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Repro II > Robbins Ch 23 - Breast > Flashcards

Robbins Ch 23 - Breast Flashcards

1
Q

Break shows more numerous branchings of terminal ducts and larger lobules, lactational changes are occuring

A

Findings during pregnancy

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2
Q

Breast lobules decrease in number and size, interlobular stroma is replaces by adipose tissue making mammograms are more radiolucent

A

Findings with increasing age

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3
Q

MC palpable lesions

A

Cysts, fibroadenomas, invasive carcinomas

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4
Q

MC area for carcinomas

A

Upper outer quadrant of the breast

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5
Q

Drugs that can cause milky discharge

A

OCs, tricyclic antidepressants, methyldopa, phenothiazines

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6
Q

Bloody or serous breast d/c in a non-pregnant F is MCly from

A

Large duct papilloma and cysts

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7
Q

Clusters of apocrine cysts, hyalineized fibroadenomas, sclerosing adenosis

A

Calicifications on mammogram - b9 lesions

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8
Q

Small, irregular, numerous and clustered calcifications on mammography

A

MCly ass’d with malignancy

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9
Q

Breast ca that is MCly detected as mammographic calcifications

A

Ductal carcinoma in situ

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10
Q

Breast is radiodense or white in appearance, there is a predominanace of fibrous interlobular stroma with a small amount of adipose tissue, lobules are small and are invested in loose cellular intralobular stroma

A

Findings in young women

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11
Q

Occurs during the first month of breastfeeding and is cause by local bacterial infection of the breast

A

Acute mastitis

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12
Q

MCCs of acute mastitis

A

Staphlylococcus > streptocci

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13
Q

Causes acute mastitis with breast single or multiple abscesses

A

Staph

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14
Q

Causes acute mastitis that spreads as cellulitis

A

Streptococci

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15
Q

Recurrent subareolar abcesses, periductal mastitis, zuska disease

A

Sq metaplasia of lactiferous ducts

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16
Q

Keratinizing sq metaplasia of the nipple duct leasing to dilation and rupture

A

Sq metaplasia of the lactiferous ducts

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17
Q

Sq metaplasia of the lactiferous ducts occurs MCly in

A

smokers

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18
Q

Thick, white nipple secretions, skin retraction, multiparous F in 5th/6th decade

A

Duct ectasia

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19
Q

Duct fulled with inspissated secretions and numerous lipid-laden MPs, potentially granuloma formation

A

Duct ectasia

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20
Q

Duct ectasia can mimic

A

Invasive breast carcinoma

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21
Q

Hemorrhagic areas with central liquefactive necrosis that appear as firm, gray/white nodeuls with small chalky-white foci grossly

A

Fat necrosis of the breast

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22
Q

Hard palpable mass(es) with lymphocytic infiltrate, MCly in women with T1 DM or autoimmune thyroid dz

A

Lymphocytic mastopathy

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23
Q

Granulomatous mastitis only occurs in

A

Parous women

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24
Q

Caused by HSN reaction to antigens expressed during lactation

A

Granulomatous mastitis

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25
Q

MCC of cystic neutrophilic granulomatous mastitis

A

Corynebacteria

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26
Q

Breast cyts diagnosis is confirmed by

A

Disappearance of mass after FNA of contents

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27
Q

Increased number of acini per lobule

A

Adenosis

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28
Q

Clonal proliferation ass’d with deletions of ch 16q

A

Flat epi atypia of the breast

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29
Q

Palpable masses in pregnant or lactating F that are an exaggerated local response to gestational hormones

A

Lactational adeomas

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30
Q

Increased numbers of luminal andmyoepithelial cells that fill and distend breast ducts and lobules

A

Epithelial hyperplasia

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31
Q

Increased in acini that are compressed, distorted in the center with stromal fibrosis potentially compressing the lumen; acini are arraged in a swirling pattern with a well circumscribed outer border

A

Sclerosing adenosis

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32
Q

Central nidus of small tubules entrapped in a densely fibrotic stroma with numerous projections, varying degrees of cyst formation and hyperplasia

A

Radial sclerosing lesion

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33
Q

More than 80% of duct papillomas produce

A

Nipple discharge

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34
Q

Imbalance btwn estrogens and androgens can result in

A

Gynecomastia

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35
Q

Proliferation of regularly spaces ells with cribiform spaces that only partially fill involved ducts; looks like DCIS

A

Atypical ductal hyperplasia

36
Q

Atypical lobular cells btwn ductal BM and normal luminal cells that do not fill or distend more than 50% of the acini; resembles LCIS

A

Atypical lobular hyperplasia

37
Q

Hyperplasia ass’d with loss of e-cadherin

A

Atypical lobular hyperplasia

38
Q

Malignant clona proliferation of epi ells limited to ducts and lobules by the BM

A

DCIS

39
Q

Appear as clusters or liner branching areas of calcification; tumor cells with pleomorphic, high grade nuclei and areas of central necrosis

