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Reproductive - step > breast pathology > Flashcards

breast pathology Flashcards

1
Q

what pathologies are foudn at the nipple

A

paget disease

breast absecess

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2
Q

what pathologies are found in the lactiferous sinus

A

intraductal papilloma
abscesses
mastitis

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3
Q

what pathologies are found in the major duct

A

fibrocystic change
DCIS
invasive ductal carcinoma

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4
Q

what pathologies are foudn in the terminal duct

A

tubular carcinoma

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5
Q

what pathologies are found in the lobules

A

lobular carcinoma

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6
Q

what pathologies are foudn in the stroma

A

fibroadenoma

phylolodse tumor

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7
Q

what are the benign breast tumours and their locations pelase

A

fibroadenoma @ stroma
intraductal papilloma @ lacteriferous sinus
phyllodes tumor @ stroma

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8
Q 
small
mobile
firm mass
sharp edges
< 35 years old
A

fibroadenoma

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9
Q

increased size and tenderness with estrogen

< 35 years odl

A

fibroadenoma

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10
Q

small tumour that grows in lactiferous duts

typically beneath the areola

A

intraductal papilloma

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11
Q

what is the most common cause of bloody nipple discharge in women under 50

A

intraductal papilloma - can have bloody or serous discharge

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12
Q

risk for carcinoma of itnraductal papilloma

A

slight increased 1.5-2x increased

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13
Q

large bulky mas of connective tisseu and cysts

A

phyloodes tumor @ stroma

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14
Q

when are phyllodes tumors most common

A

in the 5th decade

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15
Q

malignancy potential for phyllodes tumours

A

some malignancy potential

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16
Q

leak like projections

A

phyllodes tumor 2 stomra - connective tissue and cysts

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17
Q

what can cause galactorrhea

A

mechanical stimulation
prolactinoma
primary hypothyroidism
drugs: OCP, phenothiazin, methyldopa, TCA, antianxieity

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18
Q

hyperplasia of the breast stroma?

A

firbosis a proliferative breast disease

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19
Q

fluid filled, blue domed, ductal dilation?

A

cystic proliferative breast disease

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20
Q

increased acini and intralobular fibrosos

A

sclerosing adeosis - prolifartaiton fo small ductules and acini in the lobules

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21
Q

proliferation fo small ductules and acini in the lobules

A

sclerosing adenosis

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22
Q

increase in number of epithelial cells in terminal duct lubolue

A

epithelial hyperplasia

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23
Q

which proliferative breast diseases are associated with increased risk of developing cnacer

A

sclerosing adenosis - increased acini and intralobular fibrosis
epithelial hyperplasia - increased number of epithelial cell lyaers in the terminal duct lobule

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24
Q

which proliferative breast diseases are NOT associated with increased risk of developing cancer

A

fibrosis - hyperplasia of breast stroma

cystic - fliud fille,d blue domw = ductal dilation

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25
Q

what are the most common cause of breat lumpds from 25- menopause

A

proliferative breast disease = fibrosis, cystic, sclerosing adenosis (icnreased acinin and intratubular fibrosis), epithelial hyperplasia = increased number of epi layers in terminal ductules

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26
Q

premenstural breast pain
multiple lesions
ofetn bilateral
fluctuation in size and mass

A

proliferative breast disesase
firosis - hyperplasia of breast stroma
cystic - fluid filled, blud domes, ductal dilation
sclerosign adenosis - icnreased acini and itnralobular fibrodis
epithleila hyperplasia - increased ep cell layers in terminla ductules

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27
Q

which proliferative breast disease is associated with microcalcifications?

A

sclerosign adenosis - icnrease acini and intralobular fibrosis

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28
Q

which proliferative breast disease is in women > 30 years ol

A

epithelial hyperplasia - icnreased number of epi cell layers

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29
Q

what is lactational mastitis

A

at breastfeeding ahve increased risk of infection by bacteria thorugh cracks in the niplle

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30
Q

what is most common moo for lactational mastitis

A

staph auerus

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31
Q

treatment of lactational mastitis

A

dicloxacillin and continue breastfeeding

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32
Q

bening painless (usually) bump after trauma

A

fat necrosis

33
Q

how does fat necorsis show up on mammography

A

abnormal calcification

34
Q

biopsy of fat necrosis

A

necotic fat, giant cells

35
Q

what is gynecomastia

A

breast enlargment in males

36
Q

what causes gynecomastia

A

hyperestrogenism @ cirrhosis, testicular tumor, puberty and old age
klinefeter and androgen insensntivity syndrome
drugs: some drugs create awesome knockers - spironoloactone, cimetidine, digoxin, alcohol, ketoconazole

37
Q

list the drugs that can cause gynecomastia

A 
some drugs cause awesome knockers
spironolactone
digoxin
cimetidine
alcohol
ketoconazole
38
Q

name the physiological causes of gynecomastia

A

birth
puberty
old age

39
Q

what age to malignant breat tumors typically present

A

post menopausal

40
Q

where do malignant breast tumours usually arise from

A

ternimal duct lobular unit

41
Q

what is commonly overexpressed in malignant breast tumors

A

Er, PR or c-erbB2 (HER-2, an EGF receptor)

42
Q

what is expressed on more aggressive breast tumors

A

triple negative
no ER
no PR
no Her2/Neu

43
Q

what is the single most important prognostic factor in maligi breast tumors

A

axillary lymph node involvement = indicates mets

44
Q

what part of breast are malignant breast tumors usually located?

