Breast Histology/Benign Disease Flashcards
What composes the breast stroma?
Adipose tissue
Fibrous tissue
What are the 2 main components of the breast?
Epithelial (glandular) component
Stromal component
What is the lymphatic drainage of the breast?
Axillary nodes
Supraclavicular nodes
Mediastinal nodes
What is the most common lymphatic site breast cancer spreads to?
Axillary nodes
What comprises a terminal duct lobular unit?
Acini
Terminal duct
Describe the lining of the breast ductual system.
2 cell layer epithelium
Epithelial cell layer- produces milk
Myoepithelial cell layer- outer layer that expells milk
What is a breast lobule?
What is a breast lobe?
Lobule- collection of terminal duct lobular units
Lobe- collection of lobules (women have ~15-20 lobes)
How does the male breast differ from female breast?
It lacks lobules
What hormonal/physiologic changes take place in the breast tissue at the time of puberty?
Stimulation by E/P
Formation of lobules
What physiologic changes take place in the breast tissue during the menstrual cycle?
Increased size/nodularity of lobules
What physiologic changes take place in the breast tissue during pregnancy/lactation?
Epithelial vaculoization
Secretion into lumen
What pysiologic changes take place in the breast tissue during menopause?
Loss of terminal duct lobular units
Increased fatty tissue
What is the most common site of ectopic breast tissue?
Axilla
A congenital nipple retraction must be distinguished from what condition?
Advanced breast cancer
Cancer can be associated with fibrosis that pulls on the nipple/skin leading to involution
When is gynecomastia normal in men?
Newborn
Puberty
Elderly men
Why can gynecomastia occur in patients with liver disease?
Liver is site of estrogen metabolism
Liver disease leads to decreased estrogen metabolism
Acute mastitis presents similarly to what malignant condition?
Inflammatory carcinoma
How do you distinguish acute mastitis from inflammatory carcinoma?
Give antibiotics
If it does not clear with antibiotics, biopsy
What is the cellular lining of the nipple?
Stratified squamous epithelium
Recurrent subareolar abscess is commonly associated with what environmental health factor?
Smoking
Detail the changes that occur in recurrent subareolar abscess.
Squamous epithelial metaplasia
Abscess
Fistula opening at edge of areola
What patients can be effected by recurrent subareolar abscess and what is the treatment?
Men/women
Surgery
What is the most common cause of nipple discharge?
Intraductual papilloma
What 3 benign lesions have malignant potential?
Intraductual papilloma
Phyllodes tumor
Sclerosing adenosis
Contrast nonproliferative fibrocystic change with proliferative fibrocystic change.
Nonproliferative FCC: epithelial hyperplasia absent
Proliferative FCC: epithelial hyperplasia present
How can sclerosing adenosis be differentiated from carcinoma?
Stain for myoepithelial cells
A pathology report for a patient states that she has lobular carcinoma in situ. What side of the breast is at risk for malignancy?
Both
FCC can be proliferative or nonproliferative. If it is proliferative, epithelial cell hyperplasia is present. How can epithelial cell hyperplasia progress to cancer?
Hyperplasia (ductal or lobular)
Atypical hyperplasia
D/L-CIS
Invasive carcinoma
What distinguishes lobular atypical hyperplasia from lobular CIS?
Less than 50% duct involvement is atypical hyperplasia
More than 50% duct involvement is LCIS
Is lobular carcinoma in situ associated with increased risk for invasive lobular or ductal carcinoma?
Both (IDC is actually more common, does not have to originate from the site of CIS)
