breast

Question 1

painful breast is suggestive of ___ lesion

benign/malignant

Answer 1

benign

Question 2

would you suspect cancer of the breast when the nipple discharge is spontaneous and unilateral?

Answer 2

yes

Question 3

most common bacteriologic cause of acute mastitis

Answer 3

S. aureus

Question 4

[diagnosis]

mimic cancer, history of breast trauma

Histo: hemorrhagic, liquefactive fat necrosis with neutrophils and macrophages

Answer 4

fat necrosis

Question 5

[benign or malignant?]

Benign ductal cells
Myoepithelial cells present

Answer 5

benign

Question 6

[diagnosis]

malignant ductal cells
present myoepithelial cells

Answer 6

DCIS

Question 7

[diagnosis]

malignant ductal cells
absent myoepithelial cells
negative p63

Answer 7

invasive CA

Question 8

[diagnosis: proliferative disease without atypia]

> 2 layers of cells in aduct
distorted lumina at periphery
mimics DCIS

Answer 8

Epithelial hyperplasia

Question 9

[diagnosis: proliferative disease without atypia]

solid cords or double strands of cells in a densely fibrotic stroma

closely mimics carcinoma; inner ducts are compressed

Answer 9

sclerosing adenosis

Question 10

[diagnosis: proliferative disease without atypia]

papillary fronds with fibrovascular cores growing in a dilated duct

present myoepithelial layer

Answer 10

papilloma

Question 11

[diagnosis: proliferative disease without atypia]

combination of epithelial hyperplasia, sclerosing adenosis and papilloma

central nidus of entrapped glands in a hyalinized stroma

mimics cancer

Answer 11

complex sclerosing lesion

Question 12

[diagnosis: proliferative disease with atypia]

DCIS without full duct involvement
cribiform pattern (cookie cutter appearance)

Answer 12

atypical ductal hyperplasia

Question 13

[diagnosis: proliferative disease with atypia]

LCIS but less than 50% involvement of acini in a lobule; loss of E-cadherin

Answer 13

Atypical lobular hyperplasia

Question 14

most common non-skin malignancy in women

Answer 14

breast CA

Question 15

2nd to lung CA in causing deaths in women

Answer 15

breast CA

Question 16

BRCA 1 is located in what chroomosome?

Answer 16

Ch 17

Question 17

BRCA 2 is located in what chroomosome?

Answer 17

Ch 13

Question 18

the duct system of that breast that is hormonally responsive

Answer 18

terminal duct-lobular unit

Question 19

site in the breast where invasive breast CA arise

Answer 19

terminal duct-lobular unit

Question 20

[diagnosis: cancer or not CA?]

small, irregular, numerous, clustered calcification

Answer 20

CA

Question 21

[diagnosis: comedo vs non comedo DCIS]

high grade nuclei, central necrosis

Answer 21

comedo DCIS

Question 22

[diagnosis: comedo vs non comedo DCIS]

variable nuclear grade and architectural pattern

Answer 22

non comedo DCIS

Question 23

[diagnosis: comedo vs non comedo DCIS]

ducts filled with cells with high grade nuclear atypia, central necrosis

Answer 23

comedo

Question 24

[diagnosis: comedo vs non comedo DCIS]

ducts completely filled with cell, appearing as solid nets

Answer 24

non-comedo, solid

Question 25

[diagnosis: comedo vs non comedo DCIS] ducts filled with cells with secondary lumina

Answer 25

non-comedo, cribiform

Question 26

[diagnosis: comedo vs non comedo DCIS] bulbous projections WITHOUT fibrovascular cores

Answer 26

non-comedo, micropapillary

Question 27

[diagnosis: comedo vs non comedo DCIS] papillary fronds WITH fibrovascular cores but NO myoepithelial layer in fronds

Answer 27

papillary

Question 28

[diagnosis: CA] monomorphic cellular appearance, distinct cytoplasmic borders, pale cytoplasm, round nuclei, absent streaming, CK5 (+), CK 6 (-), ER (+), diffuse

Answer 28

DCIS

Question 29

[diagnosis: CA] heterogenous appearance, indistinct borders, eosinophilic cytoplasm, oval nuclei, present streaming, CK5 (+) CK6 (+), ER (+), mosaic

