BREAST | GOLJAN

Question 1

define : apocrine metaplasia

seen in ?

Answer 1

presence of large, pink cells

seen in FCC - epithelial hyperplasia

Question 2

greenish brown nipple discharge

Answer 2

plasma cell mastitis AKA mammillary duct ectasia

Question 3

define: galactorrhea

causes

Answer 3

milky discharge from nipple

1. prolactinoma - MC
2. hypothyroidism - TRH stimulates prolactin

Question 4

bloody nipple discharge

Answer 4

intraductal papilloma

ductal cancer

Question 5

locations of breast pathology

Answer 5

1. areola/nipple
2. lactiferous sinus
3. major duct
4. terminal duct
5. lobule
6. stroma

Question 6

which pathology is seen in STROMA?

Answer 6

fibroadenoma

phyllodes tumor

Question 7

which pathology is seen in AREOLA/NIPPLE?

Answer 7

breast abscess

paget’s disease of the nipple

Question 8

which pathology is seen in LACTIFEROUS SINUS?

Answer 8

breast abscess
intraductal papilloma
plasma cell mastitis

Question 9

which pathology is seen in MAJOR DUCT?

Answer 9

ductal cancer

FCC*

Question 10

which pathology is seen in TERMINAL DUCT?

Answer 10

tubular carcinoma

Question 11

which pathology is seen in LOBULE?

Answer 11

lobular carcinoma
sclerosing adenosis (FCC)

Question 12

*mondor disease

Answer 12

superficial thrombophlebitis of veins overlying the breast

seen as a palpable, painful cord

Question 13

MCC of breast pain <50

Answer 13

FCC

Question 14

types of FCC

Answer 14

1. fibrous
2. cystic
3. sclerosing adenosis
4. ductal hyperplasia

Question 15

describe - cystic FCC

Answer 15

cysts hemorrhage

*blue-domed cysts

Question 16

which type of FCC is mistaken for cancer?

Answer 16

sclerosing adenosis

- b/c of microcalcifications

Question 17

describe : traumatic fat necrosis

Answer 17

trauma to breast leads to fibrosis and dystrophic calcification

acute- painful mass
chronic- painless indurated mass

lipid laden macrophages with giant foreign body cells

Question 18

MC breast tumor in women <35

Answer 18

fibroadenoma

Question 19

describe : fibroadenoma

Answer 19

discrete painful or painless movable tumor
multiple lesions / bilateral - LUMPY BUMPY
located in stroma
estrogen sensitive - size changes accordingly

seen in post renal transplant women

Question 20

describe : phyllodes tumor

Answer 20

large bulky tumor \ lobules with cysts
LEAF LIKE projections
located in stroma

Question 21

location of : intraductal papilloma

Answer 21

lactiferous duct

Question 22

MCC of acute mastitis

Answer 22

staph aureus
red, swollen, painful breast

breast feeding!

Question 23

*clinical findings in breast cancer

Answer 23

painless mass
painless axillary LAD
skin \ nipple retraction \ discharge

Question 24

non invasive breast cancer types

Answer 24

DCIS

LCIS

Question 25

describe DCIS

Answer 25

ductal carcinoma in situ non palpable seen on mammogram b/c of microcalcifications

Question 26

which non invasive cancer shows CASEOUS NECROSIS

Answer 26

comedocarcinoma - DCIS

Question 27

which non invasive cancer has lacks E-CADHERIN

Answer 27

LCIS

Question 28

describe LCIS

Answer 28

lobular carcinoma in situ non palpable NO calcifications and therefore cant be identified *cancer in opposite breast

Question 29

name the INVASIVE types of breast cancer

Answer 29

``` invasive ductal carcinoma invasive lobular carcinoma Paget disease of the nipple medullary carcinoma inflammatory carcinoma ```

Question 30

stellate morphology

Answer 30

invasive ductal carcinoma

Question 31

describe : invasive ductal carcinoma

Answer 31

``` stellate morphology firm, fibrous, ROCK HARD mass gray-white color MC type of all breast cancers gritty on cut surface ```

Question 32

describe : invasive lobular carcinoma

Answer 32

usually bilateral "L in lobular" neoplastic cells are either arranged Linearly ( indian file) or in Lobules ( bulls eye )

Question 33

describe : PAGET disease of the nipple

Answer 33

eczematous patches on nipple with or w/o nipple retraction extension of DCIS

Question 34

*paget cells

Answer 34

large cells in epidermis with clear halo

Question 35

describe : medullary carcinoma

Answer 35

bulky, soft, fleshy tumor w LYMPHOCTYIC infiltrate BRCA1 good prognosis the "medulla" is usually bulky, soft, and filled w/ cells

Question 36

describe : inflammatory carcinoma*

Answer 36

``` invasion of lymphatics by carcinoma causes lymphedema this prevents sweat glands from closing leading to ERYTHEMATOUS breast with PEAU D'ORANGE poor prognosis b/c of invasion ```

Question 37

peau d' orange

Answer 37

inflammatory carcinoma

Question 38

lacks e-cadherin

Answer 38

LCIS

Question 39

bulls eye appearance

Answer 39

invasive lobular carcinoma

Question 40

lymphocytic infiltrate

Answer 40

medullary carcinoma