Flashcards in Chapter 23 Female Genital Tract- The Breast Deck (62)
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1
True or false Each element is a source of benign and malignant lesions.
True
2
The superficial lining of breast is Keratin squamous cell. What are the 2 types of epithelial cells?
a. Luminal
b. Myoepithelial
3
2 major structures remain after the double-layered epithelium (luminal and emyoepithlial cells)
a. Ducts: 6-10 open on skin surface at nipple
b. Lobules
4
What 3 features distinguish the breast from other organs?
a. Function: Nutritional support another individual/infant
b. Structure: periodic change in adulthood (pregnancy), before b4 involving age
c. Visible: has a social, cultural, personal significance
5
What is the origin of common breast lesions such as
Cyst
sclerosing adenosis
small duct papilloma
hyperplasia
atypical hyperplasia
Carcinoma
lobules and terminal ducts
6
What common breast lesions are found in large ducts?
Duct ectasia
Squamous metaplasia of Lactiferous ducts
Large duct papilloma
Paget disease
7
Fibroadenoma and Phyllodes tumor are lesions found where in the breast tissue?
Intralobular Stroma
8
Fat necrosis, lipoma, Fibromatosis and Sarcoma are breast lesions associated with what part of the breat?
Inter-lobular stroma
9
The breast become completely mature and functional in the onset of what
Pregnancy
10
what produces colostrum (high in protein)? What does colostrum change into?
a. after parturition lobules
b. milk (higher in Fat and Calories)
11
Interlobular stroma converts from radio-dense fibrous stroma to what?
radiolucent adipose tissue
12
Supernumerary nipples or breasts result from persistence of epidermal thickenings along what?
Milk line (extends from Axilla to perineum)
13
The Milk line extends from the axilla to what?
Perineum
14
Disorders affecting normally situated breast rearly arise in
Heterotropic hormone-responsive foci
15
What is the aka for Milk Line Remnants?
Polythelia
16
Aquired nipple retraction indcates the presence of what disorders?
invasive cancer or
inflammatory nipple disease
17
What are the MC symptoms reported women with breast disorders?
Pain
Palpable mass, lumpiness (w/o discrete mass)
nipple discharge
18
These nonspecific signs/symptoms Must be evaluated for possibility of malignancy?
pain
palpable mass, lumpiness w/o discrete mass
nipple discharge
19
Diffuse cyclic Pain (mastalgia or mastodynia) may be d/t what?
premenstrual edema
20
Non-cyclic Pain (mastalgia or mastodynia) localized in one area may be caused by ruptured cysts, physical injury and what?
infections
21
True or False: Almost all painful masses are malignant, about 90% of breast cancers present with pain.
False: Almost all painful masses are BENIGN about 10% of breast cancers present with pain.
22
The most common palpable lesions are what?
•Cysts,
•Fibroadenomas,
•Invasive carcinomas.
23
Breast mass are malignant in women younger than age 40 is ___ %, and masses in women over age 50 is ____%.
a. 10
b. 60
23
Breast mass are malignant in women younger than age 40 is ___ %, and masses in women over age 50 is ____%.
a. 10
b. 60
24
Carcinomas are mostly located where in the breast?
Majority of cancers are generalliy what size before they metastasize ?
upper outer quadrant
2 to 3 m.
25
Milky discharges (galactorrhea) are associated with what?
Elevated prolactin levels (e.g., by a pituitary adenoma), hypothyroidism, or endocrine anovulatory syndromes,
26
Milky discharges (galactorrhea) occurs in pt's taking what?
oral contraceptives,
Tricyclic antidepressants,
methyldopa, or
Phenothiazines
27
True or False: Galactorrhea is NOT associated with malignancy
True
28
MC cause of a Bloody or serous nipple discharges is what?
large duct papillomas and cysts
29
What are the Different types of nipple discharges?
A: milky discharge;
B: yellowish ± greenish multiple pore discharge in a context of fibrocystic breast disease;
C: straw-colored single pore discharge;
D: bloody single pore discharge.
