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Flashcards in Pathology of the Breast Deck (82)
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1

A large number of pivotal events in cancer treatment occurred with what type of cancer?

breast cancer

2

Breast cancer arises where?

in the epithelial

3

Is it easier to see cancer in the breast in pre or post menopausal women?

post

4

What can often been mistaken for cancer in the breast?

Fat necrosis
-localized
-unlateral
-due to trauma
-presents as a mass which can mimic a tumor

5

What does this describe:
Localized
Unilateral
Due to trauma
Presents as a mass which can mimic a tumor

fat necrosis

6

What does this describe:
Present in over 50% of female breasts
May be a palpable mass(40% of all breast masses)
Certain types increase risk of invasive cancer
Mammographic microcalcifications

fibrocystic change

7

The anatomy of the breast can be compared to a tree why?

because it has branches an leaves (large ducts and lactiferous sinuses)

8

Why kinds of lesions can occur on the Lobular Unit or Terminal Duct?

cyst, sclerosing adenosis, small duct papilloma, hyperplasia, atypical hyperplasia, carcinoma

9

What kinds of lesion occur in the lobular stroma?

fibroadenoma, phyllodes tumor

10

What kinds of lesions occur in the nipple and areola?

Duct ectasia, recurrent subareola abcess, solitary ductal papilloma, pagets disease

11

What lesion occur on the interlobular stroma?

fat necrosis, lipoma, fibrous tumor, PASH, fibromatosis, Sarcoma

12

(blank) breast lesions can mimic the appearance of malignant lesions both on imaging studies as well as on biopsy.

Benign

13

What is the malignant phenotype?

○ Self-sufficiency in growth signals
○ Insensitivity to growth-inhibitory signals
○ Evasion of apoptosis
○ Limitless replicative potential
○ Sustained angiogenesis
○ Ability to invade and metastasize

14

What are the 3 modes of metastasis?

§ Lymphatic spread-regional lymph nodes usually affected first
§ Hematogenous spread-spread through the blood usually to the lung, liver, brain, bone marrow and adrenals.
§ Transcoelomic spread (seeding of body cavities)- spread into the peritoneal, pleura, pericardial and subarachnoid spaces.

15

Ductal carcinoma in situ threatens what?

Not life, but the breast

16

(blank) are providing useful prognostic and predictive biomarkers of this disease .

Molecular classifications

17

What does this describe:
Most common
Increased fibrous stroma and dilated ducts
Apocrine metaplasia
“lumpy” to palpation

Nonproliferative Fibrocystic Changes Cysts, fibrosis, and adenosis

18

What does this describe:
Epithelial hyperplasia
Sclerosing adenosis
Radial scar
The presence of cytologic atypia significantly increases relative risk of developing invasive carcinoma

Proliferative Fibrocystic Change

19

What does this describe:
Risk of invasive carcinoma related to complexity of hyperplasia and atypia
Characterized by multilayered duct cell proliferation
Solid or papillary

epithelial hyperplasia

20

What does this describe:
Proliferation of small ductules and fibrosis
Gross: can be very firm
Lobular arrangement maintained
Mild increase in risk of invasive carcinoma

sclerosing adenosis

21

What type of adenosis mimics the appearance of invasive cancer of the breast?

sclerosing adenosis/ radial sclerosing

22

Is there a risk of developing carcinoma from cysts, fibrosis, apocrine metaplasia, mild hyperplasia?

No

23

Is there a risk of developing carcinoma from sclerosing adenosis, moderate/severe hyperplasia?

Slight increase

24

Is there a risk of developing carcinoma from proliferative change with cellular atypia

Considerable increase

25

What does this describe:
Most common benign tumor in female breast
Most common before age 30 but can occur at any age
Well circumscribed, soft, moveable, usually spherical
Characteristic microscopic features
Does not increase risk of future carcinoma

fibroadenoma

26

What does this describe:
Grossly and microscopically similar to fibroadenomas but have a more cellular stroma
Average age is 45 years
Average size is 4-5 cm; range is 1-20 cm
Histologically classified as benign, low grade malignant (borderline), and high grade malignant

phyllodes tumor

27

What term describes this behavior:
low probability of local recurrence; does not metastasize

benign

28

What term describes this behavior:
higher chance of local recurrence; low probability of metastasis

low grade malignant

29

What term describes this behavior:
most likely to recur locally and metastasize

high grade malignant

30

Where do metastases typically go?

to bone and lungs; axillary node mets rare