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Life Cycle Exam 2 > Breast – Normal Histology and Benign Disease > Flashcards

Breast – Normal Histology and Benign Disease Flashcards

1
Q

The ducts are largest near the ____________.

A

areolae

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2
Q

Where do the lymph nodes of the breasts drain?

A

Most (45%) drain to the axillary lymph nodes. Second-most drain to the supraclavicular lymph nodes. Some can drain to the mediastinum or below the diaphragm.

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3
Q

The entire ductal system is lined by _______________.

A

a two-cell layer (any more is abnormal): inner is glandular, outer is myoepithelial

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4
Q

Between the lobules is ______________.

A

intralobular stroma, which is hormone-responsive Note: there is also interlobular stroma between different lobular units, which is fibrous.

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5
Q

What is the main difference in male breasts?

A

There are ducts in males breasts, but there are no lobules.

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6
Q

In a malignancy, the ___________ layer is lost.

A

myoepithelial

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7
Q

Puberty prompts the formation of _____________.

A

acini

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8
Q

During pregnancy, _____________ increase in number.

A

acini

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9
Q

After menopause, there is ______________.

A

more stroma and fat; less glandular tissue

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10
Q

In addition to increased lobules, there is _____________ during pregnancy as well.

A

epithelial vacuolization

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11
Q

During pregnancy or even menstruation, breast tissue can appear in the ___________.

A

axilla

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12
Q

Nipple retraction (having an innie nipple) can occur due to ______________.

A

congenital abnormality or cancer

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13
Q

In gynecomastia, _____________ accounts for most of the extra mass.

A

stromal proliferation

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14
Q

What causes acute mastitis?

A

Usually occurring in lactating women, acute mastitis results from cracks in the nipple that allow Staphylococci into the ducts (where they survive on milk). This presents with redness and tenderness of the breast.

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15
Q

What causes chronic mastitis?

A

Generally non-infectious causes like milk obstructions. Most often presents in perimenopausal women. Can mimic carcinoma because irregular fibrosis often results from healing.

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16
Q

What causes recurrent subareolar mastitis?

A

Squamous metaplasia around the main nipple duct leads to recurrent inflammation due to the accumulation of keratin where it should not be.

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17
Q

Recurrent subareolar mastitis most often occurs in ____________.

A

smokers

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18
Q

_____________ can cause fat necoris of the breast.

A

Trauma and ischemia

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19
Q

Describe how a fibroadenoma presents.

A

Firm but regular; well-encapsulated; mobile

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20
Q

How do fibroadenomas appear on histologic exam?

A

There is proliferation of glands and fibrous stroma, but in general the fibrous stroma takes over and occludes the lobules.

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21
Q

______________ presents as primarily a proliferation of glandular tissue.

A

Lactating adenoma

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22
Q

Which masses can be benign or malignant?

A

Phyllodes tumors and papillomas

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23
Q

____________ are often described as large fleshy tumors.

A

Phyllodes tumors

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24
Q

Papillomas tend to occur near the ____________.

A

sub-areolar region

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25
Q

Papillomas arise from ____________ and invade the ducts.

A

epithelium

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26
Q

About 50% of women present with _____________ at autopsy.

A

fibrocystic change (most often asymptomatic)

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27
Q

_______________ is like fibrocystic change without cysts.

A

Sclerosing adenosis

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28
Q

Fibrocystic change can present as ______________ or ________________.

A

proliferative (with epithelial hyperplasia); nonproliferative (no hyperplasia)

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29
Q

_______________ often leads to fibrous obliteration of the terminal lobules.

A

Sclerosing adenosis

30
Q

Apocrine metaplasia is associated with ________________.

A

fibrocystic change

31
Q

Lobular carcinoma in situ is distinct from atypical lobular hyperplasia in that ______________.

A

LCIS involves more than 50% of the lobules, while ALH involves less than

32
Q

LCIS raises risk of ____________.

A

carcinoma bilaterally

33
Q

_______________ presents with hyperplasia and discrete punched-out lesions.

A

Atypical ductal hyperplasia

34
Q

Bloody nipple discharge is associated with _____________.

A

papillomas and carcinomas

35
Q

True or false: LCIS raises risk of only lobular carcinoma.

A

False. It raises the risk of both.

36
Q

On fine-needle aspiration, malignant cells will appear as _____________, while benign cells will appear as _________________.

A

frangible cells; cohesive masses

37
Q

Describe the changes in skin types that occur from the outside of the nipple to the duct.

A

Outside: keratinizing, stratified squamous epithelium Inside: double-layer cuboidal epithelium (myoepithelium and luminal epithelium)

38
Q

Prior to puberty, the breasts are _______________.

A

branching ducts without the terminal lobules

39
Q

At the end of pregnancy, the breast is composed almost entirely of _____________.

A

lobules

40
Q

By what cellular processes does the breast shrink after cessation of lactation?

A

Atrophy of stroma and apoptosis of epithelial cells

41
Q

Describe juvenile hypertrophy of the breasts.

A

Some girls get extensive development of the breast in the absence of hormone imbalances.

42
Q

Ductal papillomas typically present in _____________.

A

large ducts as papillary protrusions

43
Q

Both types of ______________ raise risk of carcinoma.

A

atypical hyperplasia

44
Q

Blue-domed cysts are characteristic of ______________.

A

non-proliferative FCC

45
Q

what is this image showing?

A

male breast tissue

46
Q

what is this imaige?

A

terminal duct lobular unit

47
Q

what is this imaige?

A

resting adult female breast tissue

48
Q

what is this imaige?

A

breast tissue during pregnancy and lactation

49
Q

what is this imaige?

A

postmenopausal breast tissue

50
Q

what is this imaige?

A

gynocomastia

51
Q

what is this imaige?

A

fat necrosis (early phase)

late phase in answer

52
Q

whats this?

A

fibroademoma (benign)

53
Q

what is this imaige?

A

fibroadenoma

54
Q

what is the origin of a fibroadenoma?

A

the TDLUs

55
Q

what is this image?

A

lactating adenoma

56
Q

what is this image?

A

phyllodes tumor

57
Q

what is this image?

A

papilloma

58
Q

what is this image?

A

papilloma

59
Q

what is this image?

A

fibrocystic change

60
Q

what is this image?

A

sclerosing aenosis

61
Q

what is this image?

A

non proliferative fibrocystic change

62
Q

what is this image?

A

microcalcifications

63
Q

what is this image?

A

apocrine metaplasia

64
Q

what is this image?

A

atypical lobular hyperplasia

65
Q

what is this image?

A

LCIS

66
Q

what is this image?

A

proliferative fobrocystic change

67
Q

what is this image?

A

proliferative fibrocystic change (florid hyperplasia)

68
Q

what is this image?

A

atypical ductal hyperplasia

69
Q

what is this image?

A

ductal carcinoma in situ

70
Q
A

Life Cycle Exam 2 (22 decks)

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