Pathology of the Breast Flashcards Preview

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Flashcards in Pathology of the Breast Deck (37):
1

What is the most common cancer in females?

Breast

2

What are the 2 cells layers that line the ducts and lobules of the breast?

- Epithelium
- Myoepithelium

3

What are the 3 tissues that make up the breast?

- Fat
- Stroma
- Epithelium

4

What changes occur in breast tissue as patients age?

Less lobules with stroma replaced by adipose tissue

5

What are common reasons of breast pathology for patient clinic visits?

- Palpable Mass
- Mammogram Lesion
- Nipple Discharge

6

Acute Mastitis

Occurs during lactation due to skin breaks with S. aureus as the most common cause

7

Fat Necrosis of Breast

Generally due to trauma but can be due to surgery or radiation

8

What is a possible risk of fat necrosis?

Confusion with cancer even on x-ray

9

What is the most common breast disorder?

Non-proliferative fibrocystic changes

10

What are examples of stroll lesions without atypia?

- Fibroadenoma
- Phyllodes Tumor

11

Fibroadenoma

Most common benign tumor, usually small with well-circumscribed borders and occurs during reproductive life around less than 30 yrs

12

What happens to fibroadenomas with age?

Calcifications grow and the glands decrease

13

Phyllodes Tumor

More common in older patients - 60s - and are larger than fibroadenomas with leaflike shape and are not well defined
- Most are benign but they can be malignant

14

Most common cause of bloody nipple discharge in younger women

Intraductal Papilloma

15

Intraductal Papilloma

Multiple branching fibrovascular cores, each having a connective tissue axis lined by luminal and myoepithelial cells.

16

Atypical Duct Hyperplasia

Expansion of ductal cells

17

Atypical Lobar Hyperplasia

Expansion of terminal duct lobar units

18

Where do most breast carcinomas arise?

Upper Outer Quadrant

19

What are some risk factors for breast cancer?

- Age
- Female gender
- Family history of breast cancer
- Genetic predisposition
- Prior personal history of breast cancer
- Increased estrogen exposure

20

Do OCPs increase the risk of breast cancer?

No

21

What type of breast carcinoma in situ is more common?

Ductal Carcinoma In Situ

22

What type of invasive breast carcinoma is more common?

Invasive Ductal Carcinoma

23

What breast is at risk of cancer with lobar carcinoma in situ?

Both breasts

24

What breast is at risk of cancer with ductal carcinoma in situ?

Only the ipsilateral breast

25

Paget Disease

Rare manifestation of breast cancer- DCIS arising within ductal system of the breast can extend up the lactiferous ducts into nipple skin without crossing the BM

26

What will be seen in Paget disease?

A scaly crust on the skin surface and histology will show Paget cells in the epidermis

27

What are some features that indicate increased likelihood of BRCA mutations?

- Multiple cases of early onset breast cancer
- Ovarian cancer
- Breast and ovarian cancer in the same woman
- Bilateral breast cancer
- Male breast cancer

28

What is the function of BRCA1/2?

They are tumor suppressor genes

29

What are risk factors for male breast cancer?

- 1st degree family with breast cancer
- Testicular dysfunction
- Obesity

***Gynecomastia is NOT a risk

30

What will be seen on histology of gynecomastia?

- micropapillary hyperplasia of ductal lining
- periductal lymphocytic infiltrate

31

A 34 year old female presents with a 4 cm palpable mass in her left breast. A mammogram reveals a speculated mass, a core biopsy is performed and a diagnosis of Invasive Ductal Carcinoma, Nottingham Grade III, Basal Like Type.

This patient most likely has a mutation of the following gene:
 BRCA2
 BCR/ABL
 PTEN
 BRCA1

In what chromosome is this gene located:
1  10  17  22 X

BRCA1 on Ch17

32

What do basal-like type invasive ductal carcinomas have as their gene profile?

ER- PR- and HER2-

33

What is the most common cause of bloody nipple discharge:
 Intraductal papilloma
 Paget’s disease
 Fibroadenoma
 Invasive ductal carcinoma

Intraductal papilloma

34

Of the following breast carcinomas which is the one with the best prognosis
 Fibroadenoma
 Phyllodes tumor
 Tubular carcinoma
 Metaplastic carcinoma
 Invasive ductal carcinoma

Tubular carcinoma

35

 What is the most common breast pathology in men:  Invasive lobular carcinoma
 Invasive ductal carcinoma
 Gynecomastia
 Chronic mastitis
 Granulomatous mastitis  Infectious mastitis

Gynecomastia

36

What is the most common location for breast carcinoma in males?
Upper outer quadrant
 Retroareolar
 Lower outer quadrant
 Lower inner quadrant

Retroareolar

37

What are the 2 most important prognostic factors in breast cancer:
 Laterality and histologic grade
 Size and histologic grade
 Histologic grade and lymph node metastasis
 Lymph node metastasis and size
 Size and resistance

Lymph node metastasis and size

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