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Cell Pathology II > Breast Pathology > Flashcards

Breast Pathology Flashcards

1
Q

What is function of the breast?

A

The production and expression of milk

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2
Q

What are the two main structures of the breast?

A
  • lobules
  • ducts
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3
Q

What collagenous structure is visible between breast structures?

A

Collagenous stroma

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4
Q

When is the preferred time to examine breasts?

A

In the pre-menopausal first half of the cycle

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5
Q

Are mammograms more beneficial to younger or older females?

A

Older as the density of the breast is less fibrous and there is more adipose tissue. The lobules decrease in size leading to more radiolucent tissue.

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6
Q

How small must a mass be to make it palpable?

A

> 2cm in size

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7
Q

What type of physical structures are visible on a mammogram?

A
  • densities
  • calcification
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8
Q

What type of mass is visible from ultrasonography?

A

A solid cystic lesion

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9
Q

What type of techniques are used to harvest a biopsy from a question malignancy?

A

FNAB
Core Biopsy

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10
Q

Developmental abnormalities can be at play resulting in which types of problems?

A
  • development failure
  • juvenile hypertrophy
  • milk line remnants
  • nipple inversion
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11
Q

If a milk line remains what is it subject to?

A
  • hormonal response
    Ex: supernumerary nipples
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12
Q

What are the three main types of inflammation seen with the breast?

A
  • infection
  • mammary duct ectasia
  • fat necrosis
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13
Q

What is mastitis?

A

Inflammation of the breast

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14
Q

What is SMoLD?

A

Both women and men affected
Smokers (90%)
keratin plugs, block ducts leading to dilation and rupture.
Drainage, re-occurrence, surgical duct removal.

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15
Q

In what population is duct ectasia seen the most?

A
  • post-menopausal, parous women. Periareolar palpable mass.
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16
Q

What are some symptoms of duct ectasia?

A
  • duct dilation
  • rupture
  • thick nipple discharge
  • fibrosis leads to nipple retraction
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17
Q

Fat necrosis is an inflammatory condition which occurs in the breast as a result of ?

A

Damaged adipose tissue

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18
Q

What are the three types of benign epithelial lesions of the breast?

A
  1. non-proliferating breast changes
  2. proliferative breast disease without atypia
  3. proliferative breast disease with atypia
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19
Q

What is another way of saying non-proliferating breast changes?

A

Fibrocystic changes

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20
Q

What are the 3 types of changes seen with fibrocystic changes?

A
  • cystic changes
  • fibrosis
  • adenosis
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21
Q

What is adenosis?

A

The increase in number of acini per lobule (normal in preg)

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22
Q

What type of cells line acini?

A

Columnar cells

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23
Q

How do cysts change?

A

They form by dilation and unfolding of lobules.

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24
Q

What is atypia?

A

The departure from typical normal appearance to usually histological, either reactive or sometimes denoting pre-neoplastic changes such as dysplasia.

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25
What type of abnormalities are seen in proliferative breast disease without atypia?
- epithelial hyperplasia - sclerosing adenosis - complex sclerosing lesion - papilloma
26
What is seen structurally with epithelial hyperplasia?
Lumen filled with a mix of luminal and myoepithelial cells. No atypia.
27
What is seen structurally with sclerosing adenosis?
A doubling in the number of acini in terminal ducts. They may appear compressed and distorted by dense stroma. Normal lobular arrangement Palpable mass
28
What are papillomas?
These are multiple branching fibrovascular cores with connective tissue axis lined with luminal and myoepithelial cells.
29
If a papilloma grows within a dilated duct what is often seen?
Nipple discharge, can be bloody.
30
What are the three components of a complex sclerosing lesion?
- epithelial hyperplasia - sclerosing adenosis - papilloma
31
What type of scar is a complex sclerosing lesion called?
Radial sclerosing lesion
32
What are the two main types of proliferative breast disease with atypia?
- atypical ductal hyperplasia - atypical lobular hyperplasia
33
What is seen in ADH?
Duct filled with cells
34
What is seen in ALH?
Population of cells partially fill lobule, some intracellular lumens
35
Carcinoma of the breast is a heterogenous disease and is clustered into 3 main groups, what are these groups based on?
Oestrogen receptor HER2 expression
36
What is the most common disease factors in carcinoma of the breast, luminal?
ER pos HER2 neg
37
What components are present in HER2 carcinoma of the breast?
HER2 pos, ER pos or neg
38
What components are present in the basal/triple negative carcinoma of the breast?
ER neg HER2 neg PR neg
39
HER2 is a protein in which its overexpression results from the amplification of the chromosome 17Q region, is it an oncogene or a proto-oncogene?
It is a proto-oncogene
40
How can HER2 protein be quantified?
- FISH - HER2 probe and chromosome 17 centromeric probe - its overexpression is detected by immuno staining HER2 antibodies.
41
Hereditary breast cancer is associated with which two genes?
- BRCA1 gene (50% of cases) - BRCA2 gene (35% of cases, male breast also)
42
Sporadic breast cancer is mainly due to?
Hormone exposure
43
Is the basement membrane intact with carcinoma in situ?
Yes DCIS LCIS
44
What are the two types of invasive carcinoma?
- invasive carcinoma - no special type
45
Treatment with DCIS includes?
- irradiation, surgery and tamoxifen if ER+
46
Paget disease of the nipple involves what physical manifestation?
Unilateral erythematous eruption with scale crust
47
Is paget disease of the nipple rare?
Yes, 1-4% of cases
48
What type of cells are involved in paget disease of the nipple?
Malignant cells extend from DCIS via lactiferous sinuses into nipple skin, without breaching the basement membrane
49
DCIS is the malignant clonal proliferation of ?
The epithelial cells and is limited to the ducts and lobules by the basement membrane
50
LCIS is the clonal proliferation of cells within what?
Ducts and lobules that grow in a discohesive fashion, usually due to acquired loss of e-cadherin.
51
Which is detectable with mammography LCIS or DCIS?
DCIS
52
What is seen histologically with LCIS?
- loose clusters within lobules - mucin-positive signet ring cells common - ER+ - HER2 - - E cadherin loss
53
Invasive carcinoma often presents as a palpable mass and is not detected by mammographic, where does this metastases occur in 50% of cases?
Axillary lymph node metastases - nipple retraction - blocked lymphatics - radio dense mass (mammography not effective)
54
Invasive carcinoma, no special type is what kind of carcinoma?
Ductal carcinoma. 70-80% carcinomas
55
Infiltrating lobular carcinomas account for how many carcinomas?
10% Diffuse, dyscohesive infiltrating tumor cells
56
What are some of the molecular classification techniques used to identify the cause of a malignancy?
- chromosomal rearrangements - gene expression - immunohistochemistry - morphology
57
What is the most common location of breast cancer?
50% occur in the upper outer quadrant
58
What are the two two major prognostic factors of breast cancer?
- lymph node status - tumour size - invasive or in situ distant mets
59
What is the targeted treatment for an ER positive cancer?
tamoxifen
60
What is the targeted treatment for a HER2 positive cancer?
Herceptin
61
What is the most common benign tumour in young women?
Fibroadenoma 'breast mouse' - movable, spherical 10-30mm mammographically dense
62
Stromal tumors or phyllodes tumors are leaflike tumours and are uncommon, how do they present histologically?
Proliferating stroma covered by epithelium
63
What is present in female breasts but not male?
Lobules
64
What is the most common benign enlargement of male breast?
Gynaecomastia
65
What are the 3 genes that come into play in the development of the male breast carcinoma?
- BRCA1 - BRCA2 - 47XXY

Cell Pathology II (6 decks)

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