breast

Question 1

name the most common disorder of the breast?

Answer 1

fibrocystic disease

Question 2

what are the 3 forms of fibrocystic disease of the breast?

Answer 2

non-proliferative
proliferative
sclerosing adenosis

Question 3

what are some special lab findings of non-proliferative fibrocystic breast tissue

Answer 3

dilation of ducts with no epithelial hyperplasia.
&
Increase in collagen

Question 4

what is the color of a fibrocystic cyst (non-proliferative) when removed ?

Answer 4

blue/brown

Question 5

what are some special lab findings of proliferative fibrocystic breast tissue?

Answer 5

epithelial hyperplasia
ductal papillomatosis
fenestrations
increase risk of carcinoma

Question 6

what are the findings of ductal papillomatosis?

Answer 6

multilayered with papillary folding

Question 7

what are the findings with fenestration of breast tissue?

Answer 7

filling of the ductal lumen

Question 8

what form of fibrocystic breast disease can you find papillomatosis and fenestrations?

Answer 8

proliferating form

Question 9

what is special about sclerosing adenosis?

Answer 9

*looks like carcinoma of the breast*
adenosis
intralobular sclerosis
enlarged and deformed lobular units
proliferation of acini

Question 10

what does adenosis mean?

Answer 10

the number of acini per duct is increasing

Question 11

is which form of fibrocystic disease of the breast can you find an increase of acini per duct and intralobular fibrosis?

Answer 11

sclerosing adenosis

Question 12

what is the most common benign tumor of the breast?

Answer 12

fibroadenoma

Question 13

what is special about a fibroadenoma?

Answer 13

it is hormone dependent.
responds to increase of estrogen
multiple and bilateral

Question 14

if a women comes to the clinic with a free moveable mass on her breast what should be on the top of your differential dx.?

Answer 14

fibroadenoma

Question 15

after taking a biopsy of a free moveable mass of a woman’s breast what should you expect to see?

Answer 15

intact BM
loose fibroblastic stroma
can either appear:
periductal or intraductal

Question 16

in a lab finding you see a periductal mass meaning it is what shape

Answer 16

round or oval

Question 17

in a lab finding you see a slit like mass what shape is it?

Answer 17

slit like

Question 18

in a lab finding you see a slit like mass with loose stroma and an intact BM what tumor of the breast is it?

Answer 18

intraductal fibroadenoma

Question 19

what is the name of a epithelial tumor of the breast

Answer 19

intraductal papilloma

Question 20

what are the two main locations of a intraductal papilloma?

Answer 20

lactiferous ducts and the aerola

Question 21

what are some special findings of a intraductal papilloma?

Answer 21

mostly solitary
branching papillae covered with cubical epithelium
neoplastic papillary growth

Question 22

are intraductal papilloma benign or mets?

Answer 22

benign

Question 23

what are some clinical findings of a intraductal papilloma?

Answer 23

bloody nipple discharge
unilateral
subaerolar mass

Question 24

what is the second leading cancer in america

Answer 24

carcinoma of the breast

Question 25

a lady comes into the clinic an immoveable mass in breast early menarche late menopause and used birth control for several years what is she most likely to have?

Answer 25

carcinoma of the breast

Question 26

what are some classical findings of breast carcinoma?

Answer 26

ductal or lobular epithelium left breast involved upper outer quadrants

Question 27

where can non-invasive carcinomas be found?

Answer 27

in the basement membrane

Question 28

out of the non-invasive carcinomas; | is intraductal or intralobular carcinoma of the breast most common?

Answer 28

intraductal is most common

Question 29

what are some classic lab findings of intralobular carcinoma?

Answer 29

* plugged and filled ducts * confined to BM * comedocarcinoma = central necrosis of ducts * rapid proliferation

Question 30

you find central necrosis of ducts plugging and filling of ducts and rapid proliferation of cells (mitotic figures) in tissues what carcinoma of the breast is it most likely?

Answer 30

intraductal carcinoma of the breast

Question 31

during a mammogram you incidentally find clusters of acini that are monomorphic what kind of carcinoma of the breast is it?

Answer 31

lobular

Question 32

what is the treatment for both the intralobular or intraductal forms of non-invasive carcinoma?

Answer 32

lumpectomy

Question 33

the majority of invasive breast carcinomas are

Answer 33

ductal

Question 34

pt. comes into the clinic with a hard immoveable mass on the outer quadrant of the left breast with an 'orange' look with dimpling and a retracted nipple.... what should be on the top of your differential?

Answer 34

invasive ductal carcinoma

Question 35

in the lab biopsy of a invasive ductal carcinoma what would likely be seen?

Answer 35

nests and cords of malignant cells in stroma | replacement of breast fat with fibrosis

Question 36

what are the variants of ductal carcinoma?

Answer 36

medullary colloid tubular

Question 37

microscopically the dr. finds large fleshy groups of cells separated by scant fibrous tissue and infiltration of lymphocytes what type of ductal carcinoma is it?

Answer 37

medullary

Question 38

out the 3 types of ductal carcinoma which one has the best prognosis?

Answer 38

medullary

Question 39

microscopically the dr. finds mucin intracellularlly and extracellulary with a blue/gray bulky mass... what kind of ductal carcinoma is this?

Answer 39

medullary

Question 40

microscopically you find well formed tubules... what kind of ductal carcinoma of the breast is this?

Answer 40

tubular ductal

Question 41

pt. comes into office with nipple lesion and the lab finds it extending into the ductal system and does not cross the BM they also note a 'halo' look? what kind of disease of the breast is this?

Answer 41

paget's disease | due to an existing tumor of the breast (non-invasive or invasive)

Question 42

what are some special lab findings of pagets disease?

Answer 42

* clear halo-- mucopolysaccharide * DOES NOT cross BM * invades the ductal system

Question 43

what is a special lab finding of invasive lobular carcinoma?

Answer 43

indian file line

Question 44

you find mitotic cells invading 'individually' into the stroma --> looking like a (-----------) (-------) indian file line; what type of carcinoma of the breast is this?

Answer 44

invasive lobular carcinoma

Question 45

Peau d'orange is due to?

Answer 45

localized lymphedema due to a tumor of the breast

Question 46

carcinome of the breast will spread fast/slow during pregnancy due to an increase of estrogen...

Answer 46

fast

Question 47

of carcinoma of the breast is to spread by blood where will it go?

Answer 47

lung, bone, liver, adrenals