Pathology of the Breast
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| What hormonally related changes occur to the breast at puberty | lobular unints develop
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| What Hormonally related changes occur with pregnancy | pronounced lobules, highly vacuolated lobular epithelium, lumens distended with secretions
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| What hormonally related changes occur when a woman is post-menopausal | involutional changes with lobular atrophy, related to increase in fat
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| What is the appearance of an invasive carcinoma on mammography | spiculated mass
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| What is the implications of microcalcifications on mammography | seen in up to 50% of carcinomas commonly present in benign condition
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| 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
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| 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
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| What is acute mastitis | usually occurs with breast feeding caused by S. aureus
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| What happens if you do not treat acute mastitis | you risk abscess development
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| What is the etiology of granulomatous mastitis | foreign material, mycobacterial infection, sarcoidosis are some etiologies
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| 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
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| Who gets mammary duct ectasia? older or younger women | older women
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| Where in the breast do you see mammary duct ectasia | subareolar
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| What is the cause of fat necrosis | trauma, response to ruptured cyts in fibrocystic changes
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| 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
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| What is a radial scar | central fibroelastotic core with radiated ducts and lobules often with superimposed proliferative changes (benign)
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| 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
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| 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)
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| Where do nipple papillomas arise | In the ducts within the niple may appear as nipple discharge, erosion, subareolar mass or simulate paget's disease
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| Do you worry about the risk of invasive carcinoma in the contralateral or ipsilateral or both breast with Ductal carcinoma in situ | Ipsilateral
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| Where do you worry about invasive carcinoma with Lobular carcinoma in situ, ipsilateral, contralateral or both breasts | Worry about both breasts
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| What is Paget's disease | In situ carcinoma with tumor cells confined within epithelium of the nipple
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| Paget's disease is usually associated with? | underlying carcinoma (in situ or invasive)
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| What are some risk factors for invasive carcinoma | Family History, genetics, hormonal status, Radiation exposure, Proliferative breast disease, Dietary fat?
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| What is the most common invasive carcinoma | invasive ductal carcinoma
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| what is the second most common invasive carcinoma | Invasive lobular carcinoma
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| Does invasive ductal or lobular carcinoma present with a mass | invasive ductal carcinoma is more likely to present with a mass
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| Grade of breast cancer is based on? | degree of differentiation, nuclear atypia, mitotic activity (GRADE IS VERY IMPORTANT FOR PROGNOSIS)
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| What lymph nodes are sites for spread of breast cancer | Axillary, Internal mammary lymph nodes and supraclavicular
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| What is the "leaf like" tumor | Phylloides tumor
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| What are some possible etiologies of male gynecomastia | Puberty, hypogonadism, cirrhosis, estrogen therapy
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| There is a higher risk of breast cancer in men with this genetic disease... | Klinefelter's syndrome
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