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Systemic Pathology Test 2 > Breast Diseases > Flashcards

Breast Diseases Flashcards

(59 cards)

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1
Q

Most breast lumps are?

A

Fibrocystic changes

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2
Q

Fibrocystic changes are mostly?

A

Cysts and fibrosis

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3
Q

What is the most common breast abnormality in premenopausal women?

A

Fibrocystic changes

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4
Q

What causes fibrocystic changes

A

Cyclic breast changes that occur normally in the menstrual cycle

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5
Q

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

A

Fibrosis is caused by the rupture of cysts

Cysts formed by the folding and unfolding of lobules

The lining is apocrine metaplasia

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6
Q

What is epithelial hyperplasia and what cells are involved?

A

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

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7
Q

Sclerosing adenosis presents as? What cells are preserved?

A

Presents as mammography calcifications and myoepthileal cells are preserved and increase

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8
Q

Acute mastitis is related to? What organism causes it?

A

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

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9
Q

What is seen histologically in acute mastitis?

A

The breast tissue is infiltrated by neutrophils

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10
Q

Duct ectasia is AKA?

A

Plasma cell mastitis

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11
Q

Patients with duct ectasia present with?

A

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

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12
Q

What cells are seen surrounding the ducts? Inside?

A

Plasma cells and lymphocytes. Inside see macrophages

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13
Q

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

A

Fibroadenoma, occurs in the 3rd decade

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14
Q

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

A

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

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15
Q

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

A

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

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16
Q

What happens to the stroma in older women?

A

Becomes hyalinzed and the epithelium is atrophic

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17
Q

Phyllodes tumor arises from?

A

Intralobular stroma

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18
Q

Phyllodes tumor presents in?

A

The 6th decade, older women

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19
Q

What percentage of phyllodes tumors are malignant?

A

15%

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20
Q

What are the 3 types of phyllodes tumors?

A

Benign, low grade malignant, and high grade malignant

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21
Q

Higher grade phyllodes tumors are? How do they grow?

A

Hemmorhagic, grow in a bulbous fashion

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22
Q

What distinguishes phyllodes tumors from fibroadenoma?

A
  1. Stromal cellularity and mitoses
  2. Nuclear pleomorphism
  3. infiltrative borders
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23
Q

An intraductal papilloma grows within?

A

A dilated duct

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24
Q

When does the risk for breast cancer begin to increase?

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A

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

Systemic Pathology Test 2 (10 decks)

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