Breast pathology: Fibrocystic disease; tumors; miscellaneous

Question 1

What is the most common breast disorder?

Answer 1

Fibrocystic disease of breast

Question 2

When and how does fibrocystic disease of breast present?

Answer 2

develops during reproductive life;

lumpy, tender breasts associated w/ menstrual cycle

Question 3

Pathogenesis of fibrocystic disease of breast

Answer 3

high estrogen levels;

progesterone deficiency

Question 4

Age and invasive ability of fibrosis in fibrocystic disease of breast

Answer 4

women 35-49;

not premalignant

Question 5

Gross pathology of fibrosis in fibrocystic disease of breast

Answer 5

dense, rubbery mass;
usually unilateral;
most often upper outer quadrant

Question 6

Histology of fibrosis in fibrocystic disease of breast

Answer 6

increase in stromal connective tissue;

cysts are rare

Question 7

Epidemiology of cystic disease of fibrocystic disease of breast

Answer 7

women 45-55;

may predispose to malignancy

Question 8

Gross pathology of cystic disease of fibrocystic disease of breast

Answer 8

serous cysts, firm to palpation;
may be hemorrhagic;
multifocal and often bilateral

Question 9

Histo of cystic disease of fibrocystic disease of breast

Answer 9

cysts lined by cuboidal epithelium => may have papillary projections

Question 10

What may also be associated with cystic disease of fibrocystic disease of breast?

Answer 10

chronic cystic mastitis => stromal lymphocytic infiltrate

Question 11

Epidemiology of sclerosing adenosis in fibrocystic disease of breast

Answer 11

women 35-45;

does not predispose to breast CA

Question 12

Gross path of sclerosing adenosis in fibrocystic disease of breast

Answer 12

palpable, ill-defined, firm area in upper outer quadrant;

unilateral

Question 13

histo path of sclerosing adenosis in fibrocystic disease of breast

Answer 13

glandular patterns of cells in fibrous stroma;

may be confused for cancer

Question 14

epidemiology for epithelial hyperplasia in fibrocystic disease of breast

Answer 14

women over 30 y/o;

increased breast CA risk

Question 15

gross path for epithelial hyperplasia in fibrocystic disease of breast

Answer 15

variable w/ ill-defined masses

Question 16

histo path for epithelial hyperplasia in fibrocystic disease of breast

Answer 16

ductal epithelium is multilayered and produces glandular or papillary configurations

Question 17

Most common benign breast tumor?

Answer 17

fibroadenoma

Question 18

How and when does fibroadenoma present?

Answer 18

single movable breast nodule (upper, outer quadrant) that is not fixed to skin;
usually before age 30

Question 19

What is possible cause of fibroadenoma?

Answer 19

increased estrogen sensitivity

Question 20

How might a pregnant and postmenopausal women present?

Answer 20

show menstrual variation and increased growth during pregnancy;
postmenopausal regression is usual

Question 21

gross path of fibroadenoma

Answer 21

round and encapsulated w/ grey-white cut surface

Question 22

histo path of fibroadenoma

Answer 22

glandular epithelial lined spaces w/ fibroblastic stroma

Question 23

Tx for fibroadenoma

Answer 23

surgery required for definitive Dx

Question 24

Distinguish fibroadenoma from cystosarcoma phyllodes

Answer 24

nature of stromal component as cystosarcoma phyllodes => malignant fibrous, carilaginous and bony elements may be present

Question 25

define cystosarcoma phyllodes

Answer 25

fibroadenoma-like tumors that have become large, cystic and lobulated

Question 26

Gross path of cystosarcoma phyllodes

Answer 26

irregular mass;

often fungating or ulcerating

Question 27

Histo path of cystosarcoma phyllodes

Answer 27

myxoid stroma w/ increased cellularity, anaplasia, increased mitoses

Question 28

what is unique in spread of cystosarcoma phyllodes

Answer 28

initially localized but may spread later to distant sites => NOT LOCAL LYMPH NODES

Question 29

Epidemiology of intraductal papilloma

Answer 29

women 20-50 w/ solitary lesion w/in a duct

Question 30

How will a patient present w/ intraductal papilloma?

Answer 30

nipple discharge (serous or bloody), nipple retraction, or small subareolar mass

Question 31

Gross path of intraductal papilloma

Answer 31

small, sessile or pedunculated that is usually close to the nipple in major ducts

Question 32

histo of intraductal papilloma

Answer 32

multiple papillae

Question 33

spread of intraductal papilloma

Answer 33

single => benign;

multiple => increased risk of CA