Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

DERS (reproductive) > L31- Breast Pathology I > Flashcards

L31- Breast Pathology I Flashcards

1
Q

Breast Development:

  • (1) status at birth
  • (2) occurs at menarche
A

1- not fully formed

2- terminal duct development + inc in interlobular stroma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

breast changes during menstrual cycle

A
  • quiescent in follicular phase

- vacuolization and edema in secretory phase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

breast changes during pregnancy, postpartum

A

Pregnancy- functional and mature development

Postpartum- incomplete regression + further involution after 30 y/o

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

breast changes during menopause

A
  • lobular atrophy

- interlobular stroma becomes fatty

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Breast Tissue, list the main structures: base, supportive structures, functional structures

A

Base: sits on Pectoralis Major muscle

Functional: lobules (+ extralobular, intralobular ducts) –> terminal ducts –> large duct

Support: intralobular and interlobular stroma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

describe structure and composition of breast lobule

A

(produces milk)

  • acinus is lined with cuboidal secretory cells
  • initial duct is lined with centroacinar cells
  • lobule leads into terminal duct
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

describe the layers of breast ducts (include functions)

A

(outside in)
-BM (basement membrane)

  • myoepithelial cells: assist in milk ejection during lactation + structural support to lobules
  • luminal epithelial cells: produces milk during lactation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

define these breast congenital anomalies:

  • (1) Polythelia
  • (2) Polymastia
  • (3) Amastia
  • (4) Inversion of nipple
A

1- accessory nipples, supernumerary nipples

2- accessory true mammary gland (can have same pathologies as normal breasts)

3- absence of breast

4- unilateral or bilateral, failure of nipple eversion – often mistaken for cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

name the congenital anomaly:

  • (1) absence of breast
  • (2) accessory mammary glands
  • (3) accessory nipples
  • (4) often mistaken for breast CA
A

1- amastia
2- polymastia
3- polythelia
4- inverted nipple

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

list the types of Breast clinical presentations

A

Lumps / Nodules: CAs, fibroadenoma, cysts

Pain (mastodynia): 95% are benign – infection, trauma, ruptured cyst, hormones

Discharge:

  • milky: pituitary adenoma, hypothyroidism, drugs
  • serous/bloody: papilloma, cyst, pregnancy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

list the breast symptoms by frequency (high to low)

A
  • lumpiness / ‘other symptoms’
  • pain (mastodynia)
  • palpable mass
  • nipple discharge
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

describe the most common clinical presentations of breast cancer (by symptom, high to low frequency)

A

Asymptomatic / Abnormal Mammogram
palpable mass
mastodynia
nipple discharge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what are the main breast investigations

A

(mainly imaging)
Mammogram: screening
-densities / calcifications (small, irregular, clustered –> worrisome) are breast cancer signs

  • US
  • MRI
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

list the many techniques for sampling breast specimen and processing samples

A
  • FNAC (fine-needle aspiration cytotology)
  • excision biopsies
  • Mastectomies (simple skin sparing, only areola-nipple complex)
  • Radical Mastectomy- includes Pec major muscles
  • Modified Radial Mastectomy: includes axillary LNs
  • Subcutaneous mastectomy (w/o skin, for men)
  • Prophylactic Mastectomy
  • Therapeutic Mastectomy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Galactocele, aka (1):

  • (2) definition
  • (3) symptoms
  • (4) complication
A

1- lacteal cyst, milk cyst

2- cystic dilatation after lactation b/c of obstructed duct during lactation

3- painful fluctuant lump (obstruction of lactiferous ducts)

4- infection- persistent induration / pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what are the DDx for clinical presentation of breast pain and tenderness

A

Inflammatory Disorders

  • acute mastitis (abscess)
  • mammary duct ectasia
  • traumatic fat necrosis
  • reaction to implants
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Acute Mastitis:

  • usually occurs during (1)
  • (2) is the brief mechanism
  • (3) general Sxs
  • (4) general Tx
A

