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Dx Of Breasts Flashcards

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1
Q

Number of lobes per mammary glands

A

15-20

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2
Q

What is a mammary gland lobe

A

Individual Compound tubule alveolar gland with its own lactiferous duct and sinus opening on the surface of the nipple

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3
Q

Where do the ductal system drain into

A

L’activerons sinus

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4
Q

Are congenital malformation of the breast common

A

No rare

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5
Q

Types of congenital malformation

A 
Polymastia
Accessory breasts and nipples
Failure of development of breast
Precocious development
Adolescent hypertrophy
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6
Q

In which syndrome do you say failure of development of breast due to ovarian agenesis

A

Turner syndrome

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7
Q

In which Disease do you see precocious development of breast

A

Granulosa cell tumor

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8
Q

Are inflammatory lesions of the best common

A

No rare

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9
Q

What are some inflammatory lesions of the breast

A

mastitis
Duct ecTasia
Fat necrosis

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10
Q

Type of infection in acute mastitis

A

Bacterial infection

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11
Q

Main population affected by Acute mastitis

A

Postpartum or lactating breast women

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12
Q

Presentation of Acute mastitis

A

Pain, swelling or redness of breast
Fever
malaise

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13
Q

Most common organism in Acute mastitis

A

Strep or staph

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14
Q

Gross morphology of Acute mastitis

A

Firm walled-off nontender abscess

chronic localized scar

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15
Q

Structure involved duct ecTasia

A

Large ducts

smaller interlobular duct in some cases

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16
Q

At what point in life is a woman Susceptible to duct ecTasia

A

Second half of reproductive life

after menopause

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17
Q

Why are duct ecTasia often mistaken for carcinoma

A

Because of nipple discharge which may be blood stained

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18
Q

Main cause of fats necrosis of breast

A

Trauma

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19
Q

How does Fat Necrosis of breast mimics carcinoma

A

Calcification in mammography

Presents as discrete lump

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20
Q

Woman at risk of fats necrosis

A

Obese women

womenin menopause

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21
Q

Gross morphology of fat necrosis of breast

A

Yellowish and Hemorrhagic tissue

Flecks of Calcification

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22
Q

Microscopy a fat necrosis of breast

A

Macrophages collection
giant cell with lipid material
Lymphocytes ,fibroblasts ,small vascular channels

