Path Breast

Question 1

Periductal Mastitis

- A/S

Answer 1

• A/s: smoking, piercings, inversion

Question 2

LActational abcess

• eti
• s/s

Answer 2

• eti: staph aur

- s/s: pain, fever, chills; currently breast feeding

Question 3

Fat Necrosis of breast

- s/s

Answer 3

• s/s: painless palpable mass; skin thickening/retraction; densities on mammogram; Hx trauma/Sx

Question 4

intraductal papilloma

Answer 4

• rarely exceed 3 cm
• soft/fragile w/ areas of hemorrhage
• nipple discharge

Question 5

Firbocystic changes/ fibrocystic breast disease S/S

Answer 5

• swollen, painful, thick/lumpy breast w/ or w/out discharge which INC w/ menstrual cycle

Question 6

Fibroadenoma

Answer 6

• well-defined grey, rubbery, mobile, glandular/stromal tumor
• FNA taken if >2cm or exhibiting growth

Question 7

Phallodes Tumor

Answer 7

• f/ intralobular stroma
• rarely metastasize
• Only stromal components metastasize w/ high grade lesions
• “leaf-like” architecture

Question 8

DCIS general characteristics

Answer 8

• involves lobules; spread via ductal system
• myoepithelium preserved
• Almost always ID by mammogram due to calcification

Question 9

DCIS subtypes

Answer 9

• Comedo: vague nodulatiory; Pleomorphic w/ areas of central necrosis
• Noncomedo: lacks high grade nuclei/central necrosis; “cookie-cutter” like spaces

Question 10

LCIS General

Answer 10

• Discohesive fashion of growth in ducts/lobules; lobular architexture preserved
• Mammogram densities absent
• Bilateral is more common (20-40%)
• Does NOT involve Nipple skin
• almost always express ER/PR

Question 11

Invasive Carcinoma subtypes

Answer 11

1. ER + HER2 -
2. HER-2 +
3. ER - HER2 -

Question 12

ER + HER2 - ICA Subtypes

Answer 12

LoPro: Most common; Older women; late metastasis; Tx hormone

HiPro: A/s BRCA2; Tx Chemo

Question 13

Her2 + ICA

Answer 13

• Young nonwhite women

- Metastasize early to viscera/brain + small in size

Question 14

ER - HER2 - ICA

Answer 14

• BRCA1 a/s
• young premenopausal women; rapid growth palpable mass
• Prolonged survival rare after distant metastasis