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Path 20
Pathology of the Breast
| Question | Answer |
|---|---|
| What hormonally related changes occur to the breast at puberty | lobular unints develop |
| What Hormonally related changes occur with pregnancy | pronounced lobules, highly vacuolated lobular epithelium, lumens distended with secretions |
| What hormonally related changes occur when a woman is post-menopausal | involutional changes with lobular atrophy, related to increase in fat |
| What is the appearance of an invasive carcinoma on mammography | spiculated mass |
| What is the implications of microcalcifications on mammography | seen in up to 50% of carcinomas commonly present in benign condition |
| What are the pros and cons of a core biopsy | Pros-Minimally invasive adn can discriminate invasive from non-invasive Cons: small sample so may not be representative |
| Pros and Cons of a lumpectomy | Pros: often therapeutic Cons: may not fully excise the lesion, requiring additional surgery, requires anesthesia, may require post operative radiation |
| What is acute mastitis | usually occurs with breast feeding caused by S. aureus |
| What happens if you do not treat acute mastitis | you risk abscess development |
| What is the etiology of granulomatous mastitis | foreign material, mycobacterial infection, sarcoidosis are some etiologies |
| What is it called with the ducts of the breast are dilated (both large and intermediate) and filled with histiocytes and inspissated secretions, adn surrounded by fibrosis adn chronic inflammation | Mammary Duct Extasia |
| Who gets mammary duct ectasia? older or younger women | older women |
| Where in the breast do you see mammary duct ectasia | subareolar |
| What is the cause of fat necrosis | trauma, response to ruptured cyts in fibrocystic changes |
| What is the determining factor that increases risk of carcinoma with fibrocytic changes | risk for carcinoma determined by the presence of ductal hyperplasia, especially atypical ductal hyperplasia |
| What is a radial scar | central fibroelastotic core with radiated ducts and lobules often with superimposed proliferative changes (benign) |
| You have a 20 year old women who comes to you with a non-cystic mass that is smooth and movable what is the likely diagnosis | fibroadenoma |
| Do older or yonger women get intraductal papillomas | older average age is 50 (will occur in large ducts in older women and small ducts in younger women) |
| Where do nipple papillomas arise | In the ducts within the niple may appear as nipple discharge, erosion, subareolar mass or simulate paget's disease |
| Do you worry about the risk of invasive carcinoma in the contralateral or ipsilateral or both breast with Ductal carcinoma in situ | Ipsilateral |
| Where do you worry about invasive carcinoma with Lobular carcinoma in situ, ipsilateral, contralateral or both breasts | Worry about both breasts |
| What is Paget's disease | In situ carcinoma with tumor cells confined within epithelium of the nipple |
| Paget's disease is usually associated with? | underlying carcinoma (in situ or invasive) |
| What are some risk factors for invasive carcinoma | Family History, genetics, hormonal status, Radiation exposure, Proliferative breast disease, Dietary fat? |
| What is the most common invasive carcinoma | invasive ductal carcinoma |
| what is the second most common invasive carcinoma | Invasive lobular carcinoma |
| Does invasive ductal or lobular carcinoma present with a mass | invasive ductal carcinoma is more likely to present with a mass |
| Grade of breast cancer is based on? | degree of differentiation, nuclear atypia, mitotic activity (GRADE IS VERY IMPORTANT FOR PROGNOSIS) |
| What lymph nodes are sites for spread of breast cancer | Axillary, Internal mammary lymph nodes and supraclavicular |
| What is the "leaf like" tumor | Phylloides tumor |
| What are some possible etiologies of male gynecomastia | Puberty, hypogonadism, cirrhosis, estrogen therapy |
| There is a higher risk of breast cancer in men with this genetic disease... | Klinefelter's syndrome |
Created by:
UVAPATH1
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