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Repro Week 4 > Breast Pathology > Flashcards

Breast Pathology Flashcards

1
Q

what is each lobe of a breast associated with?

A

main lactiferous duct

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2
Q

what are the three cell types in breast ducts and lobular acini?

A

epithelial
myoepithelial
stem cells

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3
Q

what is the most ocmmon benign breast tumor?

A

fibroadenoma

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4
Q

how do fibroadenomas change over time/

A

can enlarge with pregnancy or menstrual cycles

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5
Q

where do fibroadenomas usually arise?

A

inner quadrants of breast

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6
Q

who gets fibroadenomaS?

A

young females

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7
Q

what is therapy for fibradenoma of breast?

A

surgical excision

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8
Q

how does fibroadenoma feel on exam?

A

firm smooth rubbery and mobile

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9
Q

what is histopath of fibroadenoma?

A

proliferation of the glands and stroma with no cellular atypia

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10
Q

how does fibroadenoma appear on mammogran?

A

well circumcribed hypodense ovoid mass

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11
Q

what is the super bulky tumor of the breast?

A

phyllodes tumor

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12
Q

who often gets phyllodes tumors?

A

AA women

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13
Q

what is rx for phyllodes tumor?

A

local excision of mastectomy

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14
Q

what can phyllodes tumors do but rarely do?

A

metastasize

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15
Q

=is phyllodes tumor benign or malignant?

A

benign

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16
Q

what is the pathopnemonic description of phyllodes tumor growth?

A

leaf like appearance

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17
Q

what is classic symptom of fat necrosis of the breast?

A

it is PAINFUL

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18
Q

what else is on differential of painful breast mass?

A

mastitis

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19
Q

what is fat necrosis associated with?

A

trauma in past history

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20
Q

what do you do to treat fat necrosis of the breast?

A

nada

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21
Q

how does fat necrosis appear on mammogram?>

A

irregular borders with microcalcifications

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22
Q

what are three cells found on histopath of fat necrosis?

A

fat cells without nuclei
giant cells
histiocytes

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23
Q

what is PE findings of mastitis?

A

wedge shaped area of erythema over breast and loss of nipple integrity

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24
Q

what is cause of mastitis?

