Breast (Robbins)

Question 1

Apocrine metaplasia

Answer 1

Calcifications with densities
Does not cause cancer!
Abundant pink cytoplasm

Question 2

Fibrocytic change

Answer 2

Painless or painful, non-movable, dilated ducts, in premenopausal women
Screen for breast cancer

Question 3

Mammary duct ectasia

Answer 3

Dilated ducts, greenish-brown nipple discharge
Mass present!
Multiparous postmenopausal women

Question 4

Periductal mastitis

Answer 4

Think smokers! Due to Vit A deficiency

Subareolar mass+ nipple retraction

Question 5

Intraductal Papilloma

Answer 5

Premenopausal women with bloody nipple discharge

Finger-like projection lined by epithelial and myoepithelial cells

Question 6

Intranodular cirrhosis

Answer 6

Can lead to bilateral gynecomastia

Seen in alcoholics

Question 7

Most significant risk factor for lobular carcinoma

Answer 7

Atypical hyperplasia

Question 8

Trastuzumab

Answer 8

Rx for HER2/neu BC (-ve for ER/PR)

Question 9

HER2/neu

Answer 9

Epidermal growth factor

Question 10

Type A Luminal BC

Answer 10

ER +ve, HER2 -ve.

Low risk of recurrence. Responsive to estrogen therapy

Question 11

DCIS

Answer 11

My not produce a mass, large atypical cells in cribriform pattern

Question 12

Does Paget disease of the breast represent an underlying carcinoma?

Answer 12

Yes!

Eczematous nipple

Question 13

LoBular CIS

Answer 13

Tends to be BILATERAL, ill-defined
Single file metastasis
No E-cadherin

Question 14

Infiltrating Ductal carcinomas tend to produce what symptoms in what patients

Answer 14

Axillary lymphadenopathy and unilateral breast mass

Question 15

Medullary carcinoma

Answer 15

High in BRCA1 patients, poorly differentiated, triple negative, lymphoid infiltrates

Question 16

Major risk factor for male breast cancer

Answer 16

Old age

Question 17

Rx for triple negative NST no special type BC

Answer 17

Chemotherapy

Why? Too aggressive for surgery and radiation

Question 18

Nipple retraction is seen in which 2 conditions?

Answer 18

Chronic mastitis and infiltrating ductal carcinoma

Question 19

Infiltrating ductal carcinoma

Answer 19

Orange peel+ nipple retraction

Question 20

What hormone can cause the shrinkage of a fibroadenoma?

Answer 20

Estrogen

Question 21

Do fibroadenomas increase in pregnancy?

Answer 21

Yes

Question 22

How are breasts related to sweat glands?

Answer 22

They are modified sweat glands

Question 23

What types of cell layers are found in normal breast tissue?

Answer 23

A luminal (inner) cell layer and a myoepithelial cell layer

Question 24

When do breasts become hormone sensitive?

Answer 24

After menarche

Question 25

What changes are seen in breast during menstruation? Why?

Answer 25

They are tender | Due to increased estrogen and progesterone

Question 26

What changes are seen in breast during pregnancy? Why?

Answer 26

Hyperplasia. To prepare for milk production

Question 27

What changes are seen in breast during menopause? Why?

Answer 27

Atrophy | No progesterone or estrogen

Question 28

Which quadrant of the breast has the most breast tissue?

Answer 28

Upper outer quadrant

Question 29

Define galactorrhea

Answer 29

Milk let down outside of lactation.

Question 30

Is galctorrhea cancer-related?

Answer 30

No

Question 31

What causes galactorrhea?

Answer 31

Prolactinoma drugs and nipple stimulation

Question 32

Acute mastitis common cause

Answer 32

S. aureus

Question 33

Acute mastitis presentation

Answer 33

Warm, erythematous skin, (?) pruritic | Could lead to abscess formation

Question 34

Fat necrosis findings

Answer 34

Mass on PE, calcifications on mammogram. | Giant cells on histology

Question 35

Fibrocystic change definition

Answer 35

Cystic (fibrosis) change of TDLUs | Common in premenopausal women

Question 36

Fibrocystic change presentation

Answer 36

Blue benign cells | No increased risk for cancer

Question 37

How much does ductal hyperplasia increase cancer?

Answer 37

2x increased risk of developing invasive BC

Question 38

Sclerosing adenosis

Answer 38

Fibrosis (Sclerosing) + Increased number of glands (adenosis)

Question 39

Atypical hyperplasia

Answer 39

Increased risk of bilateral invasive breast cancer

Question 40

Phyllodes tumor

Answer 40

Fibroadenoma with more proliferation of stroma | Leaf-like projections