Answer 29

epithelial hyperplasia

Question 30

[diagnosis: CA] unilateral eruption with a scale crust, pruritic, malignant cell reaches the ductal cell without violating the basement membrane

Answer 30

paget cells

Question 31

[diagnosis: CA intact basement membrane, no disruption of lobules, absent necrosis, nipple of the skin not involved, ER(+), PR(+), HER2(-)

Answer 31

LCIS

Question 32

most common type of invasive carcinoma of the breast

Answer 32

invasive breast CA, no special type

Question 33

[diagnosis: infiltrating carcinoma] in situ with absence of myoepithelial layer, haphazarly disposed cells with desmoplasia

Answer 33

invasive breast CA, no special type

Question 34

[diagnosis: infiltrating carcinoma] E-cadherin loss, ER/PR (+), HER2 (-), little desmoplasia, indian file/ dyscohesive infiltrating tumor cells in single file mucin (+)

Answer 34

invasive lobular carcinoma

Question 35

[diagnosis: infiltrating carcinoma] clusters of small islands of tumor cells floating in pools of extracellular mucin, low atypia ER/PR(+), HER2 (-)

Answer 35

mucinous (colloid) carcinoma

Question 36

[diagnosis: infiltrating carcinoma] syncitium-like solid sheets of large cells with pleomorphic nuclei and prominent nucleoli, increased mitosis, lymphoplasmatic infiltrates, pushing borders ER(-) HER2(-)

Answer 36

medullary carcinoma

Question 37

[diagnosis: infiltrating carcinoma] extensive invation and proliferation within lymphatic channels, presents as swelling that can mimics non-neoplastic inflammatory disorder

Answer 37

inflammatory CA

Question 38

this test is done to confirm positivity to HER2 in cases of equivocal result

Answer 38

FISH fluorescence in situ hybridization

Question 39

[diagnosis: drug treatment for this subtype/molecular subtype] ER(+) Her2(-) Ki67 low

Answer 39

Luminal A, tamoxifen

Question 40

[diagnosis: drug treatment for this subtype/molecular subtype] ER(+) Her2(-) Ki67 high

Answer 40

Luminal A, tamoxifen

Question 41

[diagnosis: drug treatment for this subtype/molecular subtype] ER(+/-) PR(+/-) Her2(+) Ki67 high

Answer 41

Her 2 enriched, Trastuzumab

Question 42

``` [diagnosis: drug treatment for this subtypemolecular subtype] in study ER(-) Her2(-) Ki67 high ```

Answer 42

Basal

Question 43

most common benign tumor of the female breast

Answer 43

fibroadenoma

Question 44

[diagnosis: stromal tumor] older females, larger breast mass stromal overgrowth, infiltrative boarders, high cellularity, high mitosis, nuclear pleomorphism, leaf-like projections

Answer 44

phyllodes tumor

Question 45

[diagnosis: type of phyllodes tumor] Well defined borders, fibroblastic appearance, little to mild atypia, <5 mitoses/10HPF, no stromal overgrowth

Answer 45

benign phyllodes tumor

Question 46

[diagnosis: type of phyllodes tumor] focally infiltrative borders, moderate cellularity, moderate atypia, 5-9 mitoses/10HPF, no stromal overgrowth or focal stroma

Answer 46

borderline phyllodes tumor

Question 47

[diagnosis: type of phyllodes tumor] infiltrative borders, high cellularity, marked atypia, >/10 mitoses/10HPF, with stromal overgrowth

Answer 47

malignant phyllodes

Question 48

[diagnosis: type of phyllodes tumor] metaplastic elements containing bone, skeletal, cartilage tissues

Answer 48

malignant phyllodes

Question 49

[diagnosis: type of phyllodes tumor] 4 LPO field shows only stromal component

Answer 49

malignant phyllodes

Question 50

[diagnosis: stromal tumors] young female, relatively smaller breast mass stromal proliferation = epithelial lesion, lesser stromal cellularity, not atypia, no mitosis

Answer 50

fibroadenoma

Question 51

in gynecomastia, the duct lining undergoes ___ (hypertrophy/hyperplasia)

Answer 51

hyperplasia