Breast

Question 1

They are located in large lactiferous sinuses or ducts, and have a tendency to bleed

Answer 1

Intraductal carcinoma

Question 2

contain ducts with stroma and are not highly vascular; these lesions are not located in ducts

Answer 2

Fibroadenoma

Question 3

also arise from intralobular stroma and can be malignant

Answer 3

Phyllodes tumor

Question 4

common and may enlarge during pregnancy or late in each menstrual cycle

Answer 4

Fibro adenomas

Question 5

smaller than 1 cm and are not influenced by hormonal changes

Answer 5

Intraductal papillomas

Question 6

is typically an ill-defined lesion without a mass effect

Answer 6

Lobular carcinoma in situ

Question 7

typically caused by trauma to the breast. The damaged, necrotic fat is phagocytosed by macrophages, which become lipid laden. The lesion resolves as a collagenous scar within weeks to months. The firm scar can mammographically and grossly resemble a carcinoma

Answer 7

Fat necrosis

Question 8

most often a consequence of chronic alcoholism and impairs hepatic estrogen metabolism, which can lead to gynecomastia

Answer 8

Micronodular cirrhosis

Question 9

irregular lesions, not discrete masses

Answer 9

Fibrocystic change

Question 10

masses with irregular outlines

Answer 10

Fat necrosis

Question 11

more diffuse involvement, without mass effect

Answer 11

Mastitis

Question 12

are large cells that have clear, mucinous cytoplasm and infiltrate the skin. They are malignant and extend to the skin from an underlying breast carcinoma

Answer 12

Paget cells

Question 13

typically produces localized abscesses, whereas streptococcal infections tend to spread throughout the breast

Answer 13

Staphylococcal acute mastitis

Question 14

account for the largest category of breast lumps, statistically about 40% of all breast “lumps.” These lesions are probably related to cyclic breast changes that occur during the menstrual cycle

Answer 14

Fibrocystic change

Question 15

Bilateral malignant

Answer 15

Lobular carcinoma in situ

Question 16

antiestrogenic compound that has effectiveness in the treatment of breast cancers positive for estrogen receptor

Answer 16

Tamoxifen

Question 17

The expression of HER2/neu suggests that biotherapy with __________ may have some effectiveness

Answer 17

trastuzumab

Question 18

although grossly and microscopically similar to fibroadenomas, occur at an older age, are larger, and are more cellular; they can recur locally, but rarely metastasize

Answer 18

Phyllodes tumor

Question 19

may increase the risk of carcinoma, but it does not produce visible surface skin changes

Answer 19

Atypical ductal hyperplasia

Question 20

can be large and sometimes tender, but the overlying skin is typically not affected, and spread to lymph nodes is uncommon

Answer 20

Phyllodes tumor

Question 21

is a feature of benign fibrocystic changes and has no skin involvement

Answer 21

Sclerosing adenosis

Question 22

is a feature of benign fibrocystic changes and has no skin involvement

Answer 22

Sclerosing adenosis

Question 23

They tend to occur in women at younger ages than do most other breast cancers

Answer 23

Medullary carcinoma

Question 24

occur about as frequently as medullary carcinomas, but they are often positive for ER-PR, and the prognosis is better than average

Answer 24

Colloid carcinoma

Question 25

absence of estrogen receptors and progesterone receptors (ER-PR

Answer 25

Medullary carcinoma

Question 26

are small benign lesions that tend to stop enlarging after menopause, when hormonal stimulation has ceased

Answer 26

Fibroadenoma

Question 27

tend not to produce large, localized lesions because they are more invasive, and they lack a distinct lymphoid infiltrate

Answer 27

Infiltrating ductal

Question 28

accounts for a small percentage of breast cancers, primarily in families in which cancer onset occurs at a young age

Answer 28

BRCA1 gene

Question 29

Fibrocystic changes without epithelial hyperplasia do not suggest an

Answer 29

Increased risk of breast cancer

Question 30

There are two known breast cancer susceptibility genes: BRCA1 and BRCA2. Both are cancer suppressor genes. Specific mutations of __________ are common in some ethnic groups, such as Ashkenazi Jews

Answer 30

BRCA1

Question 31

is a growth factor receptor gene that is amplified in certain breast cancers and is a marker of poor prognosis, not susceptibility

Answer 31

HER2/neu

Question 32

Distant metastases are unlikely to be found

Answer 32

Ductal carcinoma in situ

Question 33

A 29-year-old woman and her 32-year-old sister were diagnosed with infiltrating ductal carcinoma of the breast, and both had bilateral mastectomies. Which of the following risk factors is most significant for this type of cancer

Answer 33

Inheritance of mutant p53 allele

Question 34

The physician palpates a firm area that has a cordlike feel. No lesions of the overlying skin are present, and there is no axillary lymphadenopathy Cribriform pattern

Answer 34

Comedocarcinoma

Question 35

An intraductal carcinoma, or ductal carcinoma in situ (DCIS), may not

Answer 35

Produce a palpable mass

Question 36

An epidemiologic study is conducted with male subjects who have been diagnosed with breast carcinoma. Their demographic data, past medical histories, family histories, and laboratory data are examined to identify factors that increase the risk of cancer. Which of the following factors is most likely to increase significantly the risk of developing male breast carcinoma

Answer 36

Age older than 70

Question 37

A clinical study is performed on postmenopausal women living in Tampa, Florida, who are between the ages of 45 and 70 years. All have been diagnosed with infiltrating ductal carcinoma positive for estrogen receptor (ER) and progesterone receptor (PR), which has been confirmed by biopsy and microscopic examination of tissue. None has the BRCA1 or BRCA2 mutation. Which of the following is most likely to indicate the highest relative risk of developing the carcinomas seen in this group of women

Answer 37

First degree relative with breast cancer

Question 38

26 yo Genetic analysis shows that she is a carrier of the BRCA1 gene mutation, as are her mother and sister. Which of the following histologic types of breast carcinoma has the highest incidence in families such as hers

Answer 38

Medullary carcinoma

Question 39

A Tumor Registry tracks patients diagnosed with breast cancer. Statistical analyses are performed regarding survival of these patients. Which of the following parameters recorded for these breast cancers is most likely to show the strongest correlation with longer patient survival

Answer 39

Tumor size

Question 40

Best treatment for negative ER PR and H er2/neu

Answer 40

Chemotherapy

Question 41

usually solitary and smaller than 1 cm

Answer 41

Intraductal carcinoma