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23
Q

What are some non-neoplastic proliferative lesions of the breast

A

Fibrocystic change

epithelial hyperplasia’s

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24
Q

Is there an increased risk of malignancy with ductal hyperplasia

A

Yes

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25
Two types of ductal hyperplasia
Proliferative disease without atypia proliferative diseass atypia
26
type of neoplastic disease of breast
Benign | malignant
27
Benign tumor of the breasts
Fibroadenoma Phyllodes tumor Intra ductal papilloma
28
Commonest benign tumor of the best in Ghanaians and Africans
Fibroadenoma
29
Age of female who commonly have fibroadenoma
Below 30 years
30
Grass morphology of fibroadenoma
Firm lobulated Circumscribes mobile mass ( breast mouse )
31
Micro of fibroadenoma
Branching ducts and acini | connective tissue proliferation
32
Is malignant change in fibroadenoma common
No
33
People at risk of phyllodes tumor
Middle age and elderly persons
34
Macro of phyllodes tumor
Massive enlargement of breast | large lobulated tumor
35
Micro phyllodes tumor
Like fibroadenoma Cellular stroma , Atypical nuclei with mitotic figures Normal ductal epithelium
36
How do you cure phyllodes tumor
Mastectomy
37
When can you have malignancy in phyllodes tumor
If incomplete excision of benign tumor , can turn into malignancy in 5-10%
38
What are intraductal papilloma
Solitary benign tumor
39
Common age group affected by intraductal papilloma
20 to 30 years old
40
Main presentation of intraductal papilloma
Bloody nipple discharge | Duct distention by papillary tumor
41
When can you get carcinoma in intraductal papilloma
If benign tumor not excised
42
Group of people more at risk of carcinoma of the breast
Caucasians above 30 years old | Woman with a family history
43
Risk factors for breast cancer
``` Gender female Over 50 years old Hereditary history Previous breast pathology Hormones endogenous or exogenous Obesity Lifestyle (lack of exercise ,alcohol ,fatty diet, smoking) ```
44
Classification of breast carcinoma stage I and ii
45
Classification of breast carcinoma stage three and four
46
What’s impacts the likelihood of invasive cancer rising after in situ carcinoma diagnosis
Histologic subtype Grade Extent of in situ disease Family history for breast cancer
47
DCIS comedo (high grade ) subtype histology
``` Very large pleomorphic epithelial cell Abundant cytoplasm irregular nuclei Permanent heterogeneous nucleoli Intraductal necrosis ```
48
Grass morphology of high-grade in situ carcinoma
Distended ducts with white necrotic material resembling comedo
49
Most histologically common type of breast cancer
Invasive ductal carcinoma
50
Tissue invaded in invasive ductal carcinoma
Stroma of breast
51
Gross of invasive ductal carcinoma
Firm palpable mass Modified contour of breasts Visible dense mass lesion on mammography
52
Later stage presentation in invasive ductal carcinoma
Large ulcerating masses Deformation of breast Regional or distant metastases symptoms
53
is there a greater incidence of unilaterally or bilaterality in invasive lobular
Bilaterality
54
Histologic hallmark of invasive lobular carcinoma
Single infiltrating tumor cells or lose clusters of cells Cells arranged in concentric rings around normal ducts Signet ring cells
55
What is paget disease of the nipple
Red scaly eczematous lesion of nipple | Associated to underlying ductal carcinoma of breast
56
Histology of paget disease of the nipple
Squamous epithelium thickened Paget cell in epithelium Chronic inflammatory cells in stroma
57
Prognosis of paget disease of the nipple
Depends on underlying tumor
58
Is inflammatory carcinoma of breast a specific histologic subtype of breast carcinoma
No
59
What os inflammatory carcinoma of breast
Clinical presentation of carcinoma involving dermal lymphatics with enlarged erythematous breast
60
Morphology of inflammatory carcinoma
Diffuse infiltrating pattern in underlying carcinoma | No palpable mass
61
Percentage f inflammatory carcinoma in all type of breast cancer
1%
62
Average age in people with inflammatory ca
56 yo
63
Prognosis of inflammatory ca
Worse than other tumor
64
Risk factors of inflammatory ca
Estrogen therapy
65
Location of breast ca
``` Upper outer quadrant - 50% Central -20% Lower outer - 10% Upper inner - 10% Lower inner - 10% ```
66
Grading system used
Bloom Richardson method
67
Bloom Richardson method characteristics
Tubule formation Nuclear Pleomorphism Number of mitotic figures
68
Grades of tumors
Grade I - score 3-5 Grade II - score 6-7 Grade III- score 8 and 9
69
How to assign score in grading system
70
Two staging in ca
UICC | AJCC
71
UICC staging
T - size of primary tumor N - axillary lymph nodes M - distant metastases
72
AJCC stage of tumors
Stage O - in situ (DCIS or LCIS) Stage I - early invasive , tumor <2cm , no , no lymph node metastases Stage II - tumor size > 2cm , metastasis confined to lymph node Stage III - locally advanced ,metastatic tumor spread beyond confines of lymph node Stage IV - metastasis to other organs or parts of body
73
Prognostic factors
``` Size of tumor Grade Stage ( most important ) Hormonal status Resection margin Age Histologic subtype Mitotic count Lymphovascular invasion Inflammatory carcinoma ```
74
Routes of spread
``` Direct skin and muscle Lymphatic (seen as peau d’orange ) Blood to lung, liver, bone Transcolemic to pleura and peritoneum Implantation with scar recurrence ```
75
Male breast disease
Gynecomastia | Carcinoma
76
What is Gynecomastia
Enlargement of adult male breast
77
Causes of Gynecomastia
Hormones Medication Klinefelter syndrome Cirrhosis Testicular tumor like Leydig cell tumor Drugs ( alcohol, marijuana , heroin, antiretroviral therapy , anabolic steroids )
78
Are male breast cancer common
Rare , 1%
79
Is Gynecomastia a risk factor for Male breast cancer
No
80
Breast lesions presentation
``` Breast mass Nipple discharge Eczema Peau d’orange (Invasive ca , Inflammatory ca ) Nipple retraction ```

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