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breast pathology - non cancer Flashcards

1
Q

breast histology

A

stroma –> termnal duct lobular unit –> Major duct –> lactiferous sinus –> Nipple

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2
Q

Fibroadenoma - epidemology/presentationsituations

A

MC under 35. Small, well-defined marble-like, mobile mass

increased size with estrogen (pregn, prior to menstr)

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3
Q

Fibroadenoma - cancer

A

not increased risk

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4
Q

Fibroadenoma - histology/location in breast

A

stroma –> fibrous tissue and glands

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5
Q

Fibrocystic changes - epidemiology/cancer

A

MC in premenopausal over 35

no risk for cancer

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6
Q

Fibrocystic changes - presentation

A

premenstrural breast pain or lumps, often bilateral or multifocal

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7
Q

Fibrocystic changes - histology

A

terminal duct lobular unit –> nonproliferative lesions include simple cysts (fluid-filled duct dilation, blue done) papillary apocrine change/metaplasia, stromal fibrosis

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8
Q

Sclerosing adenosis?

A

increased number of the acini and their glandsi and stromal fibrosis –> associated with calcification

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9
Q

Sclerosing adenosis - cancer

A

1.5-2x increased risk

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10
Q

MCC of nipple discharge (serous or body)

A

Intraductal papilloma

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11
Q

Intraductal papilloma - definition/histology

A

small papillary tumor (fibrovascular projection) within lactiferous ducts (lactoferous sinus or major duct), typically beneath areola
–> 2 LAYERS (luminal epith + myoepithelial) (vs CA)

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12
Q

Intraductal papilloma - cancer

A

1.5-2x increased risk

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13
Q

breast - epithelial hyperplasia?

A

increased cell in terminal ductal or lobular epithelium

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14
Q

breast - epithelial hyperplasia - cancer

A

increased risk of carcinoma with atypical cells (x5)

if not atypical –> x2

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15
Q

Phyllodes tumor - definiton/appearance

A

large mass of connective tissue and cysts with leaf-like lobulations (AT STROMA)

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16
Q

Phyllodes tumor - cancer

A

some may becoma malignant

17
Q

Phyllodes tumor - age

A

MC in 5th decade (postmenopausal)

18
Q

Fat necrosis - definition/presentation

A

Benign, usually painless, lump due to injury to breast tissue
Up to 50% patients may not report trauma

19
Q

Fat necrosis - appearance

A
  1. calcified oil cyst on mammography

2. necrotic fat and giant cells on biopsy

20
Q

Intraductal papilloma - epidemiology

A

premenopausal women

21
Q

indraductal papilloma vs cancer

A
  1. papiloma has also the myeoepithelial layer

2. papilloma is premenopausal

22
Q

Lactational mastitis?

A

during breastfeeding –> high risk of bacterial infection through cracks in nipple

23
Q

Lactational mastitis - MC pathogen/presentation

A

S. aureus / presentation: warm, red breast with purulent nipple discharge

24
Q

Lactational mastitis - treatment

A
  1. antibiotics (dicloxacilin)

2. continue breastfeeding

25
Q

Gynecomastia?

A

breast enlargement in males due to high estrogen levels compared with androgen activity

26
Q

Gynecomastia is physiologic in

A
  1. newborn
  2. pubertal (but may perists after puberty
  3. elderly males
27
Q

causes of pathologic gynecomastia

A
  1. cirrhosis
  2. hypogonadism (eg. Klinefelter)
  3. testicular tumors
  4. drugs
28
Q

drugs that causes gynecomastia

A
  1. spironolactone
  2. Hormones
  3. cimetidine
  4. Ketoconazole
29
Q

Periductal mastitis - definition/epidemiology

A
  • inflammation of subareolar ducts
  • in smokers (low vit A –> epithelial become squamous
  • -> keratin –> plag –> inflammation behind –> granoulation tissue –> retraction
30
Q

Periductal mastitis - presentation

A

subareolar mass with nipple retraction

31
Q

Mammary duct ectasia - definition/epidemiolgy/presentation

A
  • inflammation with dilation (ectasia) of subareola ducts
  • multiparous postmenopauseal
  • -> green brown nipple discharge
32
Q

Mammary duct ectasia - biopsy

A

chronic inflammation with plasma cells

33
Q

benign breast conditions - cancer?

A
  1. Fibroadenoma - no
  2. fibrocystic changes - no
  3. sclerosing adenonis - 1.5-2 x cancer
  4. Intraductal papilloma –> 1.5-2 x cancer
  5. epithelial hyperplasia –> x5 if atypical, x2 if not atypical
  6. Phylloid tumor –> some may become malignant
  7. Fat necoris
  8. Lacational mastitis
  9. Gynecomastia
  10. Periductal mastitis
  11. Mammary duct ectasia
34
Q

Breast pathology - disease on stroma

A

fibroadenoma

phyllodes tumor

35
Q

Breast pathology - disease on termina duct lobular unit

A
  1. Fibrocystc change
  2. DCIS and invasive
  3. LCIS and invasive
36
Q

Breast pathology - disease on lactiferous sinus / Major duct

A
  1. intraductal papilloma
  2. abscess/mastitis
  3. paget disease

Reproductive (20 decks)

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