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Pathology > Pathology of the Breast > Flashcards

Pathology of the Breast Flashcards

1
Q

What is the most common cancer in females?

A

Breast

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2
Q

What are the 2 cells layers that line the ducts and lobules of the breast?

A
  • Epithelium

- Myoepithelium

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3
Q

What are the 3 tissues that make up the breast?

A
  • Fat
  • Stroma
  • Epithelium
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4
Q

What changes occur in breast tissue as patients age?

A

Less lobules with stroma replaced by adipose tissue

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5
Q

What are common reasons of breast pathology for patient clinic visits?

A
  • Palpable Mass
  • Mammogram Lesion
  • Nipple Discharge
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6
Q

Acute Mastitis

A

Occurs during lactation due to skin breaks with S. aureus as the most common cause

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7
Q

Fat Necrosis of Breast

A

Generally due to trauma but can be due to surgery or radiation

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8
Q

What is a possible risk of fat necrosis?

A

Confusion with cancer even on x-ray

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9
Q

What is the most common breast disorder?

A

Non-proliferative fibrocystic changes

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10
Q

What are examples of stroll lesions without atypia?

A
  • Fibroadenoma

- Phyllodes Tumor

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11
Q

Fibroadenoma

A

Most common benign tumor, usually small with well-circumscribed borders and occurs during reproductive life around less than 30 yrs

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12
Q

What happens to fibroadenomas with age?

A

Calcifications grow and the glands decrease

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13
Q

Phyllodes Tumor

A

More common in older patients - 60s - and are larger than fibroadenomas with leaflike shape and are not well defined
- Most are benign but they can be malignant

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14
Q

Most common cause of bloody nipple discharge in younger women

A

Intraductal Papilloma

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15
Q

Intraductal Papilloma

A

Multiple branching fibrovascular cores, each having a connective tissue axis lined by luminal and myoepithelial cells.

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16
Q

Atypical Duct Hyperplasia

A

Expansion of ductal cells

17
Q

Atypical Lobar Hyperplasia

A

Expansion of terminal duct lobar units

18
Q

Where do most breast carcinomas arise?

A

Upper Outer Quadrant

19
Q

What are some risk factors for breast cancer?

A
  • Age
  •  Female gender
  •  Family history of breast cancer
  •  Genetic predisposition
  •  Prior personal history of breast cancer
  •  Increased estrogen exposure
20
Q

Do OCPs increase the risk of breast cancer?

21
Q

What type of breast carcinoma in situ is more common?

A

Ductal Carcinoma In Situ

22
Q

What type of invasive breast carcinoma is more common?

A

Invasive Ductal Carcinoma

23
Q

What breast is at risk of cancer with lobar carcinoma in situ?

A

Both breasts

24
Q

What breast is at risk of cancer with ductal carcinoma in situ?

A

Only the ipsilateral breast

25
Q

Paget Disease

A

Rare manifestation of breast cancer- DCIS arising within ductal system of the breast can extend up the lactiferous ducts into nipple skin without crossing the BM

26
Q

What will be seen in Paget disease?

A

A scaly crust on the skin surface and histology will show Paget cells in the epidermis

27
Q

What are some features that indicate increased likelihood of BRCA mutations?

A
  •  Multiple cases of early onset breast cancer
  • Ovarian cancer
  • Breast and ovarian cancer in the same woman
  • Bilateral breast cancer
  • Male breast cancer
28
Q

What is the function of BRCA1/2?

A

They are tumor suppressor genes

29
Q

What are risk factors for male breast cancer?

A
  • 1st degree family with breast cancer
  • Testicular dysfunction
  • Obesity

***Gynecomastia is NOT a risk

30
Q

What will be seen on histology of gynecomastia?

A
  • micropapillary hyperplasia of ductal lining

- periductal lymphocytic infiltrate

31
Q

A 34 year old female presents with a 4 cm palpable mass in her left breast. A mammogram reveals a speculated mass, a core biopsy is performed and a diagnosis of Invasive Ductal Carcinoma, Nottingham Grade III, Basal Like Type.

 This patient most likely has a mutation of the following gene:
 BRCA2
 BCR/ABL
 PTEN
 BRCA1

In what chromosome is this gene located:
1  10  17  22 X

A

BRCA1 on Ch17

32
Q

What do basal-like type invasive ductal carcinomas have as their gene profile?

A

ER- PR- and HER2-

33
Q 
What is the most common cause of bloody nipple discharge:
 Intraductal papilloma
 Paget’s disease
 Fibroadenoma
 Invasive ductal carcinoma
A

Intraductal papilloma

34
Q 
Of the following breast carcinomas which is the one with the best prognosis
 Fibroadenoma
 Phyllodes tumor
 Tubular carcinoma
 Metaplastic carcinoma
 Invasive ductal carcinoma
A

Tubular carcinoma

35
Q

 What is the most common breast pathology in men:  Invasive lobular carcinoma
 Invasive ductal carcinoma
 Gynecomastia
 Chronic mastitis
 Granulomatous mastitis  Infectious mastitis

A

Gynecomastia

36
Q 
What is the most common location for breast carcinoma in males?
 Upper outer quadrant
 Retroareolar
 Lower outer quadrant 
 Lower inner quadrant
A

Retroareolar

37
Q

What are the 2 most important prognostic factors in breast cancer:
 Laterality and histologic grade
 Size and histologic grade
 Histologic grade and lymph node metastasis
 Lymph node metastasis and size
 Size and resistance

A

Lymph node metastasis and size

Pathology (203 decks)

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