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MCC final Flashcards

(49 cards)

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1
Q

What is the functional unit of the breast?

A

the terminal duct-lobular unit (TDLU)

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2
Q

What is galactorrhea?

A

breast milk production outside of lactation

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3
Q

What are three primary causes of galactorrhea?

A

Nipple stimulation
prolactinoma of AP
drugs

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4
Q

What is the name for the most common breast changes in premenopausal women?

A

fibrocystic changes

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5
Q

What are two notable features of fibrocystic changes on a gross exam?

A

-Vague irregularity of breast tissue “lumpy bumpy”

-“blue dome” cyst presentation

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6
Q

What characterizes sclerosing adenosis? What is the associated increase risk of carcinoma?

A

too many glands in lobule, with accompanying fibrosis notable for calicification; 2x normal risk

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7
Q

What characterizes an intraductal papilloma?

A

a papillary lesion within the duct which often leads to bloody nipple discharge

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8
Q

How is intraductal papilloma best distinuished from papillary carcinoma?

A

Benign proliferations of epithelium with posess BOTH layers (luminal and myoepithelial)

Carcinomas will only have ONE layer of epithelium (myoepithelial absent in PC)

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9
Q

What is the most common benign tumor of the breast?

A

Fibroadenoma

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10
Q

What is the most common tumor in a premenopausal female?

A

Fibroadenoma

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11
Q

What type of pathology is indicated here?

A

Fibroadenoma

Note sharp demarcation from normal tissue, and extra glands and fibrous tissue

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12
Q

What three things are most noteworthy about a fibroadenoma?

A

Well-circumscribed marble-like mass

Estrogen sensitive

No increasd risk for carcinoma

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13
Q

How is a phyllodes tumor different from a fibroadenoma?

A

A phyllodes tumor involves an overgrowth of the FIBROUS component

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14
Q

Out of a fibroadenoma and a phyllodes tumor, which have potential for malignancy?

A

Phyllodes tumor

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15
Q

What type of pathology is indicated here?

A

Phyllodes tumor

Note the “leaf like” projections

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16
Q

What type of pathology is indicated here?

A

Intraductal papilloma

Note the growth of the papilloma into the milk duct

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17
Q

What pathology is indicated here?

A

fibrocystic changes

Note the bluish hue to the conglomerates in the cyst

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18
Q

What pathology is indicated here?

A

Atypical ductal hyperplasia

Note the clonal proliferations that partially fill involved ducts

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19
Q

What is the relative risk for carcinoma in a discovery of atypical ductal hyperplasia?

A

5x

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20
Q

What differentiates usual from atypical ductal hyperplasia?

Study These Flashcards
A

atypical presents with clonal cells of similar size and shape

21
Q

What pathology is indicated here?

Study These Flashcards
A

Proliferative disease without atypia (usual ductal hyperplasia)

Note the variance in cell size

22
Q

What pathology is indicated here?

Study These Flashcards
A

Atypical lobular hyperplasia

23
Q

What are the three general types of DCIS?

Study These Flashcards
A

Comedo DCIS
Noncomedo DCIS
Paget disease

24
Q

What is the typical treatment for DCIS?

Study These Flashcards
A

Localized excision and radiation therapy (breast conserving therapy)

25
What pathology is indicated here?
Comedo DCIS Note the poor differentiation of cells inside the ducts
26
What pathology is indicated here?
Papillary carinoma (papillary DCIS) Note how there is only one layer of epithelial cells for the duct (two would indicate intraductal papilloma)
27
What pathology is indicated here?
Lobular carcinoma in situ (LCIS)
28
What significant phenotype/genotype is the same for atypical lobular hyperplasia, invasive lobular carcinoma and LCIS?
estrogen receptor + E-cadherin -
29
What is the usual treatment for LCIS?
Usually tamoxifen usually not surgery
30
What are the relative risks of invasive carcinoma with DCIS or LCIS?
8-10x
31
What are the four most significant risks for breast cancer?
female gender increasing age personal history family history (there are many more)
32
What are the defining characteristics of a luminal breast cancer?
ER+ Her2-
33
What are the defining characteristics of a HER2 cancer?
Her2+ ER+/-
34
What is the defining characteristic of a triple negative breast cancer?
ER- PR- HER2-
35
Male breast cancer is more likely related to a BRCA1 or BRCA2 mutation?
BRCA2
36
Ovarian and female breast cancer is more likely related to a BRCA1 or BRCA 2 mutation?
BRCA1
37
Using the Notingham scoring system, what grade of invasive breast carcinoma is indicated here?
Grade 1 Note hyperplasia of small, clonal cells with some stroma present
38
Using the Notingham scoring system, what grade of invasive breast carcinoma is indicated here?
Grade 2 Note the vast hyperplasia of small, clonal cells with very little fibrous tissue
39
Using the Notingham scoring system, what grade of invasive breast carcinoma is indicated here?
Grade 3 Note the extreme hyperplasia of small, clonal cells with almost no fibrous tissue visible, as well as high mitotic activity of cells
40
What are the four general subtypes of invasive ductal carcinoma?
Tubular carcinoma Medullary carcinoma Mucinous carcinoma Inflammatory carcinoma
41
What pathology is indicated here?
Mucinous carcinoma Note malignant cells floating in mucus pools
42
Which two subtypes of invasive ductal carcinoma have a good prognosis? Which has the worst prognosis?
Tubular and mucinous carcinoma Inflammatry carcinoma
43
What pathology is indicated here?
Tubular carcinoma Note the desmoplastic stroma (blue-gray color), loss of two epithelial cell types
44
What pathology is indicated here?
medullary carcinoma Note the high grade malignant tumor cells with many inflammatory cells in background *increased liklihood in BRCA1 mutations
45
What is a prognostic factor?
A factor providing information on clinical outcome at the time of dx independent of therapy
46
What is a predictive factor?
A factor providing information on the likelihood of a response to a given treatment
47
What are major prognostic factors for breast cancer?
Distant metastases (M) Regional lymph nodes (N) Tumor extent (T) Tumor grade ER, PR and HER2 expression special histologic types
48
What are major predictive factors of breast cancer?
ER, PR and HER2 expression proliferation markers
49
What is meant by the ABCD warning signs of melanoma?
A- asymmetry B- border (irregular) C- color (multiple) D- diameter (>6mm)

MCC (10 decks)

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