Breast Pathology part 2

Question 1

When does Acute Mastitis usually occur?

Answer 1

During the 1st month of breastfeeding

Question 2

What causes Acute Mastitis and when is it seen?

Answer 2

Local infection through the nipple cracks

- Occurs during the 1st month of breastfeeding

Question 3

What are 2 common culprits of Acute Mastitis?

Answer 3

Staph Aureus

Streptococi

Question 4

What are the main symptoms of Acute Mastitis?

Answer 4

Pain, red breast and fever

Question 5

If Staph Aureus is causing the Acute Mastitis, what else may be present?

Answer 5

Abscesses

Question 6

If Streptococci are causing the Acute Mastitis, what else may be present?

Answer 6

Cellulitis

Question 7

Treatment for Acute Mastitis?

Answer 7

Antibiotics and continued milk expression

Question 8

What 2 things put you at risk for Squamous Metaplasia of Lactiferous Ducts?

Answer 8

Smoking

Vitamin A deficiency

Question 9

What 2 things put you at risk for Squamous Metaplasia of Lactiferous Ducts?

Answer 9

Smoking

Vitamin A Deficiency

Question 10

How may Squamous Metaplasia of Lactiferous Ducts present?

Answer 10

Painful, red subareolar mass with possible nipple inversion

Question 11

How may Squamous Metaplasia of Lactiferous Ducts present?

Answer 11

Painful, red subareolar mass with possible nipple inversion

Question 12

With recurrent cases of Squamous Metaplasia of Lactiferous Ducts, what can develop?

Answer 12

Fistula under the smooth muscle of the nipple that connects to the skin at the edge of the areola

Question 13

Fistula under the smooth muscle of the nipple that connects to the skin at the edge of the areolar is seen with?

Answer 13

Squamous Metaplasia of Lactiferous Ducts

Question 14

What plugs the ductal system with Squamous Metaplasia of Lactiferous Ducts?

Answer 14

Keratin

Question 15

Treatment for Squamous Metaplasia of Lactiferous Ducts?

Answer 15

Surgical removal of duct and fistula

Question 16

Who is at risk for Duct Ectasia?

Answer 16

50s/60s with kids

Question 17

How does Duct Ectasia present?

Answer 17

Periareolar mass
Thick white nipple discharge
Skin retraction

Question 18

Periareolar mass with thick white nipple discharge and possible skin retraction is?

Answer 18

Duct Ectasia

Question 19

What fills the dilated ducts with Duct Ectasia?

Answer 19

Secretions and lipid-laden macrophages

Question 20

How does Duct Ectasia mimic carcinoma?

Answer 20

Fibrosis surrounds the dilated duct and forms a mass

Question 21

Fat Necrosis of the breast can mimic cancer. What causes it?

Answer 21

Breast trauma/surgery

Question 22

In what 2 conditions is Lymphocytic Mastopathy common?

Answer 22

Type 1 DM

Autoimmune Thyroid disease

Question 23

What presents with Lymphocytic Mastopathy?

Answer 23

1+ hard masses or mammographic densities

Question 24

1+ hard masses or mammographic densities in a patient with an autoimmune disease?

Answer 24

Lymphocytic Mastopathy

Question 25

What part of Lymphocytic Mastopathy makes it hard to get a biopsy of the hard mass?

Answer 25

Collagenized stroma

Question 26

With Benign Epithelial lesions, are there symptoms? Do they often progress to cancer?

Answer 26

NO and NO | -- just an increased risk but a majority do NOT get cancer

Question 27

What are the 3 Benign Epithelial Lesion types?

Answer 27

1. Nonproliferative 2. Proliferative without atypia 3. Proliferative with atypia

Question 28

Nonproliferative breast changes risk of cancer?

Answer 28

NOT associated with a risk of cancer

Question 29

What are the 3 histo items with Nonproliferative Breast Changes?

Answer 29

1. Cystic change with apocrine metaplasia 2. Fibrosis 3. Adenosis

Question 30

What are the 3 histo items with Nonproliferative Breast Disease?

Answer 30

1. Cystic change with apocrine metaplasia 2. Fibrosis 3. Adenosis

Question 31

With Nonproliferative Breast Changes, how does the cystic change look?

Answer 31

- Cysts contain brown-blue fluid | - Lined by apocrine metaplasia = eosinophilic

Question 32

Fine needle aspiration results with the cystic change of Nonproliferative Breast Changes?

Answer 32

Disappearance of cystic change

Question 33

How does Fibrosis occur with Nonproliferative Breast Changes and what does it contribute to?

Answer 33

Cysts rupture --> fibrosis | = contributes to nodularity of breast

Question 34

What is Adenosis?

Answer 34

Increased number of acini per lobule

Question 35

What are the 4 histo items with Proliferative Breast Disease without Atypia?

Answer 35

1. Epithelial Hyperplasia 2. Sclerosing Adenosis 3. Complex Sclerosing Lesion 4. Papilloma

Question 36

What are the 4 histo items with Proliferative Breast Disease without Atypia?

Answer 36

1. Epithelial Hyperplasia 2. Sclerosing Adenosis 3. Complex Sclerosing lesion 4. Papilloma

Question 37

What cells increase with Epithelial Hyperplasia associated with Proliferative without Atypia breast disease?

Answer 37

Luminal | Myoepithelial

Question 38

What is Sclerosing Adenosis?

Answer 38

Increased number of acini that are compressed/distorted | -- looks swirled

Question 39

How may a Complex Sclerosing Lesion appear?

Answer 39

"radial scar"

Question 40

What are the 2 histo types of Proliferative Breast Disease with Atypia?

Answer 40

1. Atypical Ductal Hyperplasia | 2. Atypical Lobular Hyperplasia

Question 41

What are the 2 histo types of Proliferative Breast Disease with Atypia?

Answer 41

1. Atypical Ductal Hyperplasia | 2. Atypical Lobular Hyperplasia

Question 42

With what Benign Epithelial Lesion is there the greatest risk for breast cancer?

Answer 42

Proliferative with Atypia