A

Comedo DCIS

40
Q

DCIS with rounded, cookie cutter-like spaces (cribiform)

A

noncomedo type DCIS

41
Q

DCIS with bulbous protrusions without a fibrovascular core

A

Micropapillary noncomedo DCIS

42
Q

U/l erythematous eruption with a scale crust on the nipple, commonly accompanied by pruitis and mistaken for eczma

A

Paget disease

43
Q

3 indications of higher rate of recurrence of DCIS

A

1) high nuclear grade and necrosis 2) extent of disease 3) positive surgical margins

44
Q

Clonal proliferation of cells within ducts and lobules that grow in a discohesive fashion

A

LCIS

45
Q

LCIS is always an incidental finding becuase

A

Its not associated with calcifications or stromal reactions

46
Q

MC form of invasive BC

A

ER-positive HER-negative

47
Q

MC type of BC found in older F and in M

A

Low proliferation ER-positive HER-negative

48
Q

MC BC ass’d with BRCA2 mutations

A

High proliferation ER-positive HER-negative

49
Q

HER2-positive BC is MC in

A

Young F and non-white F

50
Q

Common in young, premenopausal F,AA and Hispanic women

A

ER-negative HER-negative

51
Q

Carcinomas grow in a tubular pattern with small round nuclei and low proliferative rate

A

Grade I

52
Q

Carcinoma may show some tubule formation, but solid clusters or single infiltrating cells are present with a greater degree of nuclear pleomorphism and mitotic figures

A

Grade II

53
Q

Carcinoma invades as ragged nests or solid sheets with enlarged irregular nuclei with a high proliferative rate and areas of tumor necrosis

A

Grade III

54
Q

Biallelic loss of CDH1 is found in what and increases risk of

A

Lobular BC; inc risk of gastric signet ring cell ca

55
Q

Higher survival rates and better chemo response in medullary carcinoma is ass’d with

A

Lymphocytic infiltrates

56
Q

Pale gray-blue gelatin

A

Mucinous (Colloid) carcinoma

57
Q

Hollow balls of cells that float within intercellular fluid

A

Micropapillary carcinoma

58
Q

Indicates poor prognosis in breast ca

A

Distant mets, inflammatory carcinoma

59
Q

Women with no node involvement and a carcinoma

A

> 90% survival rate

60
Q

Peau d’orange

A

Inflammatory carcinoma - poor prognosis

61
Q

Proliferation rate in primarily impt for

A

ER-positive HER2-negative

62
Q

ER-positive cancers are less likely to respond to

A

Chemo

63
Q

HER2 overespression is ass’d with

A

Poorer survival

64
Q

MC b9 tumor of the female breast

A

Fibroadenoma

65
Q

Well circumscribed, rubbery, grayish white nodules that bulge above surrounding tissue that often contain slitlike spaces

A

Fribroadenoma of the breast

66
Q

Tx with cyclosporin A after a rental transplant can lead to

A

Development of breast fribroadenomas

67
Q

Phyllodes tumors are ass’d with clonal ch changes - MCly in

A

Ch 1q

68
Q

Phyllodes tumors ass’d with more aggresive clinical behavior

A

More numerous ch abberation and HOXB13 overexpression

69
Q

Leaflike architecture

A

Phyllodes tumor

70
Q

CI in phyllodes tumor

A

axillary LN biopsy

71
Q

Type of tumor than is equally as common in M and F

A

Myofibroblastoma

72
Q

Ass’d with familial adenomatous polyposis, hereditary desmoid syndrome, and Gardner syndrome

A

Myofibroblastoma

73
Q

Only carcom that occurs with fx in the breat

A

Angiosarcoma

74
Q

Massive b/l breast invomvment, often woment are pregnancy or lactating

A

Burkitt lymphoma can present this way

75
Q

Mets to the breast are MCly from

A

Melanomas and ovarian ca

76
Q

tumor suppressor mutation ass’d with increased risk of ovarian carcinoma as well as breast cancer

A

BRCA1

77
Q

tumor suppressor mutation more fx ass’d with male breast cancer

A

BRCA2

78
Q

on ch17q21

A

BRCA1

79
Q

on ch13q12.3

A

BRCA2

80
Q

BRCA1 ass’d breast ca are very similar to

A

ER-negative/HER2-negative ca

81
Q

BRCA2 are MCly ________ than BRCA1 ca

A

ER-positive

82
Q

MC subtype of BC in BRCA2 + individuals

A

ER-positive, HER2-negative

83
Q

HER2-positive cancers are strongly ass’d with aplifications on

A

ch17q

84
Q

MC subtype of breast cancer in pts with TP53 mutations (Li-Fraumeni syndrome)

A

HER2-positive

85
Q

“basal-like” pattern of mRNA expression

A

ER-negative, HER2-negative breast ca

Repro II (12 decks)

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