A

skin flora…usually staph a or strep

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25
what is rx for mastitis?
abx and NSAIDs
26
what is fibrocystic changes of the breast?
get cysts of varying sizes surrounded by dense fibrotic tissue
27
what is an intraductal papilloma?
epithelial papillary growth wiht fibrotic components
28
where are intraductal papillomas located?
within a lactiferous duct
29
what is most common cause of serous or bloody nipple discharge?
intraductal papilloma
30
are intraductal papillomas benign or malignant?
benign
31
what is usual reason for gynecomastia in males?
increased estrogent o androgen ratio
32
what proliferates in gynecomastia?
proliferation of branching intermediate size ducts
33
if you get a palpable mass and imaging is negative, what do you do?
ASPIRATE
34
what are the two in situ breast malignancies?
ductal and lobular carcinoma in situ
35
DCIS is confined to what?
ductal tree
36
DCIS means no invasion into what cell layer?
through the myoepithelium or the basement membranes
37
what is DCIS considered a precursor to?
invasive carcinoma
38
risk of recurrent DCIS or change to invasive carcinoma increases with what?
higher nuclear grade of DCIS presence of comedo type necrosis larger tumor size
39
what is comedo type DCIS? what is found on histo | /
high grade nuclei with central necrosis and microcalification s
40
what can you stain for to confirm that DCIS is not spreading invasivley?
smooth muscle myosin..will highlight myoepithelial cells that should surround a DCIS
41
what is LCIS a risk factor for?
invasive cancer
42
describe the difference in DCIS and LCIS in terms of predictability of future invasive cancer
DCIS is a precursor whereas LCIS is risk factor
43
is LCID uni or bilateral?
bilateral often
44
what is seen on histopath of LCIS?
lobular proliferation of low grade monomorphic tumor cell s
45
define paget disease
epidermal involvement of the nipple or areole by malignant cells
46
what is paget disease almost always associated with?
underlying in situ or invasive carcinoma
47
what are PE findings of paget disease?
localized skin erythema scaling and ulceration at nipple
48
what does histopath of nipple show in paget disease?
tumor cells infiltrating the epidermis
49
what are cell characteristics of those in paget disease?
have pale cytoplasm with atypical nucleu
50
what is most common breast cancer?
invasive ductal carcinoma
51
what infiltrates the breast stroma in invasive ductal carcinoma?
infiltrating ducts within stroma...they have broken through myoepithelial and basement membrane
52
what increases in response to invasive ductal carcinoma? cellular level
stromal response...get reactive fibrosis
53
some lobules will lack what in invasive ductal carcinoma?
myoepithelial cells
54
where does invasive lobular carcinoma often metastasize?
gynecologic and GI areas
55
what is estrogen, progesterone and HER2/neu status of invasive lobular carcinoma usually?
hormone receptor positive and her 2 negative
56
how do tumor cells appear in invasive lobular carcinoma?
linear/single file arrangement of tumor cells
57
what does not happen in invasive lobular carcinoma that does happen in ductal?
desmoplastic stromal response
58
what is inflammatory carcinoma?
when there is erythema and induration of the skin with breast cancer
59
is inflammatory carcinoma a good prognosis?
hell no
60
what is pathology of inflammatory carcinoma?
invasive carcinoma invades the superficial dermal lymphatic spaces of the skin
61
what is peau d orange
dimpling of skin due to retraction of lymphatics from invasive involvement
62
what will you see in dermal lymphatic spaces on histo in inflammatory carcinoma?
tumor cells fill the dermal lymphatic spaces
63
name five key risk factors for breast cancer
``` older age family history radiation postmenopausal obesity prior breast disease ```
64
how much of breast cancer is actually familial?
only 5-10%
65
name the two big time breast cancer genes?
BRCA12
66
what chromosome is BRCA 1 on?
17
67
what chromsome is brca 2 on?
13
68
what is inheritance of BRCA1/2 mutations?
AD
69
what is BRCA1 gene in charge of?
tumor suppressor via DNA repair and cell cycle regulation
70
BRCA1 associated tumors have what findings for hormonal and HER 2 receptors?
all negative
71
BRCA2 is in charge of what processes in cell?
tumor suppressor...involved in DnA recombination and repair
72
BRCA2 mutations increase risk for breast cancer and what other cancers?
ovarian and fallopian
73
patient has BRCA2 breast cancer...what should you advise?
maybe get rid of the ovaries too `
74
what is most common form of male breast cancer?
by far...invasive ductal carcinoma
75
what is staging for breast cancer?
T N M
76
what is most important prognostic factor of breast cancer if no metastasis?
regional axillary node involvement
77
what is prognostic value of ER/PR positivity of breast cancer?
longer disease free survival and better overall survival
78
what is predictive factor with positivity of ER/PR in breast cancer ?
predicts response to hormonal therapy like SERMs and sromatase inhibitors
79
where is gene for HER2/neu?
on chromosome 17
80
what type of receptor is HER2/neu?
EGF/erbB growth factor receptor family...transmembrane growth factor receptors
81
what is role of HER2/neu in cell cycle if overexpressed ?
increases cell proliferation
82
what does HER2 overexpression increase risk for?
breast cancer
83
what is prognostic factor of HER2 overexpression in breast cancer?
decreased survival and shorter disease free interval after rx
84
what is predictive factor of HER2 overexpression in breast cancer?
predicts response to HER2 targeted therapy
85
how to test for HER2 overexpression?
FISH
86
what are two surgical options for breast canceR?
modified radical mastectomy and breast conversation...
87
what is breast conservation?
lumpectomy with nodal assessment
88
what is risk with axillary node dissection?
can often cause lymphedema of the arm
89
what is a biologic therapy for breast cancer?
trastuzamab
90
what is target of trastuzamab?
anti HER2 MAB

Repro Week 4 (8 decks)

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