Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

ABBEY MSII Unit 1 > Pathoma breast. > Flashcards

Pathoma breast. Flashcards

1
Q

What is breast tissue derived from?

A

skin (modified sweat gland)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the functional unit of the breast?

A

terminal duct lobular unit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are lobules and ducts lined by?

A

two layers of epithelium: luminal cell layer (inner cell layer responsible for milk production) and myoepithelial layer (outer cell layer; contractile function)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What supports the fact that breast tissue is hormone sensitive?

A
  1. before puberty, breast tissue is primarily large ducts under nipple 2. development after menarche is primarily driven by estrogen and progesterone 3. breast tenderness during menstrual cycle 4. breast lobules undergo hyperplasia during pregnancy 5. after menopause, atrophy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Where is breast tissue in highest density?

A

upper outer quadrant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is galactorrhea?

A

milk production outside of lactation (NOT a symptom of breast cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are causes of galactorrhea?

A

nipple stimulation, prolactinoma of the anterior pituitary, drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is acute mastitis?

A

bacterial infection of the breast usually due to staph aureus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is acute mastitis typically associated with?

A

breast feeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How does acute mastitis typically present?

A

purulent nipple discharge and may progress to abscess formation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Acute mastitis treatment

A

continued drainage and antibiotics (dicloxacillin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is periductal mastitis?

A

inflammation of the subareolar ducts due to vitamin a deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Who is periductal mastitis usually seen in?

A

smokers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What does vitamin A deficiency cause?

A

highly specialized epithelial cells require vitamin A - in breast, this causes switch from columnar to squamous metaplasia of lactiferous ducts producing duct blockage and inflammation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How does periductal mastitis typically present?

A

subareolar mass with nipple retraction (because of fibrosis - myoepithelial cells contract because of myofibroblasts pulling skin in)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is mammary duct ectasia?

A

inflammation with dilation (ectasia) of the subareolar ducts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are characteristic signs in mammary duct ectasia?

A

periareolar mass with GREEN-BROWN nipple discharge (inflammatory debris) and plasma cells seen on biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is fat necrosis?

A

necrosis of breast fat usually related to trauma - presents as mass or calcification on mammography

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is characteristic of fat necrosis?

A

biopsy showing necrotic fat with associated calcification and GIANT CELLS**

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is a fibrocystic change?

A

development of fibrosis and cysts in the breast

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

How does fibrocystic change present?

A

“lumpy breast”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How do cysts appear in fibrocystic changes?

A

blue-dome appearance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Are fibrocystic changes cancerous?

A

no benign - some can be associated with an increased risk for invasive carcinoma (risk applies to both breasts)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

fibrosis, cysts, and apocrine metaplasia

A

NO INCREASED RISK for breast cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

ductal hyperplasia and sclerosing adenosis

A

2x increased risk for cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

atypical hyperplasia

A

5x increased risk for cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is an intraductal papilloma?

A

papillary growth (fingerlike growth with blood vessel in core) - usually in large duct

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is an intraductal papilloma characterized by?

A

both epithelial and myoepithelial cells and presents as bloody nipple discharge in a premenopausal woman

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What presents as bloody nipple discharge?

A

papillary carcinoma and intraductal papilloma

30
Q

How can you tell the difference between papillary carcinoma and intraductal papilloma?

A

papillary carcinoma has no myoepithelial cells and is more commonly seen in postmenopausal women

31
Q

What is fibroadenoma?

A

tumor of fibrous tissue and glands - most common BENIGN neoplasm of the breast (no increased risk for cancer)

32
Q

How does fibroadenoma present? In who?

A

well-circumscribed, mobile marble-like mass (distinct from the rest of the breast) in premenopausal women

33
Q

What is fibroadenoma sensitive to?

A

estrogen

34
Q

What is phyllodes tumor?

A

fibroadenoma-like tumor with overgrowth of the fibrous component

35
Q

What is characteristic of a phyllodes tumor?

A

leaf-like projections

36
Q

Who is phyllodes tumor most commonly seen in?

A

post-menopausal women - so there is an increased risk of cancer

37
Q

What are the 6 risk factors for breast cancer?

A
  1. female 2. age (usually postmenopausal women) 3. early menarche/late menopause 4. obesity 5. atypical hyperplasia 6. first degree relative basically anything that gives an excess of estrogen (plus cancer genes)*
38
Q

What is DCIS?

