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systems pathology > breast > Flashcards

breast Flashcards

1
Q

name the most common disorder of the breast?

A

fibrocystic disease

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2
Q

what are the 3 forms of fibrocystic disease of the breast?

A

non-proliferative
proliferative
sclerosing adenosis

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3
Q

what are some special lab findings of non-proliferative fibrocystic breast tissue

A

dilation of ducts with no epithelial hyperplasia.
&
Increase in collagen

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4
Q

what is the color of a fibrocystic cyst (non-proliferative) when removed ?

A

blue/brown

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5
Q

what are some special lab findings of proliferative fibrocystic breast tissue?

A

epithelial hyperplasia
ductal papillomatosis
fenestrations
increase risk of carcinoma

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6
Q

what are the findings of ductal papillomatosis?

A

multilayered with papillary folding

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7
Q

what are the findings with fenestration of breast tissue?

A

filling of the ductal lumen

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8
Q

what form of fibrocystic breast disease can you find papillomatosis and fenestrations?

A

proliferating form

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9
Q

what is special about sclerosing adenosis?

A 
*looks like carcinoma of the breast*
adenosis
intralobular sclerosis
enlarged and deformed lobular units
proliferation of acini
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10
Q

what does adenosis mean?

A

the number of acini per duct is increasing

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11
Q

is which form of fibrocystic disease of the breast can you find an increase of acini per duct and intralobular fibrosis?

A

sclerosing adenosis

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12
Q

what is the most common benign tumor of the breast?

A

fibroadenoma

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13
Q

what is special about a fibroadenoma?

A

it is hormone dependent.
responds to increase of estrogen
multiple and bilateral

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14
Q

if a women comes to the clinic with a free moveable mass on her breast what should be on the top of your differential dx.?

A

fibroadenoma

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15
Q

after taking a biopsy of a free moveable mass of a woman’s breast what should you expect to see?

A

intact BM
loose fibroblastic stroma
can either appear:
periductal or intraductal

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16
Q

in a lab finding you see a periductal mass meaning it is what shape

A

round or oval

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17
Q

in a lab finding you see a slit like mass what shape is it?

A

slit like

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18
Q

in a lab finding you see a slit like mass with loose stroma and an intact BM what tumor of the breast is it?

A

intraductal fibroadenoma

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19
Q

what is the name of a epithelial tumor of the breast

A

intraductal papilloma

20
Q

what are the two main locations of a intraductal papilloma?

A

lactiferous ducts and the aerola

21
Q

what are some special findings of a intraductal papilloma?

A

mostly solitary
branching papillae covered with cubical epithelium
neoplastic papillary growth

22
Q

are intraductal papilloma benign or mets?

A

benign

23
Q

what are some clinical findings of a intraductal papilloma?

A

bloody nipple discharge
unilateral
subaerolar mass

24
Q

what is the second leading cancer in america

A

carcinoma of the breast

25
Q

a lady comes into the clinic an immoveable mass in breast
early menarche
late menopause
and used birth control for several years
what is she most likely to have?

A

carcinoma of the breast

26
Q

what are some classical findings of breast carcinoma?

A

ductal or lobular epithelium
left breast involved
upper outer quadrants

27
Q

where can non-invasive carcinomas be found?

A

in the basement membrane

28
Q

out of the non-invasive carcinomas;

is intraductal or intralobular carcinoma of the breast most common?

A

intraductal is most common

29
Q

what are some classic lab findings of intralobular carcinoma?

A
  • plugged and filled ducts
  • confined to BM
  • comedocarcinoma = central necrosis of ducts
  • rapid proliferation
30
Q

you find central necrosis of ducts
plugging and filling of ducts
and rapid proliferation of cells (mitotic figures) in tissues what carcinoma of the breast is it most likely?

A

intraductal carcinoma of the breast

31
Q

during a mammogram you incidentally find clusters of acini that are monomorphic what kind of carcinoma of the breast is it?

A

lobular

32
Q

what is the treatment for both the intralobular or intraductal forms of non-invasive carcinoma?

A

lumpectomy

33
Q

the majority of invasive breast carcinomas are

A

ductal

34
Q

pt. comes into the clinic with a hard immoveable mass on the outer quadrant of the left breast with an ‘orange’ look with dimpling and a retracted nipple…. what should be on the top of your differential?

A

invasive ductal carcinoma

35
Q

in the lab biopsy of a invasive ductal carcinoma what would likely be seen?

A

nests and cords of malignant cells in stroma

replacement of breast fat with fibrosis

36
Q

what are the variants of ductal carcinoma?

A

medullary
colloid
tubular

37
Q

microscopically the dr. finds large fleshy groups of cells separated by scant fibrous tissue and infiltration of lymphocytes what type of ductal carcinoma is it?

A

medullary

38
Q

out the 3 types of ductal carcinoma which one has the best prognosis?

A

medullary

39
Q

microscopically the dr. finds mucin intracellularlly and extracellulary with a blue/gray bulky mass…
what kind of ductal carcinoma is this?

A

medullary

40
Q

microscopically you find well formed tubules… what kind of ductal carcinoma of the breast is this?

A

tubular ductal

41
Q

pt. comes into office with nipple lesion and the lab finds it extending into the ductal system and does not cross the BM
they also note a ‘halo’ look?

what kind of disease of the breast is this?

A

paget’s disease

due to an existing tumor of the breast (non-invasive or invasive)

42
Q

what are some special lab findings of pagets disease?

A
  • clear halo– mucopolysaccharide
  • DOES NOT cross BM
  • invades the ductal system
43
Q

what is a special lab finding of invasive lobular carcinoma?

A

indian file line

44
Q

you find mitotic cells invading ‘individually’ into the stroma –> looking like a (———–) (——-) indian file line; what type of carcinoma of the breast is this?

A

invasive lobular carcinoma

45
Q

Peau d’orange is due to?

A

localized lymphedema due to a tumor of the breast

46
Q

carcinome of the breast will spread fast/slow during pregnancy due to an increase of estrogen…

A

fast

47
Q

of carcinoma of the breast is to spread by blood where will it go?

A

lung, bone, liver, adrenals

systems pathology (4 decks)

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