Week 9: Non-Neoplastic Breast Masses

Question 1

What percent of breast lesions are benign?

Answer 1

~90%

Question 2

ID the straight black arrow

Answer 2

lobule

Question 3

ID the orange arrows

Answer 3

Intralobular Terminal Ducts

Question 4

ID the green arrow

Answer 4

Extralobular Terminal Duct

Question 5

ID the pink arrows

Answer 5

lactiferous ducts

Question 6

ID the curved black arrow

Answer 6

Lactiferous Sinus

Question 7

ID the yellow arrow

Answer 7

Collecting Duct

Question 8

ID the white open arrows

Answer 8

nipple

Question 9

ID the red bracket

Answer 9

Terminal Duct Lobular Unit (TDLU)

Question 10

ID this structural and functional unit

Answer 10

Terminal Duct Lobular Unit (TDLU)

Question 11

ID the cyan arrow

Answer 11

Pectoralis Major

Question 12

ID the straight white arrow

Answer 12

Pectoralis Minor

Question 13

ID the curved white arrow

Answer 13

Ribs

Question 14

ID

Answer 14

Terminal Duct Lobular Unit (TDLU)

myoepithelial cells (black pointers) and luminal epithelial cells (green pointers)

Question 15

What hormal status is this breast tissue?

Answer 15

Pre-Menarche

Question 16

What hormonal status is this breast tissue?

Answer 16

Premenopausal

Question 17

What hormonal status is this breast tissue?

Answer 17

Lactation

Question 18

What hormonal status is this breast tissue?

Answer 18

Postmenopausal

Question 19

Which mammogram would correspond to a young patient?

Answer 19

Left

Question 20

Which mammogram would correspond to an older patient?

Answer 20

Right

Question 21

Which specimen would correspond to an invasive carcinoma?

Answer 21

Right

Left - fibroadenoma; Right - invasive ductal adenocarcinoma

Question 22

What are 2 non-proliferative breast masses?

Answer 22

• Fibrocystic changes
• Hormonal effects

Question 23

What are 2 proliferative breast masses?

Answer 23

• Intraductal Papilloma
• Sclerosing Adenosis

Question 24

ID

Answer 24

Blue-Domed Cyst

Question 25

ID

Answer 25

Clustered, rounded calcifications

Question 26

ID

Answer 26

Apocrine Metaplasia ## Footnote Simple Cuboidal epithelium lining the duct (yellow arrows) and amorphous calcifications in the duct (cyan circle and ellipse)

Question 27

ID

Answer 27

Normal duct or acinus ## Footnote single basally located myoepithelial layer

Question 28

ID

Answer 28

Usual Ductal Hyperplasia

Question 29

ID

Answer 29

Usual Ductal Hyperplasia

Question 30

ID

Answer 30

Papilloma

Question 31

ID

Answer 31

Sclerosing Adenosis

Question 32

ID

Answer 32

Radial Sclerosing Lesion

Question 33

ID

Answer 33

Ductal Papilloma ## Footnote associated with nipple discharge arise within the ducts close to the nipple (curved black arrow) and can twist on the stalk (open black arrow)

Question 34

ID

Answer 34

Ductal Papilloma ## Footnote attached to the duct by a sclerotic fibrovascular stalk  (blue open arrows)

Question 35

ID

Answer 35

Atypical Ductal Hyperplasia (ADH) ## Footnote Has Cribriform architecture

Question 36

ID

Answer 36

Atypical Lobular Hyperplasia (ALH) ## Footnote E-cadherin negative on immunohistochemistry (top right chromophobe cells along basement membrane)

Question 37

ID

Answer 37

Usual Ductal Hyperplasia

Question 38

ID

Answer 38

Atypical Ductal Hyperplasia (ADH)

Question 39

ID

Answer 39

Cribriform Ductal Carcinoma In-Situ (DCIS) ## Footnote Note the round, regular (“cookie cutter”) spaces containing calcifying secretory material and that it takes up the whole duct unlike Atypical Ductal Hyperplasia (ADH)

Question 40

ID

Answer 40

Micropapillary Ductal Carcinoma In-Situ (DCIS) ## Footnote The papillary projections lack fibrovascular cores