A

upper outer quad - most dense tissue

45
Q

what are risk factors for breast cancer

A 
ICNREASED ESTROGEN EXPOSURE
increased total number of menstrual cycltes
older age at fisrt live irth
obesity
BRCA1, 2
african american
46
Q

what ethnic group is at more risk of triple negative tumorus

A

african america

47
Q

list the noninvasive maligi breast tumours

A

dutal carcinoma in situe
comedocarcinoma
paget disease

48
Q

where do DCIS occur

A

major ducts

49
Q

what occurs in the same location fo the breast as DCIS

A

major ducts = fibrocystic change, DCIS, invasive ductal carcinoma

50
Q

microcalcifications @ mamoography with what?

A

abnormal @ fat necorsis

microcalcifications @ sclerosing adenosis proliferative breast disease AND @ ductal carcinoma in situ

51
Q

what does ductal carcinoma in situ arise from

A

ductal atypia

52
Q

histopathos at ductal carcinoma in situe

A

fills ductal lumen with engorge blood vessels in major duct

53
Q

what is the malignancy potential for ductal carcinoma in situe

A

early malignant wihtout basement membrane penetration = non invasive

54
Q

what is a comedocarcinoma

A

a subtype of DCIS

ductal with central necrosis

55
Q

fuctal subtype of DCIS with central necrosis

A

comedocarcinoma

56
Q

what causes paget disease

A

underlying DCIS of invasive breast cancer

57
Q

how does paget disease present

A

eczematous patches on nip0ple

58
Q

histopathos of paget disease

A

paget cells = large cells in epidermis wtih clear halo

59
Q

what do you think if you see extramammary; paget disease on vulva

A

is NOT suggestive of malignancy

60
Q

list the invasive malignant breast tumors

A

invasive ductal
invasive lobular
medullary
inflammatory

61
Q

describe the characteristics of invasive ductal

A 
firm
fibrous
ROCK HARD
shapr margins
small gluandular duct like cells
@ gross = stellate
62
Q

what is the most common of all breast cancers

A

invasive ductal

63
Q 
firm
fibrous
rock hard
sharp margins
small glandular duct cells
A

invasive ductal

64
Q

what is the worst and most invasive breast cancer

A

the msot common one too

invasive ductal

65
Q

describe the appreance of invasive lobular cnacers

A

orderl row of cells INDIAN FILE

oftern bilateral with multiple lesions in same location

66
Q

decreased E cadherin expression

A

invasive lobular carcinoma

67
Q

bilateral invasive breast cancer

A

invasive lobular

68
Q

what invasive breast cancer has a good prognosis

A

medullary

69
Q

describe how medullary breast tumors look

A

soft, flishy, cellular lymphocytic infiltrate

70
Q

soft
fleshy
cellular
lymphocytic infiltrate

A

medullary breast tumor

invasive

71
Q

what invasive breast tumro si often mistaken for pagets or mastitis

A

inflammatory breat tumors

72
Q

what causes inflammatory breast tumors

A

dermal lymphatic invasion by breast carcinoma

73
Q

cxpx of inflammatory breast tumors

A

puea d’oranage, erythematous dimpling

74
Q

what causes blocked lymph drainage in inflammatory breast tumorus?

A

neoplastic cells block plymphatics

75
Q

what is the prognosis of each invasive breast cancer

A

a) invasive ductal (firm, fibrous, rock hard, with small clandular duct liek cells) = worst prognosis
b) invasive lobular (indian file, decreased e cadherin, bilateral with multiple lesions in same lcatoin ) = not menitoned in first aid
c) medullary (soft, fleshy, cellular, lymphocytic infiltration) = good prognosis
d) inflammatory (peau d’orange, blocked lymph draininage) = 50% for 5 years

76
Q

stellate

A

invasive ductal

77
Q

which tumor is commonly associated with BRCA 1 and is negative ER and PR

A

medullary.

78
Q

name the breast patology:

a) small, mobile, firm mass with sharp edges
b) large bulky mass of ct and cysts
b. 2) firm, fibrous, rock hard mass with shapr margins
c) premenstrual breast pain wtih multiple lesiosn ofen bilateral that has fluctuating size
d) benging painless lump with abnormal calcifications
e) microcalcifications
f) early malignancy without basement membrane penetration
g) eczematous patch on nipple
h) lump beneath areola
i) non palpbale
j) stellate infiltration
k) decreased e cadherin
l) bilateral wtih multiple lesions in same lcoation
m) lymphocytic infiltrate
n) indian file, bulls eye
o) peau d;orange
p) leaf like projections

A

a) small mobile firm mass wtih shapr edges - fibroadenoma
b) large bulky mass of ct and cysts = phyllodes
b.2) firm, fibrous, rock hard mass with shapr margins = invasive ductal
c) premenstrual pain with multi lesions often bilateral with flucutating zia = proliferative breast disease
d) benign painless lump wtih abnromal calcifications = fat necrosis
e) microcalcifications = DCIS, sclerosis adenosis proliferative breast disease
f) early maligi withotu BM penetration = DCIS
g) eczematous patch on nipple = paget disease
h) lump benath areola = intaductal papilloma
i) non palpablae = DCIS and LCIS
j_ stellate infiltration = invasive ductal ( small glandular duct like cells)
k) decreased e cadherin - invasive lobular
l) bilateral with multiple lesions in same lcoation = invasive lobular
m) lymphocytic infiltration = inflammatory
n) indian file, bulls eye = invasive lobular
o) peau d’orange = inflammatory
p) leaf like projectiosn - phyllodes tumor

79
Q

list pathos in the following locations:

a) nipple
b) lactiferious ducts
c) main duct
d) Terminal duct
e) lobule
f) STroma

A

a) nipple = pagets, abcesses
b) lactiferous = intraductal papilloma, abscesses, mastitis
c) main duct = ductal invasive, fibrocystic change, DCIS
d) terminal duct = tubular carcinoma
e) lobule = lobular carcinoma
f) Stroma = fibroadenoma, phyllodes tmour

Reproductive - step (11 decks)

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