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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
3 predictive markers
these predict response to specific tx and consequently are suggestive of prognosis --> estrogen receptor, progesterone receptor, HER2/neu over expression amplification
26
HER2/neu predicts response to ___
herceptin
27
Predilection for breast cancer in men
klinefelter
28
What kind of cancer do men get in the breast?
ductal carcinoma only
29
Clinical manifestations of fibrocystic changes
cyclic pain, tenderness, palpable mass, abnormal mammogram, mass/calcifications
30
Progression of non-proliferative fibrocystic change
fibrosis --> cyst formation--> adenosis (increased acini/lobule) --> benign apocrine metaplasia
31
Increasing acini/terminal duct accompanied by fibrosis is called ____ which is a type of ____ fibrocystic change
sclerosis adenosis --> proliferative fibrocystic change
32
Usual duct hyperplasia is a type of ____ fibrocystic change
proliferative fibrocystic change
33
Atypical duct hyperplasia is a type of ____ fibrocystic change
borderline lesion --> proliferative fibrocystic change
34
Atypical lobular hyperplasia is a type of ____ fibrocystic change
borderline lesion --> proliferative fibrocystic change
35
T/F Mild usual ductal hyperplasia is associated with increased risk of breast cancer
F
36
T/F nonproliferative fibrocystic change is associated with mildly increased risk of breast cancer
F
37
T/F Moderate usual ductal hyperplasia is associated with mildly increased risk of breast cancer
T
38
T/F sclerosing adenosis is associated with reduced risk of breast cancer
F --> mildly increased
39
T/F Atypical ductal/lobular hyperplasia is associated with mildly increased risk of breast cancer
F ---> moderately increased risk
40
T/F Atypical ductal/lobular hyperplasia with a family hx of breast cancer is associated with moderately increased risk of breast cancer
F --> highly increased risk
41
3 benign tumors of breast
2 fibroepithelial tumors = fibroadenoma and phyllodes tumor + 1 epithelial = intraductal papilloma
42
T/F fibroadenoma is always benign
T
43
T/F Phyllodes tumor is always benign
F --> almost always
44
Key features of fibroadenoma
most common benign breast tumor, reproductive years, solitary/multiple/bilateral, excision always curative
45
T/F fibroadenoma has no breast cancer risk
T
46
Key features of phyllodes tumor
not common, reproductive years, solitary
47
Histologic features of phyllodes tumor
invasive border, high cell density
48
Intraductal papilloma
large duct lesion can be associated with nipple discharge/bleeding
49
T/F intraductal papilloma has no breast cancer risk
T
50
2 common sources of breast inflammation
postpartum infection and traumatic fat necrosis
51
post partum infections of breast are often caused by ____ and ___ and result in ____ inflammation
s. aureus and strep --> acute suppurative inflammation
52
traumatic fat necrosis involves ____ inflammation
granulomatous
53
____ is caused by relative estrogen excess in men
gynecomastia --> not precancerous
54
T/F gynecomastia increases breast cancer risk in men
F
55
Male breasts have ___ but no ___
have ducts but no lobules
56
Histology of gynecomastia
myofibroblasts producing lots of collagen around ducts

NRP511 (23 decks)

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