Fischer Reproduction Test 3: Part 1

Question 1

Q1:

Germ/Stem cells differentiate into what?

Answer 1

Spermatozoa

Question 2

Q1:

Genital/Gonadal ridges differentiate into what?

Answer 2

Gonads

Question 3

Q1:

Epithelium/Underlying mesenchyme of genital ridge differentiate into what?

Answer 3

Tunica albuginea, Sertoli cells, and Leydig cells

Question 4

Q1:

What is the major risk factor of intraductal papillomas related to breast cancer?

Answer 4

• This is the major component that determines if it can be malignant.
• If there are multiple intraductal papillomas present =carcinomas. Solitary ones are benign.

Question 5

Q1:

Distal Mesonephric Duct differentiate into what?

Answer 5

Vas deferens, seminal vesicles, and ejaculatory duct

Question 6

Q1: (Three questions of Fibrocystic disease of the breast)

What is the feature that determines of malignancy/carcinoma?

Answer 6

Atypical epithelial hyperplasia

Question 7

Q1:

In malignancy/carcinoma of the breast, what does the epithelial hyperplasia become?

Answer 7

becomes multilayered with atypical nuclear change

Question 8

Q1: Generalities of disease

What are two dominant features of fibrocystic disease of the breast?

Answer 8

Fibrous and cystic disease change

Question 9

Q1:

In fibrocystic disease of the breast, what is the name of the cyst?

Answer 9

Blue domed cyst

Question 10

Q1:

Who is more likely to get fibrocystic disease of the breast?

Answer 10

Woman of reproductive age.

i. e. Not before puberty or after menopause.
- 10-15% of women show symptoms

Question 11

Q1:

What are some symptoms present with fibrocystic disease of the breast?

Answer 11

Heaviness, pain, nodularity, and sensitivity of the breast during menses.
- Palpable lumps in breast substance.

Question 12

Q2:

What’s the major sign in a woman who has intraductal papilloma?
- What is an intraductal papilloma

Answer 12

Serous or bloody nipple discharge

- It is a neoplastic papillary growth within a duct.

Question 13

Q2:

What one major component determines whether an intraductal papilloma is malignant (will turn into breast cancer)?

Answer 13

There is only a risk of breast cancer (papillary carcinoma) if there are multiple intraductal papillomas (i.e. solitary ones are benign)

Question 14

Q2:

What is fibroadenoma
Is it benign or malignant?
Capsulated or encapsulate?
Freely movable or nonmobile?

Answer 14

Benign tumors of the breast
Encapsulated spherical nodules
Freely movable (and easily removed)

Question 15

Q2:

In fibroadenoma, it is most commonly seen around what age?

Answer 15

Reproductive age

not seen before puberty or after menopause

Question 16

Q2:

In fibroadenoma, where would it be located/seen?

• What are the two components?
• benign or malignant?

Answer 16

UPPER OUTER quadrant of the breast
– seen in the same area of breast as what you’d see in breast cancer.
Components: fibrous stroma + glandular epithelium
-Benign tumors

Question 17

Q4:

What is acute mastitis?
What is the cause?
In what situation will we see it?

Answer 17

inflammation of the breast (most common)
Caused by Purulent bacteria (staph or strep)….cracked skin.
- Diffuse swelling, nodules or abscess, infiltrated by PMNs
See it: Breast feeding/lactation

Question 18

Q5:

What is the etiology behind fat necrosis of the breast?
What is fat necrosis?

Answer 18

Trauma

- Hemorrhage + central fat necrosis –> nodule of gray-white firm tissue

Question 19

Q6:

Define gynecomastia

Answer 19

male breast enlargement associated with hormonal changes in puberty (excess E)

Question 20

Q6:

What causes the enlargement in gynecomastia?

Answer 20

enlargement = proliferation of excretory duct/C.T. or high E from cirrhosis or tumors

Question 21

Q6:

In gynecomastia, do male have both ducts and lobules?

Answer 21

No. Male have ducts and NO lobules

Females have both

Question 22

Q6:

In gynecomastia, what can be found under the areolar area?

Answer 22

Fibrous cap of tissue.

Question 23

Q6:

In Gynecomastia, is it less or more likely to be carcinoma than females?
-Does it infect more or less rapidly in male?

Answer 23

• LESS likely to be carcinoma than females

- Ductal in origin, but infects MORE rapidly.

Question 24

Q7:

Risk factors of breast cancer (adenocarcinoma)
Who is at a higher risk of getting breast cancer? Male or Female?
What %

Answer 24

Female. 100 times more likely

Question 25

Q7:

Higher risk of getting breast cancer at what age (adenocarcinoma)?
Most common in what race?
Genetics?
Hormonal?

Answer 25

Rises AFTER 35 yr-old, peak in POSTMENOPAUSAL woman who are around 60 yr-old.

• Caucasians (Jews)
• Increased risk if one’s mother/siblings had/has it.
• Prolonged E exposure, nulliparous (no kids) women are more likely than those who have multiple children.

Question 26

Q7:

The presence of what other cancers increases the risk of having adenocarcinoma?

Answer 26

Increased with ovarian or endometrial cancer since ovary and endometrium both have E receptors like the breast

Question 27

Q7:

Histologically, what other changes can increase the risk of having adenocarcinoma?

Answer 27

• Premalignant ribrocystic changes (atypical epithelial hyperplasia) + multiple intraductal papillomastosis.

Question 28

Q7:

What other causes can increase the risk of having adenocarcinoma?

Answer 28

• Obesity, high fat diets, moderate alcohol consumption

Question 29

Q11:

What are the two major types of cancer pathologically that is related to the histology of the breast.

• What three organs/sites can you find estrogen receptors?

Answer 29

• Ductal (non-or invasive) ==> unilateral, hard tumor
  Non-invasive Intraductal Carcinoma: • 20-30% of carcinomas and defined as a malig-nant population of cells that lack the capacity to invade through the basement membrane and therefore no distant spread.

Invasive Ductal carcinoma: More than 2/3 of invasive carcinomas. Reached the basement membrane.

• Lobular (non- or invasive, terminal ducts) ==> multi-focal, bilateral, soft/deep tumors.
• Breast, Ovaries and Endometrium

Question 30

Q12

What are the treatment regimes of breast cancer related to surgery. Which one has the axillary lymph node dissection?

Answer 30

a. Surgical resection of the primary tumor and any metastases
b. Several surgical procedures are currently in use:
- Lumpectomy is the most conservative surgical procedure, as it is limited to resection of the tumor with surrounding fat tissue.
- Mastectomy refers to removal of the entire breast, which is associated with axillary lymph node resection.