Breast Pathology

Question 1

epithelium layer of nipple and areola, what does it change into while entering breast?

Answer 1

• stratified squamous

- double layer cuboidal

Question 2

breast development at menarche

Answer 2

terminal ducts give rise to lobules and increased interlobular stroma

Question 3

breast development in follicular phase

Answer 3

lobules quescient

Question 4

breast development in luteal phase

Answer 4

cell proliferation with increased acini/lobule

Question 5

breast development in pregnancy

Answer 5

breast assumes complete morphologic and functional maturity

Question 6

Milk line remnants

Answer 6

persistence of epidermal thickening along milk line

Question 7

Accessory axillary breast tissue

Answer 7

mastectomy may not remove all breast tissue

Question 8

congenital inversion of nipple

Answer 8

nursing difficulties and can be confused with inversion due to carcinoma or inflammation

Question 9

macromastia

Answer 9

severe back pain

Question 10

reconstruction or augmentation

Answer 10

formation of capsule with inflammatory response causing cosmetic deformity and difficulty in mammographic evaluation

Question 11

what are the 3 most common symptoms of breast disease

Answer 11

1. pain
2. palpable mass
3. nipple discharge

Question 12

what are 2 principal signs for mammographic screening

Answer 12

1. densities

2. calcifications

Question 13

who is vulnerable to acute mastitis

Answer 13

nursing breasts

Question 14

what is the most common cause of acute mastitis

Answer 14

staph aureus

less common - strep

Question 15

treatment for acute mastitis

Answer 15

drainage and antibiotic

Question 16

Periductal mastitis

Answer 16

painful eythermatous subareolar mass

Question 17

who is most likely to get periductal mastitis

Answer 17

smokers

Question 18

what is histo for periductal mastitis

Answer 18

keratinizing squamous extends

-keratin accumulates dilating and rupturing duct

Question 19

treatment for periductal mastitis? problems

Answer 19

• incision and drainage
• does not remove squamous epithelium which can cause recurrence
• remove duct and fistulous tract

Question 20

who does mammary duct ectasia occur in

Answer 20

5th to 6th decade in multiparous women

Question 21

how does mammary duct ectasia present

Answer 21

poorly defined mass, skin retraction, cheesy discharge

Question 22

what is the morphology of mammary duct ectasia

Answer 22

• periductal and interstitial chronic granulomatous inflammation

Question 23

what are 3 incidences that can cause fat necrosis

Answer 23

trauma
prior surgical intervention
radiation therapy

Question 24

gross morphology for fat necrosis ? early and late?

Answer 24

early: hemorrhage
late: liquefaction necrosis

Question 25

histo for fat necrosis

Answer 25

central necrotic fat cells surrounded by lipid laden macrophages and intense neutrophilic infiltrate

Question 26

etiology for granulomatous mastitis

Answer 26

- systemic granulomatous disease (wegner's) | - infections

Question 27

morphology gross for granulomatous mastitis

Answer 27

granulomas in lobular epithelium

Question 28

who gets granulomatous mastitis

Answer 28

- parous women

Question 29

what is lymphocytic mastopathy

Answer 29

hard palpable masses | - collagenized stroma surrounding atrophic ducts and lobules

Question 30

what are 3 groups for benign epithelial lesions

Answer 30

1. non-proliferative 2. proliferative 3. atypical hyperplasia

Question 31

what can cause non-proliferative breast changes

Answer 31

hormonal imbalance - increase estrogen OR - decreased progesterone

Question 32

what are 3 patterns seen in non-proliferative breast changes

Answer 32

1. cyst formation 2. fibrosis 3. adenosis

Question 33

unopened cysts in non-proliferative breast changes lookl ike what

Answer 33

"blue dome cyst"

Question 34

non-proliferative breast changes the cysts can cause what metaplasia

Answer 34

aprocrine metaplasia

Question 35

apocrine metaplasia

Answer 35

lining cells have abundant eosinophilic cytoplasm resemebling sweat glands

Question 36

what causes fibrosis in non-proliferative breast changes

Answer 36

rupture of cyst and release of contents resulting in inflammation

Question 37

what is adenosis

Answer 37

increase in number of acinar units per lobule | -calcifications can be seen

Question 38

what is it called if lumens enlarged in adenosis

Answer 38

blunt duct adenosis

Question 39

What is proliferative breast disease without atypia

Answer 39

proliferation of ductal epithelium and/or stroma without cellular abnormalities suggestive of malignancy

Question 40

What are 5 parts of proliferative breast disease without atypia

Answer 40

1 epithelial hyperplasia 2. sclerosing adenosis 3. complex sclerosing lesion (radial scar) 4. papillomas 5. fibroadenomas