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Patho > Breast Pathologies > Flashcards

Breast Pathologies Flashcards

1
Q

T/F Interlobular stroma is connective tissue occurring between breast lobules, while intralobular stroma is connective tissue occurring within a breast lobule.

A

True

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2
Q

T/F Interlobular stroma is estrogen sensitive, while intralobular stroma is usually not.

A

False, this is reversed. Intra-lobular stroma is estrogen sensitive.

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3
Q

_____ refers to elevated levels of estrogen in the blood.

A

Hyperestrinism

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4
Q

T/F All fibrocystic masses of the breast should be resected as soon as possible to prevent progression of cancer.

A

False; nonproliferation fibrocystic changes are not precancerous and can usually be left alone unless they are causing other problems (such as pain due to compression). Proliferative changes, on the other hand, and especially if they involve nuclear atypic, are precancerous and should be removed.

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5
Q

T/F All fibrocystic changes in the breast are precancerous, and increase the risk of cancer 5- or 6- fold.

A

False. Non-proliferative changes do not increase cancer risk, while proliferative fibrocystic changes without atypic carry only a 1-2 fold increase.

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6
Q

This pre-cancerous condition is often treated with surgical resection of the affected tissue.

A

C: Proliferative fibrocystic change

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7
Q

This disorder is marked by cystic dilations of terminal ducts and relative increase in stroma, with or without proliferation of ductal epithelium.

A

A: Fibrocystic changes (general)

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8
Q

This specific disorder involves hyperplasia of the ductal epithelium in a context of cystic dilation of the terminal ducts and stromal expansion; this condition is pre-cancerous.

A

C: Proliferative fibrocystic change

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9
Q

This specific disorder involves cystic dilation of the terminal ducts and stromal expansion but without proliferation of the ductal epithelium or atypic; this condition is not pre-cancerous

A

B: Non-proliferative fibrocystic change

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10
Q

The development of tubal papillomas in this disorder is considered pre-cancerous and thus unfavorable

A

C: Proliferative fibrocystic change

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11
Q

This condition may show epithelial hyperplasia with atypic, a definite pre-cancerous development

A

C: Proliferative fibrocystic change

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12
Q

T/F Fibroadenomas most affect elderly women in their 60s and 70s.

A

False: fibroadenoma mostly affects prepubertal and recently post pubertal women in their teens, 20s and 30s.

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13
Q

T/F Fibroadenomas are malignant tumors.

A

False

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14
Q

Fibroadenomas are composed of two components: fibrous stroma and glandular epithelium.

A

True: the name tells you this: “fibro-“ means fibrous and “adeno” means gland.

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15
Q

Most fibroadenomas probably represent an abnormal response of breast tissue to sex hormones.

A

True

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16
Q

Fibroadenomas frequently transform into malignant tumors, and thus should be resected immediately when found.

A

False – fibroadenomas only rarely transform to malignancy.

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17
Q

_____ is the most important and the most common of the benign tumors of the breast.

A

Fibroadenoma

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18
Q

T/F Invasive breast cancer is thought to be preceded by a non-invasive stage known as carcinoma in situ (CIS).

A

True – see quiz handout for further explanation

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19
Q

Estimates are that 1 in ____ women will develop breast cancer at some point in their lives.

A

9

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20
Q

T/F Ductal carcinoma in situ (DCIS) is a pre-cancerous or benign condition that often develops into cancer.

A

False: CIS (whether ductal or not) IS cancer it is early epithelial cancer that has not yet learned to cross the basement membrane

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21
Q

T/F Most breast cancers derive from interlobular connective tissue and hence ar sarcomas.

A

False; most breast cancers are derived from epithelial tissue and hence are carcinomas

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22
Q

T/F Most breast carcinomas occur on the side of the breast medial to the areola.

A

False: the most common position (45%) is the upper outer quadrant

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23
Q

T/F The most common type of breast carcinoma is lobular carcinoma, followed closely by tubular carcinoma.

A

False – ductal carcinoma is by far the most common cancer of the breast (80%)

24
Q

T/F With aggressive treatment, breast cancer patients have 5-year survival rates in excess of 60% regardless of the stage of the cancer.

A

False: white some of the five year survival rates are in excess of 60%, unfortunately Stage III and IV are not

25
Q

______ involves en block removal of a breast, all associated axillary lymph nodes, and underlying chest wall muscles.

A

Radical mastectomy

26
Q

A(n) _____ involves removal of just the tumorous or swollen tissue of a breast.

A

lumpectomy

27
Q

A(n) ______ tumor refers to a hard, often gritty tumor; such tumors often occur in the breast.

A

scirrhous

28
Q

Which ONE of the following is NOT considered a POSITIVE risk factor for breast cancer (meaning it makes a person more likely to develop breast cancer)?
A. Living in Asia
B. Having ovarian or endometrial cancer
C. Having proliferative fibrocystic changes
D. Having a mother or sibling with breast cancer
E. Long-term exposure to estrogen
F. (None. All of the above are positive risk factors for breast cancer.)