30
What is the principal mammographic signs of breast carcinoma?
densities and calcifications
31
Rounded densities are most commonly benign, whereas invasive carcinomas generally form what?
irregular masses
32
Calcifications form on secretions, ncerotic debris and what?
Calcifications associated with benign lesions are what? Give an example.
a. hyalinized stroma
b. clusters of apocrine cysts
33
Malignant calcifications are usually what?
small, irregular, numerous and clustered
34
What percentage of invasive carcinomas are NOT detected by mammography?
10%
35
Inflammatory diseases of the breast are rare (less than 1%) and caused by?
infections
Autoimmune disease
Foreign body type reactions to extravasated keratin or secretions
36
Inflammatory breast cancer” mimics what?
inflammation and always considered in women with Erythematous swollen breast
37
Acute mastitis usually occurs when? What is it most commonly due to?
first month of breast feeding
Staphylococcus aureus (Less commonly, Streptococcus)
38
Streptococci is less common in acute mastitis, but spreads infection in the form of what?
cellulitis
39
Warm, erythematous breast,Painful,Fever,Purulent nipple discharge are all clinical features of what?
Acute Mastitis
40
What is the treatment for Acute Mastitis?
drainage via breast feeding and
Antibiotics
41
Squamous Metaplasia of Lactiferous Ducts is assocated with what?
smoking
42
Inflammation of the subareolar ducts with blockage is associated with squamous metaplasia of lactiferous ducts and what condition?
Periductal mastitis
43
A key feature of Periductal Mastitis is
keratinizing squamous metaplasia of the nipple ducts.
44
True or False: Many women have an inverted nipple, most likely as a secondary effect of the underlying inflammation
True
45
What is the clinical feature of squamous metaplasia of lactiferous ducts (aka Periductal mastitis)
Subareolar mass with nipple retraction
46
Subareolar mass with nipple retraction and offending keratinizing epithelium deep into ducts are features of what condition?
Squamous Metaplasia of Lactiferous Ducts AKA Periductal Mastitis
47
Rupture of an abscess with inflammation is a response to what
Keratin debris
48
What is Inflammation of the wall of the subareolar duct with dilation (ectasia) of the ducts but NOT associated with smoking
Mammary Duct Ectasia
49
a. Histologically, mammary duct ectasia is chronic inflammation with what type of cells? b. It is also known as what?
a. Plasma cells
b. Plasma cell mastitis
50
What are the clinical features features of mammary duct ectasia?
Palpable periareolar mass
Thick, white nipple discharge
Skin & nipple retraction
Occurs in 5th or 6th decade of life
usually in multiparous women
No increased risk for breast cancer
51
What presentation closely mimics cancer?
Fat Necrosis
52
What specific Fat Necrosis presentation closely mimic cancer?
Mammographic densities or calcifications & a PainLESS palpable mass
53
1/2 of the women with Fat necrosis have a HISTORY of what?
Breast trauma or Piror surgery
54
Fat necrosis acute lesions may be what?
hemorrhagic
55
What is the AKA for Lymphocytic Mastopathy?
Sclerosing Lymphocytic Lobulitis
56
Lymphocytic Mastopathy (aka sclerosing lymphocytic lobulitis) is the mc condition in women with what?
Type 1 (IDDM), or autoimmune thyroid disease,
57
Sclerosing Lymphocytic Lobulitis AKA Lymphocytic Mastopathy is hypothesized to have what kind of basis?
autoimmune
58
Its only clinical significance is that it must be distinguished from breast cancer. What is it?
Lymphocytic Mastopathy AKA Sclerosing Lymphocytic Lobulitis
59
Granulomatous inflammation of the breast can be a manifestation of what?
Systemic granulomatous diseases (e.g., granulomatosis with polyangiitis, sarcoidosis, tuberculosis).
60
Local granulomatous diseases is known as
Granulomatous lobular mastitis
61
