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NRP511 > Pathology of Breast > Flashcards

Pathology of Breast Flashcards

1
Q

8 Major breast cancer risk factors

A

female, >50 yrs, geography, family hx, fibrocystic change, prior breast/gyn cancer, radiation, unopposed estrogen

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2
Q

2 main forms of breast carcinoma

A

insitu (CIS) and invasive

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3
Q

2 main forms of CIS

A

ductal and lobular

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4
Q

Key features of CIS

A

microscopic, CIS cells proliferate in position, lacks capacity to spread (contained by basement membrane), benign-acting

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5
Q

Which breast carcinoma acts like a benign carcinoma

A

DCIS (Ductus carcinoma in situ)

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6
Q

T/F DCIS is always curable if treated

A

T

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7
Q

____ is a non-obligate precursor of invasive breast carcinoma

A

DCIS

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8
Q

Screening for DCIS would reveal ____

A

cluster of calcifications –> product of calcified necrosis

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9
Q

Calcification of tissues due to local acid/base changes e.g. from necrosis

A

dystrophic

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10
Q

Malignant DCIS vs Normal DCIS

A

enlarged cells, high NC ratio, nucleoli, mitoses

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11
Q

Which is more common? DCIS v LCIS (lobular carcinoma in situ)

A

DCIS = 80% vs LCIS = 20%

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12
Q

Key features of LCIS

A

microscopic, proliferate in position, BUT incidental finding –> no mass/calcification

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13
Q

T/F : LCIS is screenable

A

F –> incidental finding

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14
Q

Malignant features of LCIS

A

lack of cohesion, signet ring cells

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15
Q

T/F LCIS is benign acting

A

T

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16
Q

T/F LCIS is easy to excise

A

F –> hard to identify a singular mass

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17
Q

Tx of LCIS

A

watch and wait + sometimes tamoxifen (Anti estrogen to prevent malignant transformation)

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18
Q

Clinical presentation of invasive breast cancer

A

Mass on mammogram

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19
Q

Key features of invasive breast cancer

A

no longer in situ, can spread past basement membrane, potentially lethal

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20
Q

Paget disease of nipple

A

clinical finding involving crusting and ulceration due to surface DCIS or migration of breast carcinoma to nipple epidermis (transformation of ductal to squamous epithelium) –> paget cells

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21
Q

Inflammatory breast carcinoma

A

reddened skin on breast, evolving rapidly, virulent form of breast cancer –> carcinoma in dermal lymphatics

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22
Q

Why does skin redden in inflammatory breast carcinoma

A

unknown –> but not due to actual inflammation

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23
Q

linear infiltration pattern

A

invasive lobular carcinoma –> no glands, etc; just a linear progression of cancer cells

24
Q

Breast cancer stage classifying features

A

TNM = tumor stage, lymph node status, metastasis –> 0 - IV

25
Q

3 predictive markers

A

these predict response to specific tx and consequently are suggestive of prognosis –> estrogen receptor, progesterone receptor, HER2/neu over expression amplification

26
Q

HER2/neu predicts response to ___

A

herceptin

27
Q

Predilection for breast cancer in men

A

klinefelter

28
Q

What kind of cancer do men get in the breast?

A

ductal carcinoma only

29
Q

Clinical manifestations of fibrocystic changes

A

cyclic pain, tenderness, palpable mass, abnormal mammogram, mass/calcifications

30
Q

Progression of non-proliferative fibrocystic change

A

fibrosis –> cyst formation–> adenosis (increased acini/lobule) –> benign apocrine metaplasia

31
Q

Increasing acini/terminal duct accompanied by fibrosis is called ____ which is a type of ____ fibrocystic change

A

sclerosis adenosis –> proliferative fibrocystic change

32
Q

Usual duct hyperplasia is a type of ____ fibrocystic change

A

proliferative fibrocystic change

33
Q

Atypical duct hyperplasia is a type of ____ fibrocystic change

A

borderline lesion –> proliferative fibrocystic change

34
Q

Atypical lobular hyperplasia is a type of ____ fibrocystic change

A

borderline lesion –> proliferative fibrocystic change

35
Q

T/F Mild usual ductal hyperplasia is associated with increased risk of breast cancer

A

F

36
Q

T/F nonproliferative fibrocystic change is associated with mildly increased risk of breast cancer

A

F

37
Q

T/F Moderate usual ductal hyperplasia is associated with mildly increased risk of breast cancer

A

T

38
Q

T/F sclerosing adenosis is associated with reduced risk of breast cancer

A

F –> mildly increased

39
Q

T/F Atypical ductal/lobular hyperplasia is associated with mildly increased risk of breast cancer

A

F —> moderately increased risk

40
Q

T/F Atypical ductal/lobular hyperplasia with a family hx of breast cancer is associated with moderately increased risk of breast cancer

A

F –> highly increased risk

41
Q

3 benign tumors of breast

A

2 fibroepithelial tumors = fibroadenoma and phyllodes tumor + 1 epithelial = intraductal papilloma

42
Q

T/F fibroadenoma is always benign

A

T

43
Q

T/F Phyllodes tumor is always benign

A

F –> almost always

44
Q

Key features of fibroadenoma

A

most common benign breast tumor, reproductive years, solitary/multiple/bilateral, excision always curative

45
Q

T/F fibroadenoma has no breast cancer risk

A

T

46
Q

Key features of phyllodes tumor

A

not common, reproductive years, solitary

47
Q

Histologic features of phyllodes tumor

A

invasive border, high cell density

48
Q

Intraductal papilloma

A

large duct lesion can be associated with nipple discharge/bleeding

49
Q

T/F intraductal papilloma has no breast cancer risk

A

T

50
Q

2 common sources of breast inflammation

A

postpartum infection and traumatic fat necrosis

51
Q

post partum infections of breast are often caused by ____ and ___ and result in ____ inflammation

A

s. aureus and strep –> acute suppurative inflammation

52
Q

traumatic fat necrosis involves ____ inflammation

A

granulomatous

53
Q

____ is caused by relative estrogen excess in men

A

gynecomastia –> not precancerous

54
Q

T/F gynecomastia increases breast cancer risk in men

A

F

55
Q

Male breasts have ___ but no ___

A

have ducts but no lobules

56
Q

Histology of gynecomastia

A

myofibroblasts producing lots of collagen around ducts

NRP511 (23 decks)

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