Breast Disease

Question 1

What is the name of the fibrous bands that support the breast?

Answer 1

Cooper’s suspensory ligaments

Question 2

Major blood supply to the breast

Answer 2

internal mammary (medial and central) and lateral thoracic arteries (upper outer)

Question 3

Nerves at risk of injury during breast surgery:

Answer 3

• intercostobrachial nerve (transverses axilla): sensation to upper medial arm
• long thoracic nerve: serratus anterior (damage = winged scapula)
• thoracodorsal: latissimus dorsi
• lateral pectoral: pectoralis major and minor

Question 4

Bloody discharge is associated with what types of breast cancer?

Answer 4

• intraductal papilloma

- invasive papillary cancer

Question 5

Fibrocystic breast change

Answer 5

• exaggerated stromal response to hormones and growth factors
• multiple, bilateral painful breast masses

Question 6

Fibroadenoma

Answer 6

-benign tumors with glandular and stromal components

Question 7

Cystosarcoma phyllodes

Answer 7

• variant of fibroadenoma that involves epithelial and stromal proliferation
• 10% contain malignant cells

Question 8

Intraductal papilloma

Answer 8

• epithelial lining of lactiferous ducts

- most common cause of bloody nipple discharge

Question 9

mammary duct ectasia

Answer 9

• inflammation of ductal system –> dilated mammary ducts

- nipple discharge, breast pain, nipple retraction, subareolar masses

Question 10

How does tamoxifen work?

Answer 10

binds estrogen receptor and competitively inhibits estrogen binding

Question 11

Lobular carcinoma in situ is the proliferation of ______________________ cells

Answer 11

neoplastic epithelial in breast lobules

Question 12

Ductal carcinoma in situ is the proliferation of ______________________ cells

Answer 12

malignant epithelial cells in mammary ducts

Question 13

What is the most common breast malignancy?

Answer 13

invasive ductal carcinoma

Question 14

In Paget disease of the nipple, malignant cells enter the ____________, causing classic signs of _________

Answer 14

• epidermis of the nipple

- crusting, scaling, erosion, discharge

Question 15

______________ involves dermal lymphatic invasion and peau d’orange

Answer 15

inflammatory breast carcinoma

Question 16

ER+/PR+ characteristics

Answer 16

• well-differentiated
• less aggressive clinically
• lower recurrence, lower capacity to proliferate

Question 17

What is one negative possibility for women taking tamoxifen?

Answer 17

increased risk of endometrial cancer

Question 18

What is the most likely diagnosis?

edematous cutaneous thickening w/ superficial dimpling, erythematous, painful

Answer 18

inflammatory ductal carcinoma

Question 19

If an FNA is negative, what is the next step in evaluating a mass?

Answer 19

excisional bx (because FNA can give false negative)