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RDS Test 3 > B8-035 Breast Histology & Physiology > Flashcards

B8-035 Breast Histology & Physiology Flashcards

1
Q

[hormone] stimulates the development of the lactiferous ducts

A

estrogen

(with prolactin)

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2
Q

[hormone] stimulates the development of the lobules

A

progesterone

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3
Q

only with […] does the breast fully mature

A

pregnancy

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4
Q

milk production in pregnancy is inhibited by [hormone]

A

progesterone

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5
Q

rising levels of [hormone] throughout pregnancy increases prolactin secretion

A

estrogen

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6
Q

suckling of the infant causes the release of [hormone], causing milk ejection by contraction of the myoepithelial cells

A

oxytocin

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7
Q

surrounds the glands and ducts with connective and adipose tissue

A

Interlobular mammary stroma

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8
Q

Basic histopathological units of the mammary gland

A

Terminal ductal lobular units (TDLU)

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9
Q

loose, cell-rich connective tissue within the TDLU

A

Intralobular stroma

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10
Q

Outer layer of the TDLU is comprised of […] cells that are contractile and route the milk to the ducts in lactating breasts

A

myoepithelial

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11
Q

the Inner layer of the TDLU is comprised of cubic, apocrine glandular […] epithelial cells that can produce milk

A

luminal

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12
Q

distinct histological features of a lactating breast

A

very large lobules with tubulo-alveolar ends
small amounts of interlobular connective tissue

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13
Q

what changes to the breast are occurring in the proliferative phase of the menstrual cycle?

A

no changes

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14
Q

what changes to the breast are occurring in the secretory phase of the menstrual cycle?

A

↑ estrogen and ↑ progesterone → cell proliferation, ↑ number of acini, edema of interlobular stroma

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15
Q

what changes to the breast are occurring during menstruation?

A

desquamation and regression

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16
Q

what changes in the breast occur due to age? [4]

A

involution of the breasts due to a decrease in estrogen levels

Atrophy of mammary glands and connective tissue stroma

The milk duct system is preserved.

Relative increase in fat percentage due to replacement of stroma with fat

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17
Q

main mammographic signs of breast carcinoma [2]

A

densities
calcifications

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18
Q

most common causative agent of mastitis

A

S. aureus

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19
Q

squamous metaplasia of lactiferous ducts (SMOLD) has a strong association with […]

A

smoking

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20
Q

painful, erythematous subareolar mass
may be interpreted clinically as an abscess

A

squamous metaplasia of lactiferous ducts (SMOLD)

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21
Q

epithelium extends into ducts, keratin accumulates and ruptures causing inflammatory response

A

squamous metaplasia of lactiferous ducts (SMOLD)

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22
Q

post-menopausal women with unilateral nipple pain/bleeding

dilated ducts with lipid secretions and foamy histiocytes on microscopy

A

mammary duct ectasia

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23
Q

early lesions have hemorrhage and indurated fat

later, necrotic fat cells surrounded by lipid filled macrophages and neutrophils

A

fat necrosis

(commonly associated with trauma)

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24
Q

fibrocystic change has […] risk of developing into breast cancer

A

low

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25
Q

3 principle morphologic changes of fibrocystic change

A
  1. cystic change/apocrine metaplasia: lobules dilate or join into larger cysts
  2. fibrosis from cyst rupture
  3. adenosis: increase in number of acini per lobule
26
Q

blue dome cyst

A

fibrocystic change

27
Q

benign epithelial proliferation of duct

slit-like fenestrations on sides of duct

A

usual ductal hyperplasia

(low risk of developing invasive breast cancer)

28
Q

acini and stomal fibrosis with microcalcifications

A

sclerosing adenosis

(low risk of developing invasive breast cancer)

29
Q

benign lesion with fibroelastosis and entrapped glandular structures

may mimic invasive carcinoma on imaging due to stellate appearance

A

radial scar/complex sclerosing lesion

(associated with intraductal hyperplasia)

