Witrak: Breast Pathology

Question 1

young breast: largely _____ (fribrous or adipose) stroma

Answer 1

fibrous

Question 2

older breast: largely ____ (fibrous or adipose) stroma

Answer 2

adipose

Question 3

where is the source of most breast cancers/diseases?

Answer 3

epithelium

Question 4

proximal duct system (closer to nipple) (ex. papilloma) is usually ______ (benign/malignant)

Answer 4

benign

Question 5

what can simulate breast cancer and needs a biopsy to tell the difference? can be associated with a car accident and trauma to the breast and hemorrhage

Answer 5

fat necrosis

Question 6

what would be the ddx for erythematous breast skin rupture?

Answer 6

bacterial mastitis (lactation), dermatitis, inflammatory breast cancer (plugs up dermal lymphatics)

Question 7

what is the commonest benign tumor of the breast?

Answer 7

fibroadenoma

Question 8

what is the commonest disease of the breast (60% of women) that shows cystic change and epithelial hyperplasia

Answer 8

fibrocystic disease

Question 9

what is the difference between in-situ breast carcinoma and invasive?

Answer 9

in-situ is curable and invasive is where the basement membrane is eroded-> lymphatic invasion and dissemination.

Question 10

what breast lesion represents a ‘staghorn ductal epithelium’?

Answer 10

fibroadenoma

Question 11

what system is the source of 90% of breast cancer? (lobule/terminal or duct)

Answer 11

DUCT

Question 12

spherical calcified lesion in the breast: either fat necrosis or fibroadenoma?

Answer 12

fat necrosis- lipid layden macrophages and overtime, calcification of the breast can occur

Question 13

In DCIS (ductal carcinoma in-situ), where is the invasive cancer usually going to be? (ipsilateral OR contralateral)

Answer 13

within the same area- ipsilateral and same quadrant

Question 14

LCIS (lobular carcinoma in-situ), where is the invasive cancer usually going to be? HOW DO YOU TREAT THIS ONE?

Answer 14

IT CAN BE IN THE OTHER BREAST (EQUAL BILATERALLY). SYSTEMIC ESTROGEN SUPPRESSION OR BILATERAL BREAST REMOVAL.

Question 15

what should you consider when you see a weepy xematoid crusty look to the nipple?

Answer 15

BREAST CANCER.

Question 16

what has a higher relative risk- postmenopausal unilateral (family hx) or premenopausal bilateral (family hx)?

Answer 16

Premopausal bilateral (9) vs, postmenopausal unilateral (1.2-3)

Question 17

is the father important in taking a family history for breast cancer risk?

Answer 17

yes, apparently his genetics (BRCA-specific) can influence it. maybe different than what ONELLO WAS TALKING ABOUT?

Question 18

is hereditary breast cancer the majority cause of cancer?

Answer 18

NO. 5-10% of ALL breast cancer

Question 19

what is the commonest cancer in women in the USA?

Answer 19

breast cancer

Question 20

how does breast cancer rank compared to lung cancer as the cause of cancer death in american women?

Answer 20

lung cancer. breast cancer

Question 21

T or F: a breast lump is cancer until proven otherwise

Answer 21

T

Question 22

what is the ‘gold standard’ for diagnosis of a lump?

Answer 22

open surgical biopsy

Question 23

if you have a suscpisiouc worrisome lesion, what is the current standard first biopsy procedure?

Answer 23

stereostactic needle core breast biopsy

Question 24

when would you use a fine needle aspiration?

Answer 24

confirming clinically benign cyst disease or clinically obvious cancer

Question 25

why would you sample sentinel axillary node?

Answer 25

risk of lymphedema- chronic swelling of the arm.

Question 26

what are pathologic things associated with gynecomastia?

Answer 26

primary (klinefelters) or secondary hypogonadism. tumors producing estrogen. liver disease/renal disease/hyperthyroidism. enzyme defects in androgen synthesis.