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Reproductive > Dx Of Breasts > Flashcards

Dx Of Breasts Flashcards

1
Q

Number of lobes per mammary glands

A

15-20

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2
Q

What is a mammary gland lobe

A

Individual Compound tubule alveolar gland with its own lactiferous duct and sinus opening on the surface of the nipple

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3
Q

Where do the ductal system drain into

A

L’activerons sinus

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4
Q

Are congenital malformation of the breast common

A

No rare

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5
Q

Types of congenital malformation

A 
Polymastia
Accessory breasts and nipples
Failure of development of breast
Precocious development
Adolescent hypertrophy
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6
Q

In which syndrome do you say failure of development of breast due to ovarian agenesis

A

Turner syndrome

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7
Q

In which Disease do you see precocious development of breast

A

Granulosa cell tumor

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8
Q

Are inflammatory lesions of the best common

A

No rare

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9
Q

What are some inflammatory lesions of the breast

A

mastitis
Duct ecTasia
Fat necrosis

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10
Q

Type of infection in acute mastitis

A

Bacterial infection

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11
Q

Main population affected by Acute mastitis

A

Postpartum or lactating breast women

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12
Q

Presentation of Acute mastitis

A

Pain, swelling or redness of breast
Fever
malaise

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13
Q

Most common organism in Acute mastitis

A

Strep or staph

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14
Q

Gross morphology of Acute mastitis

A

Firm walled-off nontender abscess

chronic localized scar

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15
Q

Structure involved duct ecTasia

A

Large ducts

smaller interlobular duct in some cases

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16
Q

At what point in life is a woman Susceptible to duct ecTasia

A

Second half of reproductive life

after menopause

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17
Q

Why are duct ecTasia often mistaken for carcinoma

A

Because of nipple discharge which may be blood stained

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18
Q

Main cause of fats necrosis of breast

A

Trauma

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19
Q

How does Fat Necrosis of breast mimics carcinoma

A

Calcification in mammography

Presents as discrete lump

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20
Q

Woman at risk of fats necrosis

A

Obese women

womenin menopause

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21
Q

Gross morphology of fat necrosis of breast

A

Yellowish and Hemorrhagic tissue

Flecks of Calcification

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22
Q

Microscopy a fat necrosis of breast

A

Macrophages collection
giant cell with lipid material
Lymphocytes ,fibroblasts ,small vascular channels

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23
Q

What are some non-neoplastic proliferative lesions of the breast

A

Fibrocystic change

epithelial hyperplasia’s

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24
Q

Is there an increased risk of malignancy with ductal hyperplasia

A

Yes

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25
Q

Two types of ductal hyperplasia

A

Proliferative disease without atypia

proliferative diseass atypia

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26
Q

type of neoplastic disease of breast

A

Benign

malignant

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27
Q

Benign tumor of the breasts

A

Fibroadenoma
Phyllodes tumor
Intra ductal papilloma

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28
Q

Commonest benign tumor of the best in Ghanaians and Africans

A

Fibroadenoma

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29
Q

Age of female who commonly have fibroadenoma

A

Below 30 years

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30
Q

Grass morphology of fibroadenoma

A

Firm lobulated
Circumscribes
mobile mass ( breast mouse )

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31
Q

Micro of fibroadenoma

A

Branching ducts and acini

connective tissue proliferation

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32
Q

Is malignant change in fibroadenoma common

A

No

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33
Q

People at risk of phyllodes tumor

A

Middle age and elderly persons

34
Q

Macro of phyllodes tumor

A

Massive enlargement of breast

large lobulated tumor

35
Q

Micro phyllodes tumor

A

Like fibroadenoma
Cellular stroma , Atypical nuclei with mitotic figures
Normal ductal epithelium

36
Q

How do you cure phyllodes tumor

A

Mastectomy

37
Q

When can you have malignancy in phyllodes tumor

A

If incomplete excision of benign tumor , can turn into malignancy in 5-10%

38
Q

What are intraductal papilloma

A

Solitary benign tumor

39
Q

Common age group affected by intraductal papilloma

A

20 to 30 years old

40
Q

Main presentation of intraductal papilloma

A

Bloody nipple discharge

Duct distention by papillary tumor

41
Q

When can you get carcinoma in intraductal papilloma

A

If benign tumor not excised

42
Q

Group of people more at risk of carcinoma of the breast

A

Caucasians above 30 years old

Woman with a family history

43
Q

Risk factors for breast cancer

A 
Gender female
Over 50 years old
Hereditary history
Previous breast pathology
Hormones endogenous or exogenous
Obesity
Lifestyle (lack of exercise ,alcohol ,fatty diet, smoking)
44
Q

