Pathology - Breast

Front 1

Hormones that induce cell proliferation and number of acini perlobule?

Back 1

after ovulation when estrogen and progesterone levels rise
(menstruation is accopanied by fall in estrogen and progesterone levels and apoptosis of epithelial cells to cause regression in lobule size)

Front 2

What results post cessation of lactation?

Back 2

breast remains increased and number o lobules remains as permanent residual

Front 3

Most dominant breast pathology?

Back 3

fibrocystic changes.

Front 4

Acute mastitis is?

Back 4

Usually staph aureus infection of the breast due to cracks in nipples DURING NURSING ONLY

Front 5

Resolution of acute mastitis?

Back 5

could be fibrous scars as permanent residual of the inflammatory process, may cause retraction of the skin or nipple and be mistaken for a neoplasm

Front 6

Painful erythematous subareolar mass?

Back 6

an acute process: infectious periductal mastitis

Front 7

What causes periductal mastitis?

Back 7

abnormal keratin deposition and trapping within ductal system to cause dilation and rupture of the duct. Inflammatory response follows

Front 8

What is heavily associated with periductal mastitis?

Back 8

more than 90% of women are smokers!

Front 9

Thick cheesy nipple secretions with dilation of ducts and a chronic granulomatous inflammatory reaction. Patient population?

Back 9

This is Mammary duct ectasia see in 50-60 yr old mutliparous woman, often mistaken for carcinoma

Front 10

Central liquefactive necrosis of fat?

Back 10

fat necrosis in breast due to trauma/surgery/radiation therapy which presents as a sharply localized process in one brast

Front 11

What is granulomatous lobar mastitis?

Back 11

hypersensitivity rxn mediated by prior alterations in the lobular epithelium during lactation and thus only parous women affected

Front 12

What is granulomatous mastitis?

Back 12

granulomas in the breast due to systemic diseases which happen to involve breast *wegeners)

Front 13

Squamous metaplasia present in lactiferous duct with keratin debris in the lumen?

Back 13

Periductal mastitis = Plugged with keratin, Squamous metaplasia = Smoker

Front 14

Most common alteration of breast?

Back 14

fibrocystic changes, often of no clinial significanc

Front 15

Main cause of fibrocystic change?

Back 15

hormonal imbalances

Front 16

What drug decreases fibrocystic change, why?

Back 16

OCP because it supplies a balanced source of progresterone and estrogen

Front 17

three patterns of fibrocystic morphological change?

Back 17

cyst formation, fibrosis, and adenosis

Front 18

What is adenosis?

Back 18

an increase in the number of acinar units per lobule

Front 19

Fibrosis of breast seen in fibrocystic changes due to?

Back 19

rupture of cyst followed by inflammation and scarring fibrosis to increase firmness of breast

Front 20

What change is associated with inreased risk of breast carcinoma?

Back 20

epithelial hyperplasia (more than moderate)

Front 21

What is the most common benign tumor of the femal breast?

Back 21

a new growth with fibrous and glandular tissue: fibroadenoma

Front 22

Fibroadenomas are commonly:

Back 22

bilateral, multiple, and due to drug growth stimulation

Front 23

Freely moveable, hormonally responsive mass with popcorn calcifications?

Back 23

fibroadenoma presenting before age 30

Front 24

Why are most fibroadenomas most common before age 30?

Back 24

they are hormonally dependent and this is usually during the reproductive period of female life

Front 25

What are stromal tumors divided into?

Back 25

intralobular( fibroadenoma and phyllodes) and interlobular (CT tumors found elsewhere like lipomas)

Front 26

What is a phyllodes tumor?

Back 26

an intralobular tumor that has protrusions and nodules of proliferating stroma covered by epithelium

Front 27

Age of phyllodes tumor occurance?

Back 27

around 60, 10-20 yrs after fibroadenoma

Front 28

Increased stromal cellularity and nodule projecting into a slitlike space

Back 28

phyllodes tumor

Front 29

Usually solitary and found within principal lactiferous ducts or sinuses? Presentation?

Back 29

large duct papilloma, presents with serous or bloody nipple discharge

Front 30

Genes associated with breast cancer?

Back 30

BRCA1 and BRCA2 tumor suppressor genes, also others

Front 31

Cowden's disease?

Back 31

mutation of PTEN tumor suppression gene causing multiple harmartomas and increased risk of cancer

Front 32

Average age of carcinoma diagnosis?

Back 32

64 yrs

Front 33

Carcinoma is more common in which boob?

Back 33

left boob

Front 34

Carcinomas divided how?

Back 34

in situ (intact BM) and invasive

Front 35

What is inflammatory carcinoma?

Back 35

the CLINICAL presentation of carcinoma involving dermal lymphatics causing an enlarged, erythematous breast (not a histological term)

Front 36

All carcinomas thought to arise from?

Back 36

terminal duct lobular unit

Front 37

DCIS is?

Back 37

population of cells that can't invade through the basement membrane but spread throughout the ductal system

Front 38

solid sheet of high-grade malignant cells with central necrosis?

Back 38

comedocarinoma

Front 39

Paget cells?

Back 39

malignant cells seen in the epidermis: large cells with clear halo

Front 40

What is Paget's disease of the nipple?

Back 40

a form of DCIS that extends from the nipple ducts OUT into skin causing fissures, ulcers, and oooooozing

Front 41

What is LCIS?

Back 41

1+ terminal ducts that are larger than normal, usual incidental finding on biopsies

Front 42

Invasive ductal carcinomas?

Back 42

stone-hard, attach to underlying chest, and dimpling of the skin. Common.

Front 43

Invasive lobular carcinoma?

Back 43

most bilateral and multicentric within same breast, frequently metastasize

Front 44

Invasive lobular carcinomas lack?

Back 44

E-cadherins more than invasice ductal carcinomas

Front 45

Medullary carcinoma associated with?

Back 45

BRCA1 gene. Medul1ary.

Front 46

fleshy, cellular tumor with lymphocytic infiltrate and overexpression of adhesion molecules?

Back 46

medullary carcinomas, occur in younger than average women

Front 47

carcinoma risk of fibroadenoma?

Back 47

NONE and none with nonhyperplstic cysts either

Front 48

Stage 0 carcinoma?

Back 48

DCIS or LCIS

Front 49

Stage 1?

Back 49

invasive carcinoma without nodal or metastases less than 2 cam

Front 50

Stage 2?

Back 50

Larger carcinoma or smaller with movable axillary nodes

Front 51

Stage 3?

Back 51

Larger wtih nodal involvement or any cancer wtih fixed nodes

Front 52

Stage 4?

Back 52

metastasis

Front 53

most commonly detected s mammographic calcification and not by palpation?

Back 53

DCIS

Front 54

Gynecomastia mainfestation of what hormonal imbalance syndrome?

Back 54

Klinefelter

Front 55

most important cause of hyperestrinism in male?

Back 55

cirrhosis of liver = gynecomastia

Front 56

genetic link to male breast cancer?

Back 56

BRCA2 not BRCA1. Males are 2ools