Breast – Normal Histology and Benign Disease Flashcards
The ducts are largest near the ____________.
areolae
Where do the lymph nodes of the breasts drain?
Most (45%) drain to the axillary lymph nodes. Second-most drain to the supraclavicular lymph nodes. Some can drain to the mediastinum or below the diaphragm.
The entire ductal system is lined by _______________.
a two-cell layer (any more is abnormal): inner is glandular, outer is myoepithelial
Between the lobules is ______________.
intralobular stroma, which is hormone-responsive Note: there is also interlobular stroma between different lobular units, which is fibrous.
What is the main difference in male breasts?
There are ducts in males breasts, but there are no lobules.
In a malignancy, the ___________ layer is lost.
myoepithelial
Puberty prompts the formation of _____________.
acini
During pregnancy, _____________ increase in number.
acini
After menopause, there is ______________.
more stroma and fat; less glandular tissue
In addition to increased lobules, there is _____________ during pregnancy as well.
epithelial vacuolization
During pregnancy or even menstruation, breast tissue can appear in the ___________.
axilla
Nipple retraction (having an innie nipple) can occur due to ______________.
congenital abnormality or cancer
In gynecomastia, _____________ accounts for most of the extra mass.
stromal proliferation
What causes acute mastitis?
Usually occurring in lactating women, acute mastitis results from cracks in the nipple that allow Staphylococci into the ducts (where they survive on milk). This presents with redness and tenderness of the breast.
What causes chronic mastitis?
Generally non-infectious causes like milk obstructions. Most often presents in perimenopausal women. Can mimic carcinoma because irregular fibrosis often results from healing.
What causes recurrent subareolar mastitis?
Squamous metaplasia around the main nipple duct leads to recurrent inflammation due to the accumulation of keratin where it should not be.
Recurrent subareolar mastitis most often occurs in ____________.
smokers
_____________ can cause fat necoris of the breast.
Trauma and ischemia
Describe how a fibroadenoma presents.
Firm but regular; well-encapsulated; mobile
How do fibroadenomas appear on histologic exam?
There is proliferation of glands and fibrous stroma, but in general the fibrous stroma takes over and occludes the lobules.
______________ presents as primarily a proliferation of glandular tissue.
Lactating adenoma
Which masses can be benign or malignant?
Phyllodes tumors and papillomas
____________ are often described as large fleshy tumors.
Phyllodes tumors
Papillomas tend to occur near the ____________.
sub-areolar region
Papillomas arise from ____________ and invade the ducts.
epithelium
About 50% of women present with _____________ at autopsy.
fibrocystic change (most often asymptomatic)
_______________ is like fibrocystic change without cysts.
Sclerosing adenosis
Fibrocystic change can present as ______________ or ________________.
proliferative (with epithelial hyperplasia); nonproliferative (no hyperplasia)
_______________ often leads to fibrous obliteration of the terminal lobules.
Sclerosing adenosis
Apocrine metaplasia is associated with ________________.
fibrocystic change
Lobular carcinoma in situ is distinct from atypical lobular hyperplasia in that ______________.
LCIS involves more than 50% of the lobules, while ALH involves less than
LCIS raises risk of ____________.
carcinoma bilaterally
_______________ presents with hyperplasia and discrete punched-out lesions.
Atypical ductal hyperplasia
Bloody nipple discharge is associated with _____________.
papillomas and carcinomas
True or false: LCIS raises risk of only lobular carcinoma.
False. It raises the risk of both.
On fine-needle aspiration, malignant cells will appear as _____________, while benign cells will appear as _________________.
frangible cells; cohesive masses
Describe the changes in skin types that occur from the outside of the nipple to the duct.
Outside: keratinizing, stratified squamous epithelium Inside: double-layer cuboidal epithelium (myoepithelium and luminal epithelium)
Prior to puberty, the breasts are _______________.
branching ducts without the terminal lobules
At the end of pregnancy, the breast is composed almost entirely of _____________.
lobules
By what cellular processes does the breast shrink after cessation of lactation?
Atrophy of stroma and apoptosis of epithelial cells
Describe juvenile hypertrophy of the breasts.
Some girls get extensive development of the breast in the absence of hormone imbalances.
Ductal papillomas typically present in _____________.
large ducts as papillary protrusions
Both types of ______________ raise risk of carcinoma.
atypical hyperplasia
Blue-domed cysts are characteristic of ______________.
non-proliferative FCC
what is this image showing?
male breast tissue
what is this imaige?
terminal duct lobular unit
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resting adult female breast tissue
what is this imaige?
breast tissue during pregnancy and lactation
what is this imaige?
postmenopausal breast tissue
what is this imaige?
gynocomastia
what is this imaige?
fat necrosis (early phase)
late phase in answer
whats this?
fibroademoma (benign)
what is this imaige?
fibroadenoma
what is the origin of a fibroadenoma?
the TDLUs
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lactating adenoma
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phyllodes tumor
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papilloma
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papilloma
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fibrocystic change
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sclerosing aenosis
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non proliferative fibrocystic change
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microcalcifications
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apocrine metaplasia
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atypical lobular hyperplasia
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LCIS
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proliferative fobrocystic change
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proliferative fibrocystic change (florid hyperplasia)
what is this image?
atypical ductal hyperplasia
what is this image?
ductal carcinoma in situ