Classification of breast carcinoma stage I and ii

A
45
Q

Classification of breast carcinoma stage three and four

A
46
Q

What’s impacts the likelihood of invasive cancer rising after in situ carcinoma diagnosis

A

Histologic subtype
Grade
Extent of in situ disease
Family history for breast cancer

47
Q

DCIS comedo (high grade ) subtype histology

A 
Very large pleomorphic epithelial cell
Abundant cytoplasm 
irregular nuclei 
Permanent heterogeneous nucleoli
 Intraductal necrosis
48
Q

Grass morphology of high-grade in situ carcinoma

A

Distended ducts with white necrotic material resembling comedo

49
Q

Most histologically common type of breast cancer

A

Invasive ductal carcinoma

50
Q

Tissue invaded in invasive ductal carcinoma

A

Stroma of breast

51
Q

Gross of invasive ductal carcinoma

A

Firm palpable mass
Modified contour of breasts
Visible dense mass lesion on mammography

52
Q

Later stage presentation in invasive ductal carcinoma

A

Large ulcerating masses
Deformation of breast
Regional or distant metastases symptoms

53
Q

is there a greater incidence of unilaterally or bilaterality in invasive lobular

A

Bilaterality

54
Q

Histologic hallmark of invasive lobular carcinoma

A

Single infiltrating tumor cells or lose clusters of cells
Cells arranged in concentric rings around normal ducts
Signet ring cells

55
Q

What is paget disease of the nipple

A

Red scaly eczematous lesion of nipple

Associated to underlying ductal carcinoma of breast

56
Q

Histology of paget disease of the nipple

A

Squamous epithelium thickened
Paget cell in epithelium
Chronic inflammatory cells in stroma

57
Q

Prognosis of paget disease of the nipple

A

Depends on underlying tumor

58
Q

Is inflammatory carcinoma of breast a specific histologic subtype of breast carcinoma

A

No

59
Q

What os inflammatory carcinoma of breast

A

Clinical presentation of carcinoma involving dermal lymphatics with enlarged erythematous breast

60
Q

Morphology of inflammatory carcinoma

A

Diffuse infiltrating pattern in underlying carcinoma

No palpable mass

61
Q

Percentage f inflammatory carcinoma in all type of breast cancer

A

1%

62
Q

Average age in people with inflammatory ca

A

56 yo

63
Q

Prognosis of inflammatory ca

A

Worse than other tumor

64
Q

Risk factors of inflammatory ca

A

Estrogen therapy

65
Q

Location of breast ca

A 
Upper outer quadrant - 50%
Central -20%
Lower outer - 10%
Upper inner - 10%
Lower inner - 10%
66
Q

Grading system used

A

Bloom Richardson method

67
Q

Bloom Richardson method characteristics

A

Tubule formation
Nuclear Pleomorphism
Number of mitotic figures

68
Q

Grades of tumors

A

Grade I - score 3-5
Grade II - score 6-7
Grade III- score 8 and 9

69
Q

How to assign score in grading system

A
70
Q

Two staging in ca

A

UICC

AJCC

71
Q

UICC staging

A

T - size of primary tumor
N - axillary lymph nodes
M - distant metastases

72
Q

AJCC stage of tumors

A

Stage O - in situ (DCIS or LCIS)

Stage I - early invasive , tumor <2cm , no , no lymph node metastases

Stage II - tumor size > 2cm , metastasis confined to lymph node

Stage III - locally advanced ,metastatic tumor spread beyond confines of lymph node

Stage IV - metastasis to other organs or parts of body

73
Q

Prognostic factors

A 
Size of tumor 
Grade
Stage ( most important )
Hormonal status 
Resection margin 
Age
Histologic subtype 
Mitotic count 
Lymphovascular invasion 
Inflammatory carcinoma
74
Q

Routes of spread

A 
Direct skin and muscle 
Lymphatic (seen as peau d’orange )
Blood to lung,  liver, bone 
Transcolemic to pleura and peritoneum 
Implantation with scar recurrence
75
Q

Male breast disease

A

Gynecomastia

Carcinoma

76
Q

What is Gynecomastia

A

Enlargement of adult male breast

77
Q

Causes of Gynecomastia

A

Hormones
Medication
Klinefelter syndrome
Cirrhosis
Testicular tumor like Leydig cell tumor
Drugs ( alcohol, marijuana , heroin, antiretroviral therapy , anabolic steroids )

78
Q

Are male breast cancer common

A

Rare , 1%

79
Q

Is Gynecomastia a risk factor for Male breast cancer

A

No

80
Q

Breast lesions presentation

A 
Breast mass
Nipple discharge 
Eczema 
Peau d’orange (Invasive ca , Inflammatory ca )
Nipple retraction

Reproductive (14 decks)

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