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Systemic Pathology Test 2 > Breast Diseases > Flashcards

Flashcards in Breast Diseases Deck (59):
1

Most breast lumps are?

Fibrocystic changes

2

Fibrocystic changes are mostly?

Cysts and fibrosis

3

What is the most common breast abnormality in premenopausal women?

Fibrocystic changes

4

What causes fibrocystic changes

Cyclic breast changes that occur normally in the menstrual cycle

5

Fibrosis is caused by? Cysts form by? What lines cysts?

Fibrosis is caused by the rupture of cysts

Cysts formed by the folding and unfolding of lobules

The lining is apocrine metaplasia

6

What is epithelial hyperplasia and what cells are involved?

Increase in the number of layers of duct epithelium to more than 2. There are ductal and myoepithelial cells

7

Sclerosing adenosis presents as? What cells are preserved?

Presents as mammography calcifications and myoepthileal cells are preserved and increase

8

Acute mastitis is related to? What organism causes it?

Related to the first month of breast feeding and S. aureus causes it by entering the ducts

9

What is seen histologically in acute mastitis?

The breast tissue is infiltrated by neutrophils

10

Duct ectasia is AKA?

Plasma cell mastitis

11

Patients with duct ectasia present with?

Periareolar mass that is associated with thick white nipple discharge and skin retraction

12

What cells are seen surrounding the ducts? Inside?

Plasma cells and lymphocytes. Inside see macrophages

13

What is the most common benign breast tumor and when does it occur?

Fibroadenoma, occurs in the 3rd decade

14

Is the fibroadenoma mobile? What is the consistency? What is the most common site for one?

Mobile and rubbery. The most common site is the upper outer quadrant

15

In fibroadenoma the stroma resembles? The glandular spaces are lined by what kind of cells?

Stroma resembles normal stroma. Spaces lined by ductal and myoepithelial cells.

16

What happens to the stroma in older women?

Becomes hyalinzed and the epithelium is atrophic

17

Phyllodes tumor arises from?

Intralobular stroma

18

Phyllodes tumor presents in?

The 6th decade, older women

19

What percentage of phyllodes tumors are malignant?

15%

20

What are the 3 types of phyllodes tumors?

Benign, low grade malignant, and high grade malignant

21

Higher grade phyllodes tumors are? How do they grow?

Hemmorhagic, grow in a bulbous fashion

22

What distinguishes phyllodes tumors from fibroadenoma?

1. Stromal cellularity and mitoses
2. Nuclear pleomorphism
3. infiltrative borders

23

An intraductal papilloma grows within?

A dilated duct

24

When does the risk for breast cancer begin to increase?

After age 30 and especially after menopause

25

75% of women with breast cancer are older than?

50

26

Where is risk for breast cancer highest? What factors are involved?

North America and Northern Europe.

Diet, reproductive patterns, nursing habits

27

Ductal carcinoma in situ is associated with? What cells are present but in diminished numbers?

Calcifications

Myoepithelial cells present

28

Ductal carcinoma in situ can involve?

TDLU and larger ducts

29

How is ductal carcinoma in situ graded?

By the degree of nuclear pleomorphism

30

What is comedo DCIS or comedocarcinoma?

Sheets of cells with high nuclear grade and central necrosis
Microinvasions may be present

31

Tumor cells invading less than _ mm into stroma is seen in ___ grade DCIS?

1 mm, high grade

32

What is Paget disease?

Poorly differentiated DCIS that extends from the lactiferous ducts into skin of nipple. Resulting in unilateral inverted nipple

33

In lobular carcinoma in situ the population of cells is?

Monomorphic

34

How is lobular carcinoma in situ detected?

Incidental finding, not mammographically detected

35

How the cells appear in lobular carcinoma in situ?

Dyscohesive cells with oval or round small nuclei

36

What causes the discohesion in lobular carcinoma in situ?

Cell adhesion Protein E cadherin is lost

37

Receptors for what hormones are often expressed in lobular carcinoma in situ?

Estrogen and progesterone

38

Invasive lobular carcinomas tend to be lateral or bilateral?

Bilateral and multicentric

39

Where does invasive lobular carcinoma metastasize to?

CSF, serosa, basement membrane and solid organs

40

When breast cancers spread into the skin they cause?

Peau d'orange

41

Breast cancer often spreads to what lymph nodes?

Axillary and internal mammary nodes

42

When breast cancer involves dermal lymphatics it causes?

Inflammatory carcinoma

43

BRCA 1 is located on what chromosome?

17q21

44

BRCA puts people at risk of what other cancers?

Ovarian and prostate

45

BRCA genes code for?

Tumor suppressor proteins

46

BRCA 2 is located on what chromosome?

13q12.3

47

What cancers are associated with BRCA2?

Higher chance for breast cancer in men, slightly lower risk of ovarian cancer, stomach and melanoma, prostate, pancreas

48

What other genes have been associated with breast cancer?

RAS, MYC, p53, PTEN

49

How are estrogen and progesterone receptors detected?

Immunohistochemistry

50

What do these receptors mean for treatment?

Those with both receptors respond to hormone therapy 80% of the time, single respond 40%

Double negative respond to chemo, ER positive less likely to respond to chemo

51

What gene is sometimes over expressed in breast cancers?

HER2

52

HER2 over expression means?

More aggressive and less responsive to hormone therapy

53

HER2 tumors respond to what drug

Herceptin

54

What are the two types of surgical resection?

Lumpectomy for small tumors and mastectomy for lager ones

55

Men can only get what type of breast cancer?

Ductal carcinoma

56

What is a good marker for myoepithelial cells?

P63

57

What is the term for multiple papillomas? What does this cause?

Papillomatosis, increases the risk of breast cancer

58

Non-comedo ductal carcinoma in situ shows?

Low to moderate grade, no necrosis

59

What is the differential diagnosis for Paget Disease?

Melanoma