BREAST- INTRODUCTION, NORMAL ANA and PHYSIO

Question 1

What are the lesions found in terminal duct lobar unit?

Answer 1

1. cyst
2. adenosis
3. small duct papilloma
4. hyprplasia
5. atypical hyperplasia
6. carcioma

Question 2

What are the lesions found in lobular stroma?

Answer 2

Fibroademona

phylloides tumor

Question 3

What are the lesions in large duct and lactiferous sinuses?

Answer 3

1. Duct ectasia
2. Recurrent subareolar abscess
3. Solitary ductal papilloma
4. paget disease

Question 4

What are the lesions on Interlobular stroma ?

Answer 4

1. Fat necrosis
2. Lipoma
3. Fibrous tumor
4. Fibromatosis
5. Sarcoma

Question 5

The human
breast contains_________ major ductal systems

Answer 5

six to ten

Question 6

Normal Breast Anatomy

The keratinizing squamous epithelium of the
overlying skin dips into the orifices at the nipple and then abruptly changes to a

►

double-layered
cuboidal epithelium lining the ducts.

►

Successive branching of the large ducts eventually leads to

►
the terminal duct lobular unit.

NOTE : In adult women the terminal duct branches into a grapelike cluster
of small acini to form a lobule ( Figs. 23-1 and 23-2B ).

• *Each ductal system** typically occupies
• *more than one quadrant of the breast**, and the systems extensively overlap one another. In

Question 7

• *Mammograms in young women** are typically** _____________**, making mass-forming lesions or calcifications (which are also
  radiodense) difficult to detect. B

Answer 7

radiodense
or white in appearance

Question 8

The density of a young woman’s breast stems from the
_____________________

Answer 8

predominance of fibrous interlobular stroma and the paucity of adipose tissue.

Question 9

Before
pregnancythelobules are smalland areinvested by loose cellular intralobular stroma.
Larger ducts connect lobules

Question 10

What is the appearance of the breast during pregnancy?

Answer 10

• branching of terminal ducts produces
• more numerous, larger lobules.
• Luminal cells within lobules undergo lactational change, precursor to milk formation.

Question 11

With increasing age what happens to the lobules

Answer 11

** decrease in size and number,**
and the interlobular stroma is replaced by adipose tissue.

Question 12

What is the appearance now of Mammograms in older women?

Answer 12

become more
radiolucent with age as a result of the increase in adipose tissue, which facilitates the
detection of radiodense mass-forming lesions and calcifications.

Question 13

Two cell types line the ducts and lobules.

1. Contractile myoepithelial cells
2. . Luminal epithelial cells

Answer 13

1. Contractile myoepithelial cells
2. . Luminal epithelial cells

Question 14

_______________containing myofilaments
lie in a meshlike pattern on the basement membrane.

These cells assist in milk ejection during
lactation and provide structural support to the lobules.

Answer 14

Contractile myoepithelial cells

Question 15

_____________overlay the
myoepithelial cells.

Answer 15

**Luminal epithelial cells **

Question 16

Only the _____________ are capable of producing milk.

Answer 16

lobular luminal cells

Question 17

A committed
stem cell is located in the _________ that is postulated to give rise to both luminal and myoepithelial cells

Answer 17

terminal duct

Question 18

There are also two types of breast stroma.

1. interlobular stroma ( Latin. IN BETWEEN)
2. intralobular stroma

Answer 18

1. interlobular stroma
2. intralobular stroma

Question 19

The interlobular stroma consists of_______________

Answer 19

** dense fibrous **connective tissue

admixed with adipose tissue.

Question 20

The intralobular stroma envelopes the acini of
the lobules and consists of breast-specific hormonally responsive fibroblast-like cells admixed
with _____________.

NOTE : There is important cross-talk between breast epithelium and stroma
that promotes the normal structure and function of the breast

Answer 20

scattered lymphocytes

Question 21

In the prepubertal breast in males and females, the large duct system ends in terminal ducts with minimal lobule formation.

Question 22

Changes in the breast are most dynamic and profound during the reproductive years ( Fig. 23-2 ).

Just as the endometrium grows and ebbs with each menstrual cycle, so does the breast. [3]

Question 23

What are the changes of the breast during menstrual cycle?

Answer 23

• In the first half of the menstrual cycle the lobules are relatively quiescent.
• After ovulation, under the influence of estrogen and rising progesterone levels, cell proliferation increases, as does the number of acini per lobule.
• The intralobular stroma also becomes markedly edematous.
• Upon menstruation, the fall in estrogen and progesterone levels induces the regression of the lobules and the disappearance of the stromal edema.

Question 24

Only with the onset of__________ does the breast become completely mature and functional.

Lobules increase progressively in number and size. As a consequence.

Answer 24

pregnancy

Question 25

by the end of the
pregnancy the breast is _______________

Answer 25

composed almost entirely of lobules separated by relatively scant
stroma

Question 26

Immediately after delivery of the baby the luminal cells of the lobules produce_________________ over the next 10 days as
progesterone levels drop.

Not surprisingly, given these profound morphologic changes, the
terminally differentiated breast has a specific pattern of gene expression.

Answer 26

• • colostrum (high in
    protein) **,

which changes to milk (higher in fat and calories)

Question 27

When does colostrum changes into milk?

Answer 27

10 days

Question 28

What is the content of colostrum?

Answer 28

HIGH IN PROTEIN

Question 29

While milk content is?

Answer 29

FAt and calories

Question 30

What is the function of the breast milk

Answer 30

1. provides complete nourishment from birth until several years of age
2. also provides protection against infection, allergies, and some autoimmune diseases. Maternal antibodies (chiefly secretory IgA), vitamins, enzymes, and numerous other mediators (e.g., cytokines, antioxidants, fibronectin, and lysozyme) augment the infant’s own developing immune defenses.

Note : However, certain drugs, radioactive compounds given during diagnostic procedures, and viruses can also be passed to the infant through breast milk.

Question 31

Upon the cessation of lactation, the breast epithelium and stroma undergo extensive
remodeling. What happens?

Answer 31

• Epithelial cells undergo apoptosis,
• lobules regress and atrophy, and the
• totalbreast size is diminished

NOTE ***. However, full regression does not occur, and as a result pregnancy

causes a permanent increase in the size and number of lobules.

Question 32

After the third decade, long before menopause what happens to the breast?

Answer 32

lobules and their specialized stroma start to involute.

Lobular atrophy may be almost complete in elderly females ( Fig. 23-2D ).

The interlobular stroma also changes, since the radiodense fibrous stroma of the young female (see Fig. 23-2A ) is progressively replaced by radiolucent adipose tissue