1- breast feeding

2- cracks/fissure + infection (Staph. spp or Strep. spp)

3- red painful breast, fever

4- antibiotics, rarely surgical drainage

18
Q

describe the specific Sxs of acute mastitis depending on causal organism

A

Staph. spp: small, localized under nipple –> may leave indurated scar

Strep. spp.: whole breast, marked swelling and tenderness –> heals w/o scar

19
Q

Duct Ectasia:

  • aka (1)
  • commonly occurs during (2)
  • clinical presentation mimics (3)
A

1- plasma cell mastitis

2- 40-50 y/o around menopause

3- mimics carcinomas clinically and radiographically

20
Q

Duct Ectasia clinical presentation

A
  • peri-areolar mass
  • induration, thick greenish brown nipple discharge
  • skin/nipple retraction
21
Q

Duct Ectasia histological changes

A
  • Ducts are inspissated secretion, dilatation, rupture
  • chronic granulomatous inflammatory reaction
  • ducts are lined filled by granular debris, lipid laden macrophages
22
Q

Dust Ectasia pathogenesis:

  • (1) occurs first to elicit (2) response
  • (3) results from the (2) response
A

1- dilated duct rupture

2- inflammatory response –> plasma cells, lymphocytes, macrophages –> granulomas

3- large dilated distorted duct with large amounts of fibrosis with inflammatory cells

23
Q

Traumatic Fat Necrosis:

  • (1) causes / frequency of occurrence
  • (2) clinical presentation
  • (3) histological appearance
A

1- possible h/o trauma / breast surgery —- uncommon

2- painless, palpable mass with skin thickening / retraction (mimics carcinoma)

3- fat necrosis, cholesterol clefts, neutrophils, lipid laden macrophages —-> lymphocytes, fibrosis, cysts +/- calcifications

24
Q

Breast implants are made of (1), and (2) are the possible complications

A

1- paraffin, silicone

2- abscess, foreign body granuloma, fistula

25
Q

describe the grouping of epithelial breast lesions

A

(RR = relative risk)
1) non-proliferative = simple FCC (fibrocytic changes), RR = 1

2) proliferative disease w/o atypia, RR = 1.5-2

3) proliferative disease w/ atypia, RR = 4-5
- ADH (atypical ductal hyperplasia, ALH (atypical lobular hyperplasia)

26
Q

FCC:

  • mainly affects (1) age group, and affects (2)% of women
  • (3) clinical features
A

Firocystic Changes
1- reproductive age (may persist after menopause)
2- ~50%

3- lumpiness (lumpy bumpy), pain, tenderness: continuous or cyclical
-mammographic densities, calcifications

27
Q

FCC:

  • (1) pathogenesis
  • (2) morphology
  • (3) radiological appearance
A

Fibrocystic Changes
1- exaggerated / distorted cyclical changes, associated with changes in menstrual cycle

2- cysts, fibrosis, adenosis = blue dome ysts

3- Mammography: micocalcifications in concretions of secretions or necrotic epithelial cell heaps (mistaken for carcinoma)

28
Q

describe each of the histological changes seen in FCC

A

(Fibrocystic Changes)
Cystic:
-small cysts, formed from dilatation / unfolding of lobules
-unopened cyst with turbid / semi-translucent fluid –> brown/blue color –> Blue Dome Cyst
-lined with apocrine cells: round nuclei, abundant cytoplasm
-luminal calcifications –> forms secretory debris

Fibrosis: cystic rupture –> secretory material on adjacent stroma –> chronic inflammation + fibrosis (=> palpable breast firmness)

Adenosis: inc acini per lobule (usually occurs in pregnancy, focal change in adenosis)

29
Q

Proliferative breast disease w/o atypia:

  • (1) histological appearance
  • (2) mammographic appearance
  • (high/low) risk of carcinoma development
A