A

A. Living in Asia - not necessarily being of Asian descent – is a NEGATIVE risk factor for breast cancer

29
Q

Which ONE of the following is NOT a typical sign of breast cancer?
A. Tumors lacking sharp margins, because they lack a defined capsule and just infiltrate into the surrounding tissue.
B. Puckering of the skin and retraction of the nipple, due to the dense connective tissue pulling on adjacent tissue
C. Tumors which feel firm on palpation
D. Tumors located either in the upper lateral quadrant or centrally, under the areola
E. Tumors (“lumps”) which deflate when pierced and drained with a fine hypodermic needle
F. (None. All of the above are typical signs of breast cancer.)

A

E. Breast lumps that deflate when pierced are a good sign – it means the lump is probably a benign cyst and not cancerous

30
Q

T/F Gynecomastia often develops as a result of an imbalance between estrogens, which stimulate breast tissue, and androgens, which counteract these effects.

A

True: this means that conditions factoring hyperestrinism in a male also favor gynecomastia

31
Q

T/F Testicular cancer may cause gynecomastia.

A

True: the tumor (such as a Leydig cell tumor) may hyper secrete estrogen

32
Q

T/F The most common cause of gynecomastia is Klinefelter syndrome.

A

False: while Klinefelter syndrome may raise estrogen levels and thus lead to gynecomastia, the most common cause is cirrhosis of the liver. Recall that the liver is the main metabolic organ of the body. One of the tests it is charged with is to metabolize (i.e. degrade) hormones like estrogen. If the liver is sick, it cannot degrade estrogens and thus hyperestrinism may result, leading to gynecomastia. this can clearly be seen on advanced alcoholics – most of them have boob development.

33
Q

T/F Histologically, gynecomastia results in the development of numerous mature lobules in the male breast.

A

False. See handout for further explanation.

34
Q

T/F Gynecomastia is a major risk factor in the development of breast cancer in males.

A

False

35
Q

T/F Breast cancer in men occurs about 1/100 as often as in women.

A

True

36
Q

T/F Although breast cancer occurs in both men and women, the causes for breast cancer in men are substantially different from the causes in women.

A

False - similar causes and similar treatments

37
Q

T/F Papillary (ductal) carcinomas are more common in men (than women) and lobular carcinomas less common.

A

True – men do not have the lobular development the that a woman has, so that breast cancer in men is skew toward toward ductal carcinomas, esp of the papillary type

38
Q

T/F Breast cancers in men tend to disseminate to the medial (mediastinal) lymph nodes (in contrast to the upper lateral quadrant in women).

A

False – dissemination patterns are the same in men and women, with almost half the tumors spreading to the lymph nodes in the upper lateral quadrant

39
Q

T/F Because of the relatively sparse amount of breast tissue present, breast cancers in men tend to spread rather easily to teh underlying thoracic wall (e.g. pectorals major m.) and overlying skin.

A

True

40
Q

T/F Men with breast cancer tend to present at a more advanced stage than women.

A

True

41
Q

T/F When matched for stage, men with breast cancer have a much better prognosis than women.

A

False – when matched for stage, the prognoses are the same for men and women

42
Q

_____ refers to enlargement of, or development of tubules in, the male breast.

A

Gynecomastia

43
Q

See Question 38 for case study review and relevant questions.

A

See Question 38 for case study review and relevant questions.

44
Q

adenosis

A

increase in the number of acini per lobule; normal in pregnant women but not otherwise

45
Q

antagonist

A

drug which mimics a natural ligand (hormone etc) by binding to a receptor but not eliciting any activity, essentially occupying the receptor so that the hormone cannot bind thus blocking normal cellular responses

46
Q

en bloc

A

latin for in block. procedure where multiple parts are performed at once or as a unit. eg radical mastectomy where breast and connective tissue, skeletal muscle and ipsilateral axillary lymph nodes are removed all at once

47
Q

gynecomastia

A

enlargement or development of male breast; development of duct tissue in male breast

48
Q

interlobular

A

between lobules e.g. in breasts. Interlobular stroma is hormonally insensitive connective tissue found surrounding and between lobules

49
Q

Intralobular

A

within a lobule e.g., in breasts, intralobular stroma is hormonally sensitive connective tissue found within each lobule

50
Q

metaplasia

A

transformation of one mature tissue type into another

51
Q

multiparous

A

pertaining to a woman who has borne more than one offspring

52
Q

nulliparous

A

pertaining to a woman who has borne no offspring

53
Q

oophorectomy

A

surgical removal of the ovaries

54
Q

papilloma

A

a benign, finger or nipple shaped tumor; in the breasts, papillomas protrude into the ductal lumen

55
Q

papillomatosis

A

the condition of having papillomas

56
Q

scirrhous tumor

A

a tumor which presents as a hard sometimes gritty mass often found in the breast or liver cancer

Patho (6 decks)

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