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Path III Final > Final Breast > Flashcards

Final Breast Flashcards

1
Q

what cells line lactiferous ducts and lobules?

A

luminal epithelial cells

myoepithelial cells

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2
Q

What do luminal epithelial cells do?

A

produce milk

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3
Q

What do myoepithelial cells do?

A
  • assist in milk ejection during lactation

- maintain normal structure/function of lobule and basement membrane

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4
Q

What are the top 3 infectious bacteria that enter through cracks and fissures in the nipple?

A 
#1 Staph aureus
#2 Staph epidermitis
#3 Strep epidermitis
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5
Q

Peri-ductal mastitis is associated with what RF?

A

Tobacco smoking

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6
Q

What is galactorrhea?

A

appearance of milk in non-pregnant, non-breastfeeding female or in a male.

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7
Q

Mammary duct ectasia is characterized by what histological finding?

A

Lipid laden macrophages in the lactiferous ducts

- foamy histiocytes also found in fat necrosis

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8
Q

Where are fibrocystic breast changes most commonly found?

A

Upper outer quadrant (just like malignancy)

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9
Q

Stromal fibrosis and peri-ductal lymph infiltrate indicate what?

A

lymphocytic mastopathy: WBC surrounded by fibrotic stromal tissue

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10
Q

hist of fibroadenoma

A

well encapsulated

no nuclear atypia

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11
Q

hist of lactating adenoma

A

hyperplastic lobules with marked cytoplasmic vacuolization

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12
Q

duct cells become flattened and nuclei appear next to luminal surface as flattened, dark staining nuclei, lining up in medial ductal facing surface in what lesions?

A

intraductal papilloma

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13
Q

What is the most common type of breast CA?

A

infiltrating ductal carcinoma (80% of all breast CA)

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14
Q

What are characteristics of infiltrating ductal carcinoma?

A

not movable on exam
irregular borders
hard

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15
Q

what type of breast cancer has signet ring appearance?

A

lobular carcinoma

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16
Q

What to Paget cells look like?

A

large, round cels with pale cytoplasm and pleomorphic nuclei seen in epidermis

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17
Q

What cells are affected by Paget cells?

A

Only nipple cells, the other cells are normal

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18
Q

What are the 3 main types of breast CA?

A

Ductal (intraductal is the same thing)
Lobular
Nipple (also called Paget’s disease)

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19
Q

What is hist of ductal cells compared to myoepithelial cells?

A

ductal cells: dark staining and concentric

myoepithelial cells: lighter staining and surround ductal epithelium

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20
Q

What is amastia?

A

congenital condition where breast tissue, nipple, and areola are absent

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21
Q

What is amazia?

A

congenital condition where mammary gland tissue is absent, but nipple and areola are present

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22
Q

What is athelia?

A

presence of glandular tissue with no nipple or areola

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23
Q

Where are supernumerary nipples usually found?

A

usually along milk line, but rarely can be found beyond mammary line

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24
Q

what are some causes of galactorrhea

A

excessive stimulation
hormonal dysregulation
medication side effect
underlying malignancy (30% of women > 60yo)