(aka radial scar or complex sclerosing lesion)
1:
-Epithelial Hyperplasia- inc number of luminal and myoepithelial cells
-inc acini containing double strands of cells
-hard rubbery mass on palpation

2- (usually incidental on mammography) densities, calcifications that mimic carcinoma

3- low

30
Q

Proliferative breast disease w/o atypia – Intraductal Papilloma:

  • arises from (1), and has (2) physical description
  • (3) describe large type
  • (4) describe small type
A

1- lumen of large duct
2- single, <1cm in size

3- solitary, situated in lactiferous sinuses of nipple, bloody discharge

4- multiple, deeper w/in ductal system

31
Q

Proliferative breast disease w/o atypia – Intraductal Papilloma: clinical presentation

A
  • small sub-areolar palpable masses, density, or calcification on mammogram
  • Nipple Discharge: serous/bloody discharge, nipple retraction
32
Q

Proliferative breast disease w/o atypia – Intraductal Papilloma: describe histological changes

A
  • delicate branching papillae in lumen
  • fibrovascular core
  • double layer of epithelial cells
  • NO atypia, mitosis

If multiple = recurrence and In risk of cancer
-management = excision of whole duct system

33
Q

list the Proliferative breast diseases w/ atypia

A

Atypical Ductal Hyperplasia

Atypical Lobular Hyperplasia (usually incidental finding)

34
Q

list the types of breast tumors

A

Stromal: fibroadenoma, phyllodes tumor

Intraductal papilloma and papillary carcinoma

Carcinoma

35
Q

(1) is the most common breast tumor, it is (benign/malignant). It is related to (3) as risk factors and is associated with (4).

A

1- fibroadenoma (stromal tumor)
2- benign
3- excess estrogen, prepubertal / young women, certain drugs (cyclosporin)
4- FCC (fibrocystic changes)

36
Q

Fibroadenoma clinical features

A

-single / multiple discrete, mobile, encapsulated nodules 1-10cm

  • may enlarge with menstration, pregnancy
  • may regress with menopause
  • large lobulated popcorn calcification
  • small clustered calcification on mammogram (requires biopsy to exclude CA)
37
Q

fibroadenoma development is closely associated with…..

A

(FCC) cysts larger than 0.3cm, sclerosing adenosis, epithelial calcification, papillary apocrine changes (complex fibroadenoma)

38
Q

describe the histological features of fibroadenoma

A
  • stromal cell tumor
  • loose edematous myxoid fibroblastic stroma + duct like epithelial lined spaces (cyst like)

i) Peri-canalicular: oval ducts surrounded by stroma
ii) Intra-canalicular: elongated, compressed, distorted ducts
iii) mixed pattern
Pattern => no clinical significance

39
Q

Phyllodes tumor = (1):

  • (2) size / location
  • mostly affects (3) age group
  • mostly (benign/malignant)
  • (5) Tx
A 
(stromal tumor of breast)
1- Cystosarcoma Phyllodes
2- few cm to massive lesion involving entire breast -- palpable mass usually
3- 40-60 y/o females
4- benign
5- wide local excision w/o LN dissection
40
Q

Phyllodes tumor histological features

A
  • lobulated, cut surface slits / cleft-leaf like
  • nuclear pleomorphisms, cellularity, mitotic rate, stromal overgrowth, infiltrative border

Majority low grade- local recurrence issues
Rare high grade- aggressive behavior w/ hematogenous metastasis / differentiation (rhabdomyosarcoma, liposarcoma)

41
Q

describe Phyllodes tumor types

A

Benign: zonal hypercellularity, mild atypia stromal cells, no stromal overgrowth, mitosis <5/HPF, pushing borders

Borderline: zonal hypercellularity, moderate atypia stromal cells, no stromal overgrowth, mitosis 5-10/HPF, pushing borders

Malignant: zonal hypercellularity, moderate atypia stromal cells, stromal overgrowth, mitosis >10/HPF, infiltrative borders

DERS (reproductive) (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions