Breast Disorders, Breast Pathology

Question 1

common causes of glactorrhea

Answer 1

• xs stim
• prolactinoma
• hypOthyroid
• DA antagonists

Question 2

bloody nipple discharge causes

Answer 2

intaductal papilloma

breast cancer

Question 3

intraductal papilloma

Answer 3

• lactiferous duct, usu 2-4mm, solitary
• bloody/serous discharge (arise in lactiferous duct
• women 30-50 y/o
• multiple + atypia –> underlying cancer

Question 4

Paget’s

Answer 4

skin involvement with underlying breast cancer

Question 5

clinical breast exam recommendation

Answer 5

25-39: every 1-3 years

greater than 40: every year

Question 6

screening mammography guidelines

Answer 6

~1-2 years starting at 40-50

annual >50

Question 7

fibrocystic breast disease tx

Answer 7

NSAIDs
supportive bras
pill/patch/ring

Question 8

fibroadenomas

Answer 8

• most comm breast mass in younger women
• firm, well-circumscribed, mobile, non-tender
• may fluctuate slowly

shrink: menopause
grow: preg (via inc estrogen)

Question 9

firm, fixed, feels stuck to chest wall

Answer 9

breast cancer

Question 10

Phyllodes tumor

Answer 10

rare
younger women
single breast, lg, germ

RAPIDLY grown but rarely mets

Question 11

mastitis tx

Answer 11

dicloxacillin QID

CONTINUE BREASTFEEDING/PUMPING

Question 12

benign breast diseases

Answer 12

fibrocystic change
fibroadenoma
fat necrosis (traumatic)
acute mastitis
intraductal papilloma*
phyllodes*

Question 13

malignant phyllodes is a

Answer 13

sarcoma

Question 14

benign, non-proliferative disease

Answer 14

adenosis
apocrine metaplasia
duct ectasia
ductal hypERplasia of usual type

Question 15

slightly inc risk of breast CA

Answer 15

(WITHOUT ATYPIA)

• ductal hyperplasia of usual type, moderate or florid
• intraductal papilloma
• sclerosis adenosis

Question 16

fibrocystic change

Answer 16

25-45 y/o

-cysts, apocrine metaplasia, fibrosis, calcification, chronic inflammation, ductal hyperplasia

Question 17

High risk of invasive breast CA

Answer 17

carcinoma in situ (non-invasive malignancy)

Question 18

Ductal carcinoma in situ

Answer 18

DCIS

• intact BM
• microcalcifications
• often multicentric, may be extensive

Question 19

DCIS tx

Answer 19

surgery and hormonal

Question 20

estrogen and progesterone receptor expression predicts response to

Answer 20

hormonal therapies…

tamoxifen
aromatase inhibitors
fulvestrant

Question 21

HER2 oncoprotein/oncogene status predicts response to

Answer 21

trastuzumab

Question 22

HER2+ tumors have a _____ prognosis

Answer 22

HER2+ tumors have a WORSE prognosis

Question 23

Inflammatory breast carcinoma

Answer 23

• erythematous, swollen breast
• peau d’orange
• tumor present in dermal lymphatics
• POOR PROGNOSIS (stage T4d)

Question 24

most common type of invasive breast CA

Answer 24

invasive ductal CA

Question 25

most common benign tumor of the breast

Answer 25

fibroadenoma

Question 26

fibroadenoma

Answer 26

• biphasic, stromal epithelial
• most common benign tumor of breast
• young women <30
• well-circumscribed, movable mass
• UOQ

Question 27

Is malignant phyllodes common?

Answer 27

No, rare

Question 28

most common cause of bloody/serous discharge

Answer 28

intraductal papilloma