Breast 1

Question 1

what are the two cell types that line the ducts and acini of the breast?

Answer 1

Inner luminal epithelial cells

Outer myoepithelial cells

Question 2

What do inner luminal epithelial cells do? myoepithelial cells?

Answer 2

Luminal: produce milk during lactation
myoepithelial: contract cells on basement membrane ejecting the milk product.

Question 3

when do you have the most radiolucent breasts?

Answer 3

when you are old because there is more fat content.

Question 4

what is usually the first sign of breast pathology?

Answer 4

A palpable mass

Question 5

what is the second most common sign of breast pathology?

Answer 5

Nipple discharge.

Question 6

what is the most common cause of nipple discharge?

Answer 6

benign intraductal papilloma

Question 7

what are microcalcifications?

Answer 7

calcium deposits usually from tumor cells and necrotic tissue within the ducts

Question 8

T/F Carcinomas are more radiodense than benign breast tissue?

Answer 8

True

Question 9

What does fat necrosis mimick?

Answer 9

breast carcinoma b/c it can present as a palpable mass and show up as radiodense on mamography

Question 10

Foamy macrophages are a key finding with what type of breast pathology?

Answer 10

Fat necrosis

Question 11

What is infection during breastfeeding with erythema and pain and fever called?

Answer 11

mastitis

Question 12

what are the two most common pathogens that cause mastitis?

Answer 12

S. aureus and many strep species.

Question 13

what is periductal mastitis?

Answer 13

what ducts near nipple undergo squamous metaplasia and keratin obstructs the ductal system leading to dilatation and rupture. PAINFUL and common in SMOKERS

Question 14

when do men usually get gynecomastia?

Answer 14

puberty and when old.

Question 15

what causes gynecomastia? is it unilateral or bilateral?

Answer 15

It is caused by the imbalance of estrogens and androgensn in diseases such as Cirrhosis, Kleinfelters and drugs. It can be both unilateral or bilateral.

Question 16

Breast mouse means which type of lesion?

Answer 16

fibroadenoma

Question 17

T/F fibroadenomas are the most commmon benign breast tumor?

Answer 17

True

Question 18

Fibroadenomas are characterized by proliferation of which tissue types (2)?

Answer 18

stromal and epithelial proliferation

Question 19

Lumpy bumpy breast refers to which breast pathology?

Answer 19

fibrocystic change AKA (non proliferative change)

Question 20

What are the 3 histologic findings with fibrocytic change?

Answer 20

fibrosis
cysts
adenosis

Question 21

Are fibrocytic changes a concern for breast carcinoma?

Answer 21

No, they have no increased risk

Question 22

what is adenosis?

Answer 22

an increase in anini per lobular unit of the breast.

Question 23

what breast pathology is described as every cell type proliferates, and each at different stages; there are usually more than 2 cell layers comprising the glands?

Answer 23

proliferative breast disease without atypia

Question 24

does proliferative breast disease without atypia have an increased risk for carcinoma?

Answer 24

yes, 2x

Question 25

``` ductal epithelial hyperplasia without atypia sclerosing adenosis papillomas comples radial scars (these are all part of which grouping?) ```

Answer 25

Proliferative breast disease without atypia (This is proliferation of the DUCTAL epithelium, and these have more than the usual 2 cell layers)

Question 26

which disease is described as proliferation of ductal epithelium (more than 2 layers) that has both cytologic heterogeneity and architectural heterogeneity?

Answer 26

Ductal epithelial hyperplasia without atypia

Question 27

T/F ductal epithelial hyperplasia without atypia usually fills the ductal lumen with cells that are irregular in shape and size?

Answer 27

True

Question 28

which disease looks like a severely compressed fibrotic stroma but still having only 2 cell layers in the ducts?

Answer 28

sclerosing adenosis

Question 29

T/F sclerosing adenosis looks just like breast carcinoma on histology?

Answer 29

True

Question 30

what is the most common cause of unilateral bloody discharge?

Answer 30

intraductal papillomas (specifically large duct papillomas because they occur near the nipple while small duct papillomas occur in the lobules)

Question 31

Which disease is this describing? [histology: central nidus with fibroelastic stroma containing entrapped glands]

Answer 31

complex sclerosing lesion/radial scar

Question 32

does proliferative breast disease with atypia have and increased risk of breast carcinoma?

Answer 32

Yes, 5x

Question 33

Lesions included in the proliferative breast disease with atypia include (2)?

Answer 33

atypical ductal hyperplasia | atypical lobular hyperplasia

Question 34

what does this describe; punched out regular lumina, cribiform architecture, and monotonous cells?

Answer 34

atypical ductal hyperplasia. (you can also frequently see micorcalicifications with this)

Question 35

what does this describe; monotonous poorly cohesive cells (loss of E cadherin), looks like lobular carcinoma in situ?

Answer 35

atypical lobular hyperplasia.

Question 36

what is the lifetime risk of a woman acquiring breast cancer?

Answer 36

1/8

Question 37

what is the most common malignancy in women?

Answer 37

skin cancer

Question 38

what is the second most common malignancy in women?

Answer 38

breast cancer

Question 39

why did the incidence of breast cancer increase during the early 90's?

Answer 39

``` better detection (so you just find a higher percentage) Using hormone replacement therapy. ```

Question 40

which race has the highest incidence of breast cancer?

Answer 40

caucasians

Question 41

what are the big risk factors for breast cancer?

Answer 41

``` AGE Gender early menarchy/late menopause obesity not breastfeeding Family history Gene mutation ```

Question 42

what percentage of all breast cancers are attributable to familial breast cancers?

Answer 42

10%

Question 43

Which gene in autosomal dominant, is involved in DNA repair, and if mutated increases risk for breast cancer risk to 65% by age 70?

Answer 43

BRCA 1

Question 44

what percentage of all breast cancers are caused from BRACA 1 and BRACA 2 mutations?

Answer 44

3 percent of total | 20 percent of familial