Reproduction, Primer Of Breast Pathology

Front 1

What is this called?

Squamous epithelium extends deeper into lactiferous ducts, produces keratin, and eventually obstructs the duct and causes a abscess formation or a fistula?

Back 1

periductal mastitis

Front 2

what is the #1 risk factor for developing periductal mastitis?

Back 2

smoking is present in 90% of women with this disorder

Front 3

what is treatment of the abscess/fistula found in periductal mastitis?

Back 3

complete removal, antibiotics don't cure it because its not an infection, even though it looks like one

Front 4

what condition that develops after trauma, radiation, or surgery in the breast can lead to a focal, non-movable, lesion clinically mimicking breast cancer?

Back 4

fat necrosis

Front 5

A woman presents with a dimpling of the skin on her breast with a hard non-movable mass beneath. Histology shows foamy macrophages and fibrosis that is replacing the normal fat tissue. What is this?

Back 5

Fat necrosis from trauma, radiation, or surgery

Front 6

what is key to differentiating between normal fibrocystic changes and abnormal fibrocystic-changes?

Back 6

if epithelial proliferation is present it is considered abnormal

Front 7

why are fibrocystic changes so important if they are normal in many women?

Back 7

they account for over 50% of surgical excisions to rule out possible cancer - WISDOM - if your not 100% sure don't let anything suspicious go without a complete diagnostic workup

Front 8

describe the 3 defining components of breast tissue taken from a woman with fibrocystic changes?

Back 8

1. cysts -lined with duct epithelium
2. fibrosis - rubbery, grey-tan
3. adenosis - increased number of acinar units per lobule

Front 9

what is the most common benign breast tumor in adults?

Back 9

fibroadenoma

Front 10

what is the peak incidence of fibroadenoma?

Back 10

20-40

Front 11

what is the pathology of a fibroadenoma?

Back 11

produced via hyperplasia of the intralobular stroma

Front 12

describe the radiographic characteristics of a fibroadenoma?

Back 12

well circumscribed and demarcated nodule

Front 13

what disorder does this histologic report describe?

Hyperplastic stroma that compresses duct epithelium into this strands

Back 13

fibroadenoma

Front 14

describe the increase in risk for breast cancer with fibroadenoma?

Back 14

no epithelial proliferation - 2x
epithelial proliferation - 4x

Front 15

what is a phyllodes tumor?

Back 15

overly large fibroadenoma (Hyperplastic stroma that compresses duct epithelium into this strands)
averaging 5-6 cm in size

Front 16

a women presents with nipple bleeding and a biopsy reveals a tumor with branching papillae surfaced by uniform columnar cells with distinct fibrovascular cores. Apocrine metaplasia is present with hemorrhage and fibrosis. What is this?

Back 16

intraductal papilloma

Front 17

where would a intraductal papilloma be found?

Back 17

major lactiferous ducts

Front 18

partial filling of ducts with mixtures of epithelial and myoepithelial cells without features of malignancy describes?

Back 18

ductal hyperplasia without atypia

Front 19

what tumor does this describe?

Hard tumor with calcifications and irregular, spiculated contour. Acini are increased in number, are scared centrally, and are dilated peripherally, but lobular architecture is preserved?

Back 19

sclerosing Adenosis

Front 20

what tumor does this describe?

frond-like papillae with fibrovascualr cores found and normal two cells layers, found deep in the smaller ducts of the breast?

Back 20

small duct papilloma

Front 21

what are the 3 types of proliferative breast disease we have to know?

Back 21

1. ductal hyperplasia without atypia
2. atypical ductal hyperplasia
3. atypical lobular hyperplasia

Front 22

what are the two known auto dom genes that are associated with breast cancer?

Back 22

BRCA 1 and 2

Front 23

describe who is at risk for breast cancer with BRCA-1?

Back 23

younger women, with >70% having BCA by age 80

Front 24

what is another common cancer seen associated with BRCA-1?

Back 24

30-60% also will have ovarian cancer

Front 25

describe who is at risk for breast cancer with BRCA-1?

Back 25

older women, with >60% having BCA by age 70

Front 26

what is the location of BRCA-1?

Back 26

17q21

Front 27

what is the location of BRCA-2?

Back 27

13q12

Front 28

describe the percentage of breast carcinomas that are invasive?

Back 28

66%

Front 29

describe the percentage of breast carcinomas that are in-situ?

Back 29

33%

Front 30

of the in-situ breast carcinomas, how many are ductal and how many are lobular?

Back 30

ductal = 80%
lobular = 20%

Front 31

what are the 2 features used to classify ductal in-situ breast carcinoma and which is most important?

Back 31

1. nuclear grade (most important)
2. architectural pattern

Front 32

cribiform type describes which nuclear grade?

Back 32

low grade

Front 33

comedo type with necrosis describes which nuclear grade?

Back 33

high grade

Front 34

in what disorder might you see these cells?

Large glandular phenotype with clear cytoplasm that stains positively for mucin?

Back 34

Paget's disease

Front 35

what is so important about paget's disease of the areolar skin?

Back 35

90% have an underlying ductal carcinoma

Front 36

what distinguishes between lobular hyperplasia with atypia and lobular carcinoma in-situ?

Back 36

the percentage of the acini being expanded by the tumor (>50% with lobular carcinoma, <50% with hyperplasia)

Front 37

describe the percentage of women with bilateral carcinoma in-situ?

Back 37

>50% will be bilateral

Front 38

why is carcinoma in-situ so important to follow up with?

Back 38

>30% will develope invasive carcinoma

Front 39

what type of cells fill the acini of lobular carcinoma in-situ?

Back 39

monomorphic epithelial cells

Front 40

80% of invasive breast cancers are this type?

Back 40

NST (no special type)

Front 41

what is a firm, painless mass that dimples the skin and may feel gritty from small calcifications called?

Back 41

invasive ductal carcinoma NST

Front 42

what tumor is a rubbery or hard, poorly demarvated tumor which sends mets all over the place, causes breast tissue to lacks tubules, and has many pleomorphic small cells?

Back 42

invasive lobular carcinoma

Front 43

linear strands of small uniform cells describes which type of breast cancer?

Back 43

invasive lobular

Front 44

of the uncommon malignant neoplasms, which have a better prognosis than ductal carcinoma?

Back 44

1. invasive tubular carcinoma
2. invasive medullary carcinoma
3. invasive colloid (mucinous) carcinoma

Front 45

what is the #1 most important factor to asses prognosis of BCA in patients without distant mets?

Back 45

axillary lymph node involvement