Breast Disease Pathology

What is shown in A, B, C?

Breast ducts are normally lined by ____- cell layer of epithelial cells overlying a layers of ______ cells. The arrow points to which layer?

_____ is a semi-controlled proliferation of polymorphic cells with irregular spaces between.

Atypical ______ is when a ______ controlled monomorphic subpopulation takes over, sometimes producing more uniform spaces (_______ pattern)

The takeover by the more ______
subpopulation in ______ hyperplasia can produce a more solid pattern of cell ______ like this:

What is this? Identify the solid pattern, cribriform pattern, and necrosis.

The necrosis can make the ducts look like _____ . What is this pattern called?

Is there peridicuctal inflammation here also?

What does this carcinoma in situ show (nuclei)?

This carcinoma in situ has numerous ______. They are small round dark thing. How many are there?

This carcinoma has a very large blob of _____ in the lumen.

What is this? Cell size, shape and orientations, border. What word should you not use with this because it refers to cancer?

What is this? Comment on the lumens and the bridges.

What type of hyperplasia? Are the lumens regular or irregular?

What type of hyperplasia? Comment on what you see and some of the typical findings of this type of hyperplasia.

Again, what type of hyperplasia? Comment on the lumens (can they have a cribriform pattern)? What is the dark purple thing in the middle of the picture?

What type of hyperplasia? Comment on the bridges.

One of these is invasive. Only one is ductal carcinoma in situ. Which is invasive?

What is this? What type of morphology?

Which is HER-2 negative, which is positive?

What is HER-2 caused by?

Identify each as tubular, papillary, lobular, or mucinous.

Identify each as medullary, secretory, micro papillary, or apocrine.

Identify the lymph node involvement with each, distant metastasis involvement, and survival rates.

What type of breast cancer? What is the term for the characteristic cell pattern?

What is the most common type of breast carcinoma to present as an occult primary? What is the histologic hallmark?

What is a benign epithelial neoplasm growing within a dilated duct composed of multiple branching fibrovascular cores?

What two things are often present? Where are normally situated? Are they normally solitary? Which are commonly multiple and located deeper within the ductal system?

Fibroadenomas are grouped with “proliferative changes ______ atypia” in conferring a mildly _______ risk of subsequent cancer, but in one study the increased risk was limited to _______ associated with cysts larger than 0.3 cm, sclerosing _______, epithelial calcifications, or papillary _____ change (“complex fibroadenomas”).

What type of breast stromal neoplasms?

Are they common? More common in what race? Most present in what ages? How do they present?

What chromosomal changes do they often have? Which is often associated with higher tumor grade and more aggressive clinical behavior?

Fibroadenomas are grouped with “proliferative changes _____ atypia” in conferring a mildly ______ risk of subsequent cancer, but in one study the increased risk was limited to ________ associated with cysts larger than 0.3 cm, sclerosing _____, epithelial calcifications, or papillary ______ change (“complex fibroadenomas”).

Phyllodes tumors usually behave in a relatively ______ fