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Systemic Pathology Test 2 > Breast Diseases > Flashcards

Breast Diseases Flashcards

1
Q

Most breast lumps are?

A

Fibrocystic changes

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2
Q

Fibrocystic changes are mostly?

A

Cysts and fibrosis

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3
Q

What is the most common breast abnormality in premenopausal women?

A

Fibrocystic changes

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4
Q

What causes fibrocystic changes

A

Cyclic breast changes that occur normally in the menstrual cycle

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5
Q

Fibrosis is caused by? Cysts form by? What lines cysts?

A

Fibrosis is caused by the rupture of cysts

Cysts formed by the folding and unfolding of lobules

The lining is apocrine metaplasia

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6
Q

What is epithelial hyperplasia and what cells are involved?

A

Increase in the number of layers of duct epithelium to more than 2. There are ductal and myoepithelial cells

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7
Q

Sclerosing adenosis presents as? What cells are preserved?

A

Presents as mammography calcifications and myoepthileal cells are preserved and increase

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8
Q

Acute mastitis is related to? What organism causes it?

A

Related to the first month of breast feeding and S. aureus causes it by entering the ducts

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9
Q

What is seen histologically in acute mastitis?

A

The breast tissue is infiltrated by neutrophils

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10
Q

Duct ectasia is AKA?

A

Plasma cell mastitis

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11
Q

Patients with duct ectasia present with?

A

Periareolar mass that is associated with thick white nipple discharge and skin retraction

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12
Q

What cells are seen surrounding the ducts? Inside?

A

Plasma cells and lymphocytes. Inside see macrophages

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13
Q

What is the most common benign breast tumor and when does it occur?

A

Fibroadenoma, occurs in the 3rd decade

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14
Q

Is the fibroadenoma mobile? What is the consistency? What is the most common site for one?

A

Mobile and rubbery. The most common site is the upper outer quadrant

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15
Q

In fibroadenoma the stroma resembles? The glandular spaces are lined by what kind of cells?

A

Stroma resembles normal stroma. Spaces lined by ductal and myoepithelial cells.

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16
Q

What happens to the stroma in older women?

A

Becomes hyalinzed and the epithelium is atrophic

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17
Q

Phyllodes tumor arises from?

A

Intralobular stroma

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18
Q

Phyllodes tumor presents in?

A

The 6th decade, older women

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19
Q

What percentage of phyllodes tumors are malignant?

A

15%

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20
Q

What are the 3 types of phyllodes tumors?

A

Benign, low grade malignant, and high grade malignant

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21
Q

Higher grade phyllodes tumors are? How do they grow?

A

Hemmorhagic, grow in a bulbous fashion

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22
Q

What distinguishes phyllodes tumors from fibroadenoma?

A
  1. Stromal cellularity and mitoses
  2. Nuclear pleomorphism
  3. infiltrative borders
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23
Q

An intraductal papilloma grows within?

A

A dilated duct

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24
Q

When does the risk for breast cancer begin to increase?

A

After age 30 and especially after menopause

25
Q

75% of women with breast cancer are older than?

A

50

26
Q

Where is risk for breast cancer highest? What factors are involved?

A

North America and Northern Europe.

Diet, reproductive patterns, nursing habits

27
Q

Ductal carcinoma in situ is associated with? What cells are present but in diminished numbers?

A

Calcifications

Myoepithelial cells present

28
Q

Ductal carcinoma in situ can involve?

A

TDLU and larger ducts

29
Q

How is ductal carcinoma in situ graded?

A

By the degree of nuclear pleomorphism

30
Q

What is comedo DCIS or comedocarcinoma?

A

Sheets of cells with high nuclear grade and central necrosis

Microinvasions may be present

31
Q

Tumor cells invading less than _ mm into stroma is seen in ___ grade DCIS?

A

1 mm, high grade

32
Q

What is Paget disease?

A

Poorly differentiated DCIS that extends from the lactiferous ducts into skin of nipple. Resulting in unilateral inverted nipple

33
Q

In lobular carcinoma in situ the population of cells is?

A

Monomorphic

34
Q

How is lobular carcinoma in situ detected?

A

Incidental finding, not mammographically detected

35
Q

How the cells appear in lobular carcinoma in situ?

A

Dyscohesive cells with oval or round small nuclei

36
Q

What causes the discohesion in lobular carcinoma in situ?

A

Cell adhesion Protein E cadherin is lost

37
Q

Receptors for what hormones are often expressed in lobular carcinoma in situ?

A

Estrogen and progesterone

38
Q

Invasive lobular carcinomas tend to be lateral or bilateral?

A

Bilateral and multicentric

39
Q

Where does invasive lobular carcinoma metastasize to?

A

CSF, serosa, basement membrane and solid organs

40
Q

When breast cancers spread into the skin they cause?

A

Peau d’orange

41
Q

Breast cancer often spreads to what lymph nodes?

A

Axillary and internal mammary nodes

42
Q

When breast cancer involves dermal lymphatics it causes?

A

Inflammatory carcinoma

43
Q

BRCA 1 is located on what chromosome?

A

17q21

44
Q

BRCA puts people at risk of what other cancers?

A

Ovarian and prostate

45
Q

BRCA genes code for?

A

Tumor suppressor proteins

46
Q

BRCA 2 is located on what chromosome?

A

13q12.3

47
Q

What cancers are associated with BRCA2?

A

Higher chance for breast cancer in men, slightly lower risk of ovarian cancer, stomach and melanoma, prostate, pancreas

48
Q

What other genes have been associated with breast cancer?

A

RAS, MYC, p53, PTEN

49
Q

How are estrogen and progesterone receptors detected?

A

Immunohistochemistry

50
Q

What do these receptors mean for treatment?

A

Those with both receptors respond to hormone therapy 80% of the time, single respond 40%

Double negative respond to chemo, ER positive less likely to respond to chemo

51
Q

What gene is sometimes over expressed in breast cancers?

A

HER2

52
Q

HER2 over expression means?

A

More aggressive and less responsive to hormone therapy

53
Q

HER2 tumors respond to what drug

A

Herceptin

54
Q

What are the two types of surgical resection?

A

Lumpectomy for small tumors and mastectomy for lager ones

55
Q

Men can only get what type of breast cancer?

A

Ductal carcinoma

56
Q

What is a good marker for myoepithelial cells?

A

P63

57
Q

What is the term for multiple papillomas? What does this cause?

A

Papillomatosis, increases the risk of breast cancer

58
Q

Non-comedo ductal carcinoma in situ shows?

A

Low to moderate grade, no necrosis

59
Q

What is the differential diagnosis for Paget Disease?

A

Melanoma

Systemic Pathology Test 2 (10 decks)

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