Breast Pathology part 1

Question 1

What are the 2 major structures of the breast?

Answer 1

Ducts

Lobules

Question 2

What epithelial cells (2) line the ducts in the breast?

Answer 2

Luminal cells

Myoepithelial cells

Question 3

What are the 2 types of stroma in the breast?

Answer 3

Intralobular stoma

Interlobular stroma

Question 4

Describe the major blood supply to the breast

Answer 4

• Internal Mammary A. –> Medial Mammary A.s

- Lateral Thoracic A. –> Lateral Mammary A.s

Question 5

Describe the venous drainage of the breast

Answer 5

• Areolar plexus –> Internal Thoracic Vein

- Afferent Mammary vein

Question 6

Describe the lymphatic drainage of the breast

Answer 6

• Internal Mammary nodes

- External Mammary –> Scapular –> Central –> AXILLARY

Question 7

What is Poland Syndrome?

Answer 7

Born with missing/underdeveloped muscles on 1 side of the body

Question 8

Born with missing/underdeveloped muscles on 1 side, usually the chest, shoulder or arm?

Answer 8

Poland Syndrome

Question 9

What is an example of an internal organ abnormality that may be present with Poland Syndrome?

Answer 9

Dextrocardia - heart on the right side

Question 10

Following puberty, the ductal system expands. There will be an increase in?

Answer 10

TDLU

terminal ductal lobular units

Question 11

During Pregnancy, what is the breast almost made up of entirely?

Answer 11

Lobules

Question 12

Following 30 years old, what occurs to the lobules and stroma?

Answer 12

They involute

- fibrous stroma becomes adipose tissue

Question 13

What are Milk Line Remnants?

Answer 13

Persistence of epidermal thickenings along the milk line (axilla - perineum)

Question 14

Milk Line Remnants give rise to what 2 things and what is the possible symptom of them?

Answer 14

• Supernumerary nipples or breasts

= PAIN prior to menstruation

Question 15

With accessory axillary breast tissue, does a mastectomy resolve the risk for breast cancer?

Answer 15

NO

– normal ductal system can extend into axilla/chest wall

Question 16

Is Nipple Inversion common?

Answer 16

YES

Question 17

Congenital Nipple Inversion prognosis?

Answer 17

Not worrisome

– can spontaneously evert or fixed with simple traction

Question 18

Acquired Nipple Inversion prognosis?

Answer 18

May indicate presence of invasive cancer or inflammatory disease

Question 19

A majority of clinical symptoms of breast disease indicate malignancy or benign conditions?

Answer 19

BENIGN

Question 20

With Breast Malignancy, are symptoms common?

Answer 20

1/2 have symptoms

1/2 will be diagnosed on mammography

Question 21

Cyclic Mastalgia (Mastodynia) is associated with the menstrual cycle. What causes it?

Answer 21

Premenstrual edema

Question 22

Breast inflammation is usually due to?

Answer 22

Infections during lactation/breast feeding

Question 23

What is the normal amount of nipple discharge?

Answer 23

Small and bilateral

Question 24

What are some things that can cause Galactorrhea?

Answer 24

(milky nipple discharge)

= increased levels of prolactin, hypothyroidism, meds

Question 25

What type of nipple discharge is concerning for malignancy?

Answer 25

Bloody/serous - older and unilateral

Question 26

List 3 times not including malignancy that bloody/serous nipple discharge can occur?

Answer 26

Pregnancy Large duct papilloma Cyst

Question 27

Breast lumpiness is usually a manifestation of?

Answer 27

Normal glandular tissue

Question 28

Palpable breast masses are usually benign. At what size are they felt?

Answer 28

2-3 cm

Question 29

Features of a benign breast mass

Answer 29

Round, rubbery, mobile

Question 30

What are the 2 most common benign breast masses?

Answer 30

Fibroadenomas | Cysts

Question 31

Features of a malignant breast mass

Answer 31

Invasion Hard Irregular borders

Question 32

What is the most common malignant breast mass?

Answer 32

Invasive Ductal Carcinoma

Question 33

Malignant breast masses are usually at what location?

Answer 33

UOQ

Question 34

Does breast palpation screen decrease mortality from breast cancer?

Answer 34

NO

Question 35

What 2 things show up on Mammograms?

Answer 35

Densities | Calcifications

Question 36

What 2 things show up on mammograms?

Answer 36

Densities | Calcifications

Question 37

What are densities on mammograms?

Answer 37

Lesions that replace fat with radiodense tissue

Question 38

What will calcifications look like on mammogram if they are associated with a malignancy?

Answer 38

Small Numerous Clustered

Question 39

In addition to Mammography, what are 3 other diagnostic tests used for the breast?

Answer 39

Digital Breast Tomosynthesis (3-D mammogram) US MRI

Question 40

BI-RADS scores 4-6 are suspicious to proven malignancies. What is crucial for diagnosis?

Answer 40

BIOPSY | -- ex. core needle biopsy