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25
Mastitis
inflammation of parenchyma of mammary gland
26
etiology of mastitis?
inflammatory or infectious
27
What are top 3 bacteria that cause infectious mastitis?
``` #1 staph areus #2 staph epidermitis #3 strep epidermitis ```
28
puerperal mastitis
during pregnancy or right after
29
what pt population is more likely to get peri-ductal mastitis?
Smokers (90% of pt are smokers)
30
histology of periductal mastitis
keritinizing squamous epithelium in the duct system of the nipple that extends to abnormal depth
31
what can lead to dilation and rupture of ducts involved in periductal mastitis?
chronic granulomatous inflammatory response
32
Mammary duct ectasia
dilation of sub-areolar ducts
33
what is pt pop for mammary duct ectasia?
multiparous women in 50s and 60s
34
hist of mammary duct ectasia
dilated lactiferous ducts filled with granular debris including foamy lipid laden macrophages
35
What is the #1 most common disorder of the breast?
fibrocystic breast disease
36
fibrocystic breast disease
fibrous lumps and cords in breast tissue that are non-cancerous
37
what percentage of women are affected by fibrocystic breast disease?
30-60% | usually 20-40 yo
38
hist of fibrocystic breast disease?
fibrocystic changes: broad areas of pink dense CT fibers increased size of ducts exhibit adenosis (full of apocrine glands on surface) multilayering of ductal cells
39
What is hist diagnosis of fibrocystic breast disease?
multilayering of ductal cells or in-growth of ductal cells towards center of duct *may require biopsy or aspiration to dx from CA
40
pathophysiology of fat necrosis
rupture of adipocytes and hemorrhage from broken blood vessels into traumatized area - fat undergoes lipolysis -> FA -> glycerol - fibroblastic proliferation walls off area from surrounding tissue
41
hist of fat necrosis
- calcification and hemosiderin deposition occur in affected area - irregular fatty spaces surrounded by foamy histiocytes and multinucleate giant cells
42
gross morphology of fat necrosis
``` mass painless overlying skin thickening tissue retraction may look like neoplasm ```
43
What does mammography reveal in fat necrosis?
central radiolucent area of fat with increased density, calcifications, and hemosiderin deposition
44
what would be a better and worse prognosis found on mammography in fat necrosis?
smooth calcifications = better | spicules/pop corn shape = worse
45
lymphocytic mastopathy
single or multiple hard masses composed of collagenized stroma surrounding atrophic ducts and lobules
46
what pt gets lymphocytic mastopathy?
women with DM1 or autoimmune thyroiditis
47
hist of lymphocytic mastopathy?
- thickening and fibrosis of stromal tissue | - lymph infiltrates that surround epithelium of blood vessels
48
How do you dx lymphocytic mastopathy?
core needle biopsy reveals dense stromal fibrosis and peri-ductal lymphocytic infiltration *nests of cells around ducts
49
Granulomatous mastopathy
uncommon form of mastitis characterized by presence of granulomas formed by epithelia cells and giant cells
50
What is etiology of granulomatous mastopathy?
idiopathic but possibly TB, sarcoidosis, Wegeners granulomatosis
51
Adenosis
- increased number of glands | - no cancerous changes
52
what is most common benign tumor of breast?
fibroadenoma
53
hist of fibroadenoma?
well encapsulated at low magnification hyperplasia of intraductal epithelial cells increase in number of glands
54
seq of fibroadenoma?
benign mass, but slight increase in risk for carcinoma
55
hist of lactating adenoma
hyperplastic lobules with marked cytoplasmic vacuolization
56
hist of intraductal papilloma
myoepithelial cells and multi-layered duct cells | duct cells become flattened and nuclei line up
57
where do majority of breast CA originate?
``` glandular tissue (adenocarcinoma) - this includes lobular and ductal tissue ```
58
What pop has higher prevalence of BRCA1 mutation?
Ashkenazi Jews
59
What proto-oncogene is amplified in 30% of breast cancers?
HER2/neu gene
60
What is number one type of breast cancer
infiltrating ductal carcinoma (80%)
61
#2 type of breast CA?
lobular carcinoma (5-10%)
62
hist of lobular carcinoma
signet ring: nuclei pushed to side affects only lobular portion increased vacuolated area
63
Pagets disease of the breast
uncommon | eczematous changes overlying nipple and areola
64
hist of pagets disease
paget cells: large, round cells with pale cytoplasm and pleomorphic nuclei in epidermis - only nipple cells affected
65
Inflammatory breast cancer
form of ductal carcinoma distinguished by inflamed appearance of breast - very aggressive and highly recurrent - can present with no lump - feels warm - peau de orange

Path III Final (6 decks)

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