30
Q

small fibroepithelial tumor within lactiferous ducts, typically beneath areola

most common cause of nipple discharge

A

intraductal papilloma

(2-3x risk of invasive breast carcinoma)

31
Q

very very similar to low grade DCIS, but small amount and not well developed

A

atypical ductal hyperplasia

(close follow up due to increased risk of invasive cancer)

32
Q

non-invasive neoplastic proliferation of small, dyscohesive cells expanding less than 50% of the TDLU

A

atypical lobular hyperplasia (ALH)

(4-5x risk of invasive breast cancer)

33
Q

[…] make milk that drains via ducts to the nipple

A

lobules

34
Q

The […] is the functional unit of the breast

A

terminal duct lobular unit

35
Q

Lobules and ducts are lined by […] layers of epithelium

A

two

luminal cell layer and myoepithelium

36
Q

inner cell layer lining the ducts and lobules; responsible for
milk production in the lobules

A

luminal cell layer

37
Q

outer cell layer lining ducts and lobules; contractile
function propels milk towards the nipple.

A

myoepithelial cell layer

38
Q

During pregnancy, breast lobules undergo […]

A

hyperplasia

39
Q

after menopause, breast tissue undergoes […]

A

atrophy

40
Q

Inflammation of the subareolar ducts
Usually seen in smokers
Clinically presents as a subareolar mass with nipple retraction

A

periductal mastitis

41
Q

Inflammation with dilation of the subareolar ducts

classically arises in multiparous postmenopausal women

A

mammary duct ectasia

42
Q

Presents as a periareolar mass with green-brown nipple discharge

Chronic inflammation with plasma cells is seen on biopsy

A

mammary duct ectasia

43
Q

Papillary growth, usually into a large duct

A

intraductal papilloma

44
Q

Characterized by fibrovascular projections lined by epithelial (luminal) and myoepithelial cells

A

intraductal papilloma

45
Q

Classically presents as bloody nipple discharge in a premenopausal woman

Must be distinguished from papillary carcinoma, which also presents as bloody nipple discharge

A

intraductal papilloma

46
Q

characterized by fibrovascular projections lined by luminal epithelial cells without underlying myoepithelial cells.

A

papillary carcinoma

47
Q

Fibroadenoma-like tumor with overgrowth of the fibrous component; characteristic ‘leaf-like’ projections are seen on biopsy

A

phyllodes tumor

(can sometimes be malignant)

48
Q

during pregnancy, milk production is inhibited my high levels of […]

A

progesterone

49
Q

[…] causes ejaculation of milk through myoepithelial cells

A

oxytocin

50
Q

do breast TDLUs remain the same throughout the menstrual cycle?

A

no, fluctuate with ovulation

51
Q

male and female breast histology are [same/different] pre-puberty

A

same

52
Q

how do breast TDLUs change after cessation of lactation?

A

regress

53
Q

the most common etiology for nipple discharge is

A

solitary large duct papilloma

54
Q

bloody or serous nipples discharges are more commonly associated with [benign/malignant] lesions

A

benign

55
Q

milky nipple discharge [is/is not] associated with malignancy

A

is not

56
Q

the risk of malignancy with nipple discharge increases with […]

A

age

57
Q

usual ductal hyperplasia carries a 1-2% risk of developing malignancy in [one/both] breasts

A

both

(follow up with routine mammogram)

58
Q

management of usual ductal hyperplasia

A

follow up with routine mammograms

59
Q

poorly defined periareolar mass with thick, cheesy nipple secretion

A

duct ectasia

60
Q

dilated duct with multiple branching fibrovascular cores lined by luminal and myoepithelial cells

A

intraductal papilloma

61
Q

“lumpy bumpy” breast with microcalcifications, cysts, apocrine metaplasia, and fibrosis

A

fibrocystic changes

62
Q

unilateral, erythematous, painful breast mass

biopsy shows neutrophils

A

acute mastitis

RDS Test 3 (15 decks)

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