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Year2 Repro exam I > Breast path II > Flashcards

Breast path II Flashcards

1
Q

Fat necrosis of the breast is secondary to what

A

trauma

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2
Q

describe how fat necrosis occurs

A

liquefactive necrosis of fate releases cytoplasmic fat which causes acture foreign body granulomatous response in surrounding tissues with repair fibrosis

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3
Q

what causing dimpling of the breast skin

A

coopers ligament being retracted by a mass or fibrosis etc

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4
Q

Ddx for fat necoris

A

carcinoma with desmoplasia (tumoral fibrosis)

Bx is usually required

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5
Q

where can breast implants be inserted

A

inframammary, periareolar, transaxillary

location is subglandular or submuscular

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6
Q

complications of breast implants

A

capsule of fibrous layer forms and may be painful causing contraction
capsule can rupture and foreign body inflammation from leakage
lymphoma- anaplastic large cell lymphoma– rare

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7
Q

What can hyperplastic epithelial lobular unit progress to

A

either fibrocystic changes or atypical ductal hyperplasia

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8
Q

what is DCIS

A

ductal carcinoma in situ

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9
Q

what is IBC

A

invasive breast carcinoma

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10
Q

how do fibrocystic changes of the breast present

A

mass, pain, microcalcifications

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11
Q

what differentiates fibrocystic changes from proliferative fibrocystic change w/o atypia

A

epithelial cells are now >4 cells in thickness

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12
Q

What benign condition mimics carcinoma of the breast

A

radial scar- complex sclerosing lesion

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13
Q

what benign fibrocystic change can look like a breast polyp

A

intraductal papilloma

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14
Q

if suspect radial scar what do you need to do

A

surgical excision to confirm Dx and that it is not Breast CA

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15
Q

what is atypical ducta hyperplasia

A

low grade neoplastic cells idenntified by nuclear cytology

overlap with DCIS

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16
Q

When is atypical ductal hyperplasia called DCIS

A

when duct is completely filled with neoplastic cells and entire lesion is >2mm

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17
Q

What is atypical lobular hyperplasia

A

proliferation of low grade neoplastic cells in lobule

e-cadherin negative

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18
Q

what is e-cadherin positive

A

ductal cells

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19
Q

atypical hyperplasia of the breast increases risk by how much

A

3-5X

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20
Q

what breast CA type do you need to remove with clear margins

A

ductal

21
Q

Age of presentation of DCIS and lobular CIS

A

DCIS 54-58

LCIS 44-47

22
Q

clinical signs of LCIS

A

none

23
Q

mammographic signs LCIS and DCIS

A

LCIS none

DCIS microcalcifications

24
Q

if see necrotic tissue in CA of breast what is it

A

comido carcinoma, take out right away

25
Q

what is the difference of ductal and lobular carcinoma

A

both arise from TDLU but there is different expression of gene patterns

26
Q

invasion of ductal and lobular carcinomas is Dx how

A

based on absence of myoepithelial cells

27
Q

definition low grade DCIS

A

mild nuclear atypia and micropapillary or cribiform architecture

28
Q

definition high grade DCIS

A

malignant nuclear atypia and solid archtecture

comedonecrosis and microinvasion

29
Q

what is comedonecrosis

A

central tumoral necrosis gives unique “toothpaste” finding grossly and necrotic cells prone to dystrophic calcification

30
Q

what is definition on microinvasion

A

focus of invasion <2mm in dimension

31
Q

LCIS on microscopy

A

dyshesive architecture with signet cell morphology

+ mucin

32
Q

What is Paget disease of breast

A

eczematous red change to nipple and areola from underlying DCIS and invasion
infiltration of epidermis by malignant glandular cells
mucin+ CEA and EMA +

33
Q

prognosis of paget disease of the breast

A

depends on grade and stage

34
Q

what is cribiform histology

A

sieve- like

35
Q

what is “pagetoid finding”

A

microscopic finding of upward infiltration of epidermis by glandular neoplastic cells
seen in melanoma and SCC

36
Q

what are some biomarkers for paget disease

A

cytokeratin 7

37
Q

risk factors for invasive carcinoma of the breast

A 
lifetime exposure to E
radiation exposure
breast density
proliferative fibrocystic changes
life style: alcohol, obesity, sedentary
familial and increasing age
38
Q

what increases lifetime exposure to E

A

menarche <35 years

HRT for menopause

39
Q

the luminal invasive CA of breast will be positive for what cytology and what mutations

A

E receptor positive
Her2neu negative
BRCA2 mutation, 1q gain 16ploss, PIK3CA mutations

40
Q

the Her2 enrished breast CA have what mutations

A

P53 mutations

HER2amplification

41
Q

the Basal like invasive CA of breast have what mutations and positive cytology for what

A

BRCA1 mutations with p53 mutations
ER negative
HER2 negative

42
Q

What inhibits at G1 and G2 to allow for DNA repairs

A

GADD45

43
Q

What mutation is involved in Li Fraumeni syndrome and change of developing breast CA

A

p53

85-90%

44
Q

What cancers are also assoc with Li Fraumeni syndrome

A

soft tissue sarcoma, brain tumors, osteosarcoma, adrenocortical tumores, leukemia

45
Q

when do you consider genetic testing for li fraumeni syndrome

A

multiple early onset cancers, breast CA usually <30 y.o

46
Q

Genetic counseling is indicated for BRCA when

A

known family genetic disease (ashkenazy jews, french canadians)
early onset <50y.o
high risk breast cancer
+ family history

47
Q

prevention for hereditary breast and ovarian cancer

A

prophylactic mastectomy
salpingo-oophorectomy
tamoxifen

48
Q

if risk for hereditary breast and ovarian cancer what is screening schedule

A

annual mammogram and MRI starting at age 25

49
Q

what chrom encodes for p53 mutated in Li Fraumeni syndrome

A

17p12

Year2 Repro exam I (19 decks)

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