Quiz 4: Breast Flashcards
What cells of the lobules and terminal ducts produce milk?
Luminal epithelial cells
What 2 types of cells are the lactiferous ducts lined by?
luminal epithelial cells, myoepithelial cells
What cells assist in milk ejection during lactation?
Myoepithelial cells
During menses, which hormone stimulates epithelial cell proliferation and promotes duct elongation and branching?
Estrogen
No breast tissue, nipple, or aureola
amastia
no mammary gland tissue, has nipple and aureola
amazia
no nipple or aureola, has mammary gland tissue
athelia
one or more additional nipples, usu on the milk line
supernumerary nipple
imaginary line extends bilaterally from axillae to the groin
milk line
ectopic breast tissue
supernumerary breast tissue (polymastia)
What causes inverted nipple?
fibrous bands of tissue that tether the nipple in an inverted position
spontaneous flow of milky nipple discharge that occurs in the absence of childbirth or lactation
galactorrhea
Inflammation of the parenchyma of the mammary gland
mastitis
mastitis of lactating women
puerperal mastitis
What 2 bacteria are most commonly associated with infectious mastitis?
Staph aureus and strep epidermis
painful mass in the sub areolar area with overlying skin erythema
peri ductal mastitis
keratinizing squamous epithelium in the duct system of the nipple with often extends to an abnormal depth. Chronic granulomatous inflammatory response. Dilation and rupture of involved ducts.
Peri ductal mastitis
dilation of the sub-areolar ducts. Widening of the lactiferous ducts that are filled with granular debris including lipid laden macs.
Mammary duct ectasia
What condition is characterized by accumulation of foamy macs beneath the luminal duct epithelium
Mammary duct ectasia
Non cancerous fibrous lumps and cords in breast tissue
fibrocystic breast dz
What is the most common disorder of the breast?
Fibrocystic Breast Disease
Where are the changes of fibrocystic breast dz most often found?
Upper outer quadrant
Characterized by irregular fatty spaces which are surrounded by foamy histocytes and multinucleated giant cells
Fat necrosis
a result of prior breast trauma or subsequent to surgery
fat necrosis
Results from the rupture of adipocytes and hemorrhage from broken blood vessels
fat necrosis
mammography reveals central radiolucent area of fat with inc density and/or presence of calcifications at the fat periphery
Fat necrosis
single or multiple hard masses made up of collagenized stroma surrounding atrophic ducts and lobules
lymphocytic mastopathy
Thickening and fibrosis of stromal tissue and lymphocytic infiltrates that surrounds the epithelium and blood vessels
Lymphocytic mastopathy
Most commonly found in women with type 1 diabetes mellitus and autoimmune thyroiditis
Lymphocytic mastopathy
Core needle biopsy specimen of a palpable nodule reveals dense stromal fibrosis and occasional peri-ductal lymphocytic infiltration.
lymphocytic mastopathy
Most common benign tumor of the breast
Fibroadenoma
Freely movable, well circumscribed mass with prominent fibrotic capsule
Fibroadenoma
Well encapsulated; notable hyperplasia of intraductal epithelial cells. Hyperplastic cells have no abnormalities in nuclear size, normal nucleus to cytoplasm ratio
Fibroadenoma
Localized focus of hyperplsatic cells in breast tissue during pregnancy
Lactating adenoma
Hyperplastic lobules with marked cytoplasmic vacuolization
lactating adenoma
Originates in the large ducts and is located centrally beneath the nipple
solitary ductal papilloma (SDP)
located in the terminal ducts at the periphery of the breast
Multiple intraductal papilloma (MP)
presence f myoepithelial cells and multi-layered ductal cells
multiple intraductal papilloma
these cells become flattened and the nuclei of the cells usu appear next to the luminal surface. Long axis tend to point in the same direction
multi layered cells of MP
Majority of breast cancers originate where?
Glandular tissue
Majority of breast cancers are classified as what type of cancer?
adenocarcinomas
What 2 tissues are considered glandular and may give rise to adenocarcinomas?
lobular tissues, ductal tissues
What is the common denominator to many of the breast cancer risk factors?
Their effect on the level and duration of exposure to endogenous estrogenic stimulation
… increase the chance of DNA replication errors
Estrogens
… are over-expressed in around 70% of breast cancer cases
estrogen receptors
What mutated genes appear to be responsible for approx 30-40% of inherited breast cancers?
BRCA1/BRCA2
Tumor suppressor genes involved in DNA repair of double stranded breaks
BRCA1/BRCA2
50-85% carrying a mutated … gene will go on to develop breast cancer
BRCA1
Approx 30% of breast cancers have amplification of … gene or over-expression of its protein.
HER2/neu
What gene is associated with increased risk for dz recurrence and worse prognosis?
HER2/neu
Most common type of breast cancer
ductal carcinoma (AKA infiltrating ductal carcinoma)
Single hard mass with irregular borders, not easily movable on a PE
infiltrating ductal carcinoma
Nearly 80% of all cases of breast cancer are diagnosed as
infiltrating ductal carcinomas
What is a characteristic feature of ductal carcinoma?
Heterogeneity of the malignant ductal cells
What makes the tumor feel firmer than normal breast tissue?
Collagen bands
Second most common breast cancer
Lobular carcinoma
Scirrhous appearance
ductal carcinoma
What is associated with a worse prognosis of breast cancer?
Signet rings
single file pattern
lobular carcinoma
high risk for multiple loci, inc risk for both breasts to be involved
lobular carcinoma
Involves the nipple and areolar area. Associated with underlying in-situ or invasive carcinoma
Paget’s dz
Appearance of eczematous changes overlying the nipple and areola
Paget’s dz
large round cells with pale cytoplasm and pleomorphic nuclei, seen within the epidermis
Paget cells
cells derived from glandular epithelium
paget cells
Form of ductal carcinoma distinguished by markedly inflamed appearance of the affected breast
inflammatory breast cancer
Often presents without palpable lump
inflammatory breast cancer (IBC)
