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NMS/Genitourinary Pathology > Chapter 23 Female Genital Tract- The Breast > Flashcards

Chapter 23 Female Genital Tract- The Breast Flashcards

Test 3 review

1
Q

True or false Each element is a source of benign and malignant lesions.

A

True

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2
Q

The superficial lining of breast is Keratin squamous cell. What are the 2 types of epithelial cells?

A

a. Luminal

b. Myoepithelial

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3
Q

2 major structures remain after the double-layered epithelium (luminal and emyoepithlial cells)

A

a. Ducts: 6-10 open on skin surface at nipple

b. Lobules

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4
Q

What 3 features distinguish the breast from other organs?

A

a. Function: Nutritional support another individual/infant
b. Structure: periodic change in adulthood (pregnancy), before b4 involving age
c. Visible: has a social, cultural, personal significance

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5
Q 
What is the origin of common breast lesions such as 
Cyst
sclerosing adenosis
small duct papilloma
hyperplasia
atypical hyperplasia
Carcinoma
A

lobules and terminal ducts

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6
Q

What common breast lesions are found in large ducts?

A

Duct ectasia
Squamous metaplasia of Lactiferous ducts
Large duct papilloma
Paget disease

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7
Q

Fibroadenoma and Phyllodes tumor are lesions found where in the breast tissue?

A

Intralobular Stroma

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8
Q

Fat necrosis, lipoma, Fibromatosis and Sarcoma are breast lesions associated with what part of the breat?

A

Inter-lobular stroma

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9
Q

The breast become completely mature and functional in the onset of what

A

Pregnancy

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10
Q

what produces colostrum (high in protein)? What does colostrum change into?

A

a. after parturition lobules

b. milk (higher in Fat and Calories)

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11
Q

Interlobular stroma converts from radio-dense fibrous stroma to what?

A

radiolucent adipose tissue

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12
Q

Supernumerary nipples or breasts result from persistence of epidermal thickenings along what?

A

Milk line (extends from Axilla to perineum)

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13
Q

The Milk line extends from the axilla to what?

A

Perineum

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14
Q

Disorders affecting normally situated breast rearly arise in

A

Heterotropic hormone-responsive foci

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15
Q

What is the aka for Milk Line Remnants?

A

Polythelia

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16
Q

Aquired nipple retraction indcates the presence of what disorders?

A

invasive cancer or

inflammatory nipple disease

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17
Q

What are the MC symptoms reported women with breast disorders?

A

Pain
Palpable mass, lumpiness (w/o discrete mass)
nipple discharge

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18
Q

These nonspecific signs/symptoms Must be evaluated for possibility of malignancy?

A

pain
palpable mass, lumpiness w/o discrete mass
nipple discharge

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19
Q

Diffuse cyclic Pain (mastalgia or mastodynia) may be d/t what?

A

premenstrual edema

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20
Q

Non-cyclic Pain (mastalgia or mastodynia) localized in one area may be caused by ruptured cysts, physical injury and what?

A

infections

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21
Q

True or False: Almost all painful masses are malignant, about 90% of breast cancers present with pain.

A

False: Almost all painful masses are BENIGN about 10% of breast cancers present with pain.

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22
Q

The most common palpable lesions are what?

A
  • Cysts,
  • Fibroadenomas,
  • Invasive carcinomas.
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23
Q

Breast mass are malignant in women younger than age 40 is ___ %, and masses in women over age 50 is ____%.

A

a. 10

b. 60

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23
Q

Breast mass are malignant in women younger than age 40 is ___ %, and masses in women over age 50 is ____%.

A

a. 10

b. 60

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24
Q

Carcinomas are mostly located where in the breast?

Majority of cancers are generalliy what size before they metastasize ?

A

upper outer quadrant

2 to 3 m.

25
Q

Milky discharges (galactorrhea) are associated with what?

A

Elevated prolactin levels (e.g., by a pituitary adenoma), hypothyroidism, or endocrine anovulatory syndromes,

26
Q

Milky discharges (galactorrhea) occurs in pt’s taking what?

A

oral contraceptives,
Tricyclic antidepressants,
methyldopa, or
Phenothiazines

27
Q

True or False: Galactorrhea is NOT associated with malignancy

A

True

28
Q

MC cause of a Bloody or serous nipple discharges is what?

A

large duct papillomas and cysts

29
Q

What are the Different types of nipple discharges?

A

A: milky discharge;
B: yellowish ± greenish multiple pore discharge in a context of fibrocystic breast disease;
C: straw-colored single pore discharge;
D: bloody single pore discharge.

