Chapter 23 Female Genital Tract- The Breast Flashcards
Test 3 review
True or false Each element is a source of benign and malignant lesions.
True
The superficial lining of breast is Keratin squamous cell. What are the 2 types of epithelial cells?
a. Luminal
b. Myoepithelial
2 major structures remain after the double-layered epithelium (luminal and emyoepithlial cells)
a. Ducts: 6-10 open on skin surface at nipple
b. Lobules
What 3 features distinguish the breast from other organs?
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
What is the origin of common breast lesions such as Cyst sclerosing adenosis small duct papilloma hyperplasia atypical hyperplasia Carcinoma
lobules and terminal ducts
What common breast lesions are found in large ducts?
Duct ectasia
Squamous metaplasia of Lactiferous ducts
Large duct papilloma
Paget disease
Fibroadenoma and Phyllodes tumor are lesions found where in the breast tissue?
Intralobular Stroma
Fat necrosis, lipoma, Fibromatosis and Sarcoma are breast lesions associated with what part of the breat?
Inter-lobular stroma
The breast become completely mature and functional in the onset of what
Pregnancy
what produces colostrum (high in protein)? What does colostrum change into?
a. after parturition lobules
b. milk (higher in Fat and Calories)
Interlobular stroma converts from radio-dense fibrous stroma to what?
radiolucent adipose tissue
Supernumerary nipples or breasts result from persistence of epidermal thickenings along what?
Milk line (extends from Axilla to perineum)
The Milk line extends from the axilla to what?
Perineum
Disorders affecting normally situated breast rearly arise in
Heterotropic hormone-responsive foci
What is the aka for Milk Line Remnants?
Polythelia
Aquired nipple retraction indcates the presence of what disorders?
invasive cancer or
inflammatory nipple disease
What are the MC symptoms reported women with breast disorders?
Pain
Palpable mass, lumpiness (w/o discrete mass)
nipple discharge
These nonspecific signs/symptoms Must be evaluated for possibility of malignancy?
pain
palpable mass, lumpiness w/o discrete mass
nipple discharge
Diffuse cyclic Pain (mastalgia or mastodynia) may be d/t what?
premenstrual edema
Non-cyclic Pain (mastalgia or mastodynia) localized in one area may be caused by ruptured cysts, physical injury and what?
infections
True or False: Almost all painful masses are malignant, about 90% of breast cancers present with pain.
False: Almost all painful masses are BENIGN about 10% of breast cancers present with pain.
The most common palpable lesions are what?
- Cysts,
- Fibroadenomas,
- Invasive carcinomas.
Breast mass are malignant in women younger than age 40 is ___ %, and masses in women over age 50 is ____%.
a. 10
b. 60
Breast mass are malignant in women younger than age 40 is ___ %, and masses in women over age 50 is ____%.
a. 10
b. 60
Carcinomas are mostly located where in the breast?
Majority of cancers are generalliy what size before they metastasize ?
upper outer quadrant
2 to 3 m.
Milky discharges (galactorrhea) are associated with what?
Elevated prolactin levels (e.g., by a pituitary adenoma), hypothyroidism, or endocrine anovulatory syndromes,
Milky discharges (galactorrhea) occurs in pt’s taking what?
oral contraceptives,
Tricyclic antidepressants,
methyldopa, or
Phenothiazines
True or False: Galactorrhea is NOT associated with malignancy
True
MC cause of a Bloody or serous nipple discharges is what?
large duct papillomas and cysts
What are the Different types of nipple discharges?
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.
What is the principal mammographic signs of breast carcinoma?
densities and calcifications
Rounded densities are most commonly benign, whereas invasive carcinomas generally form what?
irregular masses
Calcifications form on secretions, ncerotic debris and what?
Calcifications associated with benign lesions are what? Give an example.
a. hyalinized stroma
b. clusters of apocrine cysts
Malignant calcifications are usually what?
small, irregular, numerous and clustered
What percentage of invasive carcinomas are NOT detected by mammography?
10%
Inflammatory diseases of the breast are rare (less than 1%) and caused by?
infections
Autoimmune disease
Foreign body type reactions to extravasated keratin or secretions
Inflammatory breast cancer” mimics what?
inflammation and always considered in women with Erythematous swollen breast
Acute mastitis usually occurs when? What is it most commonly due to?
first month of breast feeding Staphylococcus aureus (Less commonly, Streptococcus)
Streptococci is less common in acute mastitis, but spreads infection in the form of what?
cellulitis
Warm, erythematous breast,Painful,Fever,Purulent nipple discharge are all clinical features of what?
Acute Mastitis
What is the treatment for Acute Mastitis?
drainage via breast feeding and
Antibiotics
Squamous Metaplasia of Lactiferous Ducts is assocated with what?
smoking
Inflammation of the subareolar ducts with blockage is associated with squamous metaplasia of lactiferous ducts and what condition?
Periductal mastitis
A key feature of Periductal Mastitis is
keratinizing squamous metaplasia of the nipple ducts.
True or False: Many women have an inverted nipple, most likely as a secondary effect of the underlying inflammation
True
What is the clinical feature of squamous metaplasia of lactiferous ducts (aka Periductal mastitis)
Subareolar mass with nipple retraction
Subareolar mass with nipple retraction and offending keratinizing epithelium deep into ducts are features of what condition?
Squamous Metaplasia of Lactiferous Ducts AKA Periductal Mastitis
Rupture of an abscess with inflammation is a response to what
Keratin debris
What is Inflammation of the wall of the subareolar duct with dilation (ectasia) of the ducts but NOT associated with smoking
Mammary Duct Ectasia
a. Histologically, mammary duct ectasia is chronic inflammation with what type of cells? b. It is also known as what?
a. Plasma cells
b. Plasma cell mastitis
What are the clinical features features of mammary duct ectasia?
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
What presentation closely mimics cancer?
Fat Necrosis
What specific Fat Necrosis presentation closely mimic cancer?
Mammographic densities or calcifications & a PainLESS palpable mass
1/2 of the women with Fat necrosis have a HISTORY of what?
Breast trauma or Piror surgery
Fat necrosis acute lesions may be what?
hemorrhagic
What is the AKA for Lymphocytic Mastopathy?
Sclerosing Lymphocytic Lobulitis
Lymphocytic Mastopathy (aka sclerosing lymphocytic lobulitis) is the mc condition in women with what?
Type 1 (IDDM), or autoimmune thyroid disease,
Sclerosing Lymphocytic Lobulitis AKA Lymphocytic Mastopathy is hypothesized to have what kind of basis?
autoimmune
Its only clinical significance is that it must be distinguished from breast cancer. What is it?
Lymphocytic Mastopathy AKA Sclerosing Lymphocytic Lobulitis
Granulomatous inflammation of the breast can be a manifestation of what?
Systemic granulomatous diseases (e.g., granulomatosis with polyangiitis, sarcoidosis, tuberculosis).
Local granulomatous diseases is known as
Granulomatous lobular mastitis
What is rare and only occurs in Parous women and has effective steroid treatments?
Granulomatous Mastitis
