Malignant and Premalignant Breast Lesions

Question 1

Paget disease of the breast Etiology

Answer 1

Migration of neoplastic

ductal epithelial cells to nipple

Question 2

Paget disease of the breast Physical findings

Answer 2

Scaly, vesicular, ulcerated lesion +/– bloody nipple discharge

Question 3

Paget disease of the breast Diagnosis. Asociations

Answer 3

Bilateral mammogram
Wedge or punch biopsy
Underlying breast cancer in
85% of cases

Question 4

Paget disease of the breast Management

Answer 4

Simple mastectomy

Breast conservation surgery in select cases

Question 5

Phyllodes tumor Etiology

Answer 5

Papillary projections of epitheliallined stroma with varying degrees of hyperplasia and atypia

Question 6

Phyllodes tumor Physical

findings

Answer 6

Smooth mobile rapidly growing breast mass or abnormal radiographic findings

Question 7

Phyllodes tumorDiagnosis

Answer 7

Ultrasound
Core needle
biopsy

Question 8

Phyllodes tumor Management

Answer 8

Excision

Question 9

Lobular carcinoma in situ (LCIS) Etiology

Answer 9

Atypical proliferation within terminal duct lobules

Question 10

Lobular carcinoma in situ (LCIS) Physical findings

Answer 10

Usually an incidental finding diagnosed on breast biopsy performed for another reason

Question 11

Lobular carcinoma in situ (LCIS) Dx

Answer 11

Core biopsy

Question 12

Lobular carcinoma in situ (LCIS) Management

Answer 12

Surgical

excision

Question 13

Ductal carcinoma in situ (DCIS) Etiology

Answer 13

Proliferation of neoplastic epithelial cells within mammary ducts without stromal invasion

Question 14

Ductal carcinoma in situ (DCIS) Physical findings

Answer 14

Suspicious microcalcifications on mammography

Question 15

Ductal carcinoma in situ (DCIS) Diagnosis

Answer 15

Core biopsy

Question 16

Ductal carcinoma in situ (DCIS) Management

Answer 16

Lumpectomy with radiation therapy OR mastectomy

Question 17

Lobular carcinoma Etiology

Answer 17

Invasion of neoplastic cells into mammary stroma and adipose in a single-file pattern

Question 18

Lobular carcinoma Physical findings

Answer 18

Hard, immovable, single dominant lesion with irregular borders

Question 19

Lobular carcinoma Diagnosis

Answer 19

Mammogram

Core biopsy

Question 20

Lobular carcinoma Management

Answer 20

Surgery
+/– radiation therapy
+/– chemotherapy

Question 21

Ductal carcinoma Etiology

Answer 21

Nests of tumor cells within

glandular tissue

Question 22

Ductal carcinoma Physical

findings Diagnosis Management

Answer 22

Same as Lobular CA..?