30
Q

What is the principal mammographic signs of breast carcinoma?

A

densities and calcifications

31
Q

Rounded densities are most commonly benign, whereas invasive carcinomas generally form what?

A

irregular masses

32
Q

Calcifications form on secretions, ncerotic debris and what?

Calcifications associated with benign lesions are what? Give an example.

A

a. hyalinized stroma

b. clusters of apocrine cysts

33
Q

Malignant calcifications are usually what?

A

small, irregular, numerous and clustered

34
Q

What percentage of invasive carcinomas are NOT detected by mammography?

A

10%

35
Q

Inflammatory diseases of the breast are rare (less than 1%) and caused by?

A

infections
Autoimmune disease
Foreign body type reactions to extravasated keratin or secretions

36
Q

Inflammatory breast cancer” mimics what?

A

inflammation and always considered in women with Erythematous swollen breast

37
Q

Acute mastitis usually occurs when? What is it most commonly due to?

A 
first month of breast feeding
Staphylococcus aureus (Less commonly, Streptococcus)
38
Q

Streptococci is less common in acute mastitis, but spreads infection in the form of what?

A

cellulitis

39
Q

Warm, erythematous breast,Painful,Fever,Purulent nipple discharge are all clinical features of what?

A

Acute Mastitis

40
Q

What is the treatment for Acute Mastitis?

A

drainage via breast feeding and

Antibiotics

41
Q

Squamous Metaplasia of Lactiferous Ducts is assocated with what?

A

smoking

42
Q

Inflammation of the subareolar ducts with blockage is associated with squamous metaplasia of lactiferous ducts and what condition?

A

Periductal mastitis

43
Q

A key feature of Periductal Mastitis is

A

keratinizing squamous metaplasia of the nipple ducts.

44
Q

True or False: Many women have an inverted nipple, most likely as a secondary effect of the underlying inflammation

A

True

45
Q

What is the clinical feature of squamous metaplasia of lactiferous ducts (aka Periductal mastitis)

A

Subareolar mass with nipple retraction

46
Q

Subareolar mass with nipple retraction and offending keratinizing epithelium deep into ducts are features of what condition?

A

Squamous Metaplasia of Lactiferous Ducts AKA Periductal Mastitis

47
Q

Rupture of an abscess with inflammation is a response to what

A

Keratin debris

48
Q

What is Inflammation of the wall of the subareolar duct with dilation (ectasia) of the ducts but NOT associated with smoking

A

Mammary Duct Ectasia

49
Q

a. Histologically, mammary duct ectasia is chronic inflammation with what type of cells? b. It is also known as what?

A

a. Plasma cells

b. Plasma cell mastitis

50
Q

What are the clinical features features of mammary duct ectasia?

A 
Palpable periareolar mass
Thick, white nipple discharge
Skin & nipple retraction
Occurs in 5th or 6th decade of life
usually in multiparous women
No increased risk for breast cancer
51
Q

What presentation closely mimics cancer?

A

Fat Necrosis

52
Q

What specific Fat Necrosis presentation closely mimic cancer?

A

Mammographic densities or calcifications & a PainLESS palpable mass

53
Q

1/2 of the women with Fat necrosis have a HISTORY of what?

A

Breast trauma or Piror surgery

54
Q

Fat necrosis acute lesions may be what?

A

hemorrhagic

55
Q

What is the AKA for Lymphocytic Mastopathy?

A

Sclerosing Lymphocytic Lobulitis

56
Q

Lymphocytic Mastopathy (aka sclerosing lymphocytic lobulitis) is the mc condition in women with what?

A

Type 1 (IDDM), or autoimmune thyroid disease,

57
Q

Sclerosing Lymphocytic Lobulitis AKA Lymphocytic Mastopathy is hypothesized to have what kind of basis?

A

autoimmune

58
Q

Its only clinical significance is that it must be distinguished from breast cancer. What is it?

A

Lymphocytic Mastopathy AKA Sclerosing Lymphocytic Lobulitis

59
Q

Granulomatous inflammation of the breast can be a manifestation of what?

A

Systemic granulomatous diseases (e.g., granulomatosis with polyangiitis, sarcoidosis, tuberculosis).

60
Q

Local granulomatous diseases is known as

A

Granulomatous lobular mastitis

61
Q

What is rare and only occurs in Parous women and has effective steroid treatments?

A

Granulomatous Mastitis

NMS/Genitourinary Pathology (3 decks)

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