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pathology block 4 > Breast > Flashcards

Breast Flashcards

1
Q

greatest density of breast tissue in a female

A

upper, outer

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2
Q

most common physiologic cause of galactorrhea

A

nipple stimulation

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3
Q

most common pathologic cause of galactorrhea

A

prolactinoma

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4
Q

type of tumor that can cause gynecomastia

A

testicular choriocarcinoma

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5
Q

most common pathogenic cause of acute mastitis

A

S. aureus

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6
Q

cellular change responsible for predicate mastitis

A

keratinizing squamous metaplasia of the lactiferous ducts

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7
Q

characteristic d/c for mammary duct ectasia

A

green-brown nipple discharge

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8
Q

typical presentation of breast fat necrosis

A

incidental finding of micro calcifications on mammogram

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9
Q

what biopsy findings in fibrocystic change are associated with increased risk of cancer?

A

ductal hyperplasia- 2x
sclerosing adenosis- 2x
atypical hyperplasia- 5x

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10
Q

how is a papilloma differentiated from a papillary carcinoma?

A

papilloma has luminal epithelium and myoepithelial cells; carcinoma only has luminal epithelium

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11
Q

which medication is known to cause the development of multiple, bilateral fibroadenomas?

A

cyclosporin A

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12
Q

what is the characteristic biopsy finding for fibroadenoma?

A

“cave paintings’- glands become compressed due to abundant stroma

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13
Q

what is the characteristic biopsy finding for phyllodes tumor?

A

“leaf-like projections”- overgrowth of fibrous portion

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14
Q

what is the difference between fibroadenoma and phyllodes tumor? (2)

A
  • fibroadenoma is always being, phyllodes can be malignant

- fibroadenoma is more common in premenopausal, phyllodes is more common in postmenopausal

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15
Q

most common breast cancer presentation

A

asymptomatic with abnormal mammogram

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16
Q

most common site for a breast cancer in females? males?

A

females- upper/outer

males- subareolar

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17
Q

precursor lesion to DCIS

A

ductal hyperplasia

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18
Q

most common DCIS subtype

A

comedo (necrosis and calcifications)

19
Q

what is Paget’s disease of the breast?

A

extension of malignancy from the duct to the skin

20
Q

what malignancy is usually associated with Paget’s disease of the breast? exception?

A

usually DCIS, except if there is a palpable mass, then it is usually invasive carcinoma

21
Q

4 types of invasive ductal carcinoma

A

tubular
mucinous
medullary
inflammatory

22
Q

which type of invasive ductal carcinoma is associated with BRCA1?

A

medullary

23
Q

which type of invasive ductal carcinoma is associated with older women?

A

mucinous

24
Q

which type of invasive ductal carcinoma is associated with the poorest prognosis?

A

inflammatory

25
Q

what is the typical “pattern” of LCIS?

A

multifocal and bilateral

26
Q

what “cellular defect” is associated with LCIS and invasive lobular carcinoma?

A

loss of E-cadherin (gene CDH)

27
Q

2 unique biopsy findings for invasive lobular carcinoma

A
  • single file pattern of cells

- signet ring cells

28
Q

unique mets of invasive lobular carcinoma

A

carcinomatous meningitis

29
Q

most important prognostic factor in breast CA

A

mets

30
Q

most useful prognostic factor in breast CA

A

spread to LN

31
Q

which LNs are involved in spread of breast CA?

A

outer- axillary LN

inner- internal mammary LN

32
Q

treatment for ER/PR+

A

antiestrogenic - tamoxifen

33
Q

treatment for Her2/Neu

A

trastuzumab

34
Q

locus of BRCA1

A

17q21

35
Q

locus of BRCA2

A

13q12.3

36
Q

BRCA1 mutation cancers

A

breast and ovarian

37
Q

BRCA2 mutation cancers

A

breast (males and females)

38
Q

most common type of breast CA in males

A

invasive ductal carcinoma

39
Q

genetic abnormalities associated with male breast CA

A

BRCA2, Klinefelters

40
Q

fibroadenomas may grow under the influence of —

A

estrogen (during pregnancy, menstrual cycle)

41
Q

characteristic cells in medullary carcinoma

A

lymphocytes

42
Q

male breast cancers are mainly in the —

A

elderly

43
Q

4 “fibrocystic changes”

A

duct proliferation, duct dilation, apocrine metaplasia, fibrosis

44
Q

histologic appearance of gynecomastia

A

proliferation of ducts in fibrous stroma

pathology block 4 (18 decks)

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