A

ductal carcinoma in situ: malignant proliferation of cells in ducts with no invasion of the basement membrane

39
Q

How is DCIS detected?

A

does not usually produce a mass - detected as calcification on mammography

40
Q

What can calcifications be associated with?

A

DCIS, fibrocystic changes - esp sclerosing adenosis (benign), and fat necrosis

41
Q

How do you tell the difference between a malignant and benign calcification?

A

biopsy

42
Q

What is comedo type of DCIS?

A

high-grade cells with necrosis and dystrophic calcification in the center of ducts

43
Q

What is paget disease?

A

DCIS that extends up the ducts to involve the skin of the nipple (presents as nipple ulceration and erythema) - almost always associated with underlying carcinoma

44
Q

What is invasive ductal carcinoma?

A

invasive carcinoma that forms duct-like structures

45
Q

What is the most common type of invasive carcinoma (of the breast)

A

invasive DUCTAL carcinoma

46
Q

How does invasive ductal carcinoma present?

A

a mass detected by physical exam or mammography - sometimes have dimpling of skin or retraction of nipple (which also happens as a result of inflammatory cause)

47
Q

What does biopsy of invasive ductal carcinoma reveal?

A

duct-like structures in a desmoplastic stroma (has connective tissue growing with the tumor)

48
Q

Tubular carcinoma

A

form of invasive ductal carcinoma - well-differentiated tubules lacking my epithelial cells - good prognosis

49
Q

Mucinous carcinoma

A

form of invasive ductal carcinoma - abundant extracellular mucin “tumor cells floating in a mucus pool” - good prognosis (cells are stuck in mucus and can’t move)

50
Q

Medullary carcinoma

A

form of invasive ductal carcinoma - large, high-grade cells growing in sheets with lymphocytes and plasma cells - good prognosis - well-circumscribed mass

51
Q

Inflammatory carcinoma

A

form of invasive ductal carcinoma - in dermal lymphatics - presents as inflamed, swollen breast because tumor cells block drainage - no discrete mass - poor prognosis

52
Q

Which of the invasive ductal carcinomas has increased incidence in BRCA1 carriers?

A

medullary carcinoma

53
Q

Which invasive ductal carcinoma can be mistaken for acute mastitis?

A

inflammatory carcinoma - it is important to have woman checked again 5-10 days after treating her with antibiotics for acute mastitis

54
Q

Lobular carcinoma in situ

A

malignant proliferation of cells in lobules with no invasion of the basement membrane - does no produce mass or calcifications

55
Q

How is lobular carcinoma in situ usually discovered?

A

incidentally on biopsy

56
Q

How is lobular carcinoma characterized?

A

dyscohesive cells lacking E-cadherin adhesion protein

57
Q

Which carcinoma is often multifocal and bilateral?

A

lobular carcinoma in situ

58
Q

How is lobular carcinoma in situ treated?

A

tamoxifen (reduce risk of subsequent carcinoma) and close follow up

59
Q

Invasive lobular carcinoma

A

invasive carcinoma that characteristically grows in a single-file pattern

60
Q

Why does invasive lobular carcinoma not form ducts?

A

no E-cadherin

61
Q

How is breast cancer staged?

A

TNM - tumor size, metastasis to lymph nodes, distant metastasis

62
Q

What is the most useful prognostic factor?

A

spread to axillary lymph nodes

63
Q

What is used to assess axillary lymph nodes?

A

sentinel lymph node biopsy

64
Q

What factors are predictive for response to treatment?

A

estrogen receptor (ER), progesterone receptor (PR) and HER2/neu gene amplification(overexpression) status

65
Q

HER2/neu amplification is associated with what?

A

response to trastuzumab - designer antibody directed against the HER2 receptor

66
Q

Who has an increased propensity to develop triple-negative carcinoma? (ER-, PR-, HER2/neu - )

A

african american women

67
Q

What is BRCA1 associated with?

A

breast and ovarian carcinomas

68
Q

What is BRCA2 associated with?

A

breast carcinoma in males

69
Q

How does breast cancer typically present in males?

A

subareolar mass in older males, may produce nipple discharge

70
Q

What is the most common histological subtype of breast cancer in males?

A

invasive ductal carcinoma (no lobules in males - mostly ducts)

ABBEY MSII Unit 1 (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions