grossly large grey-blue lakes of mucin with neoplastic floaters.
54
Paget's disease affects the ____ of the breasts
Ductals around the nipple and areolar = oozing and edema around nipple
55
What do Paget cells look like?
Abundant clear cytoplams with keratine
56
BC metastesizes via lymphatics?
Yes
57
Where can central or medial tumors spread to?
internal mammary lymph
58
What are the main Mets sites for BC?
Bones, brain, liver, lungs, adrenals
59
90% of BC are found by
self exam
60
What is peau d' orange skin?
Carcinoma that locks a lymph = lymphedema
61
If a lump is found on self-exam, always do a ...
Breast biopsy
62
How can you do a breast biopsy?
FNA or incision biopsy (basement membrane)
63
What is Tamoxifen used for?
estrogen expressing tumors treatment
64
What is a lumpectomy vs mastectomy?
``` L = conservative resection of tummor and surrounding fat M = entire breast and axillary lymph ```
65
what is Stage 1 Stage 2 Stage 3 Stage 4 BC?
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
What is gynecomastia?
enlarged male breasts due to liver or tumor problem. Liver can't convert estrogens, so estrogens build up in men.
67
Why does Gynecomastia happen?
excess in excretory ducts due to excess estrogen

MJ- Patho Exam 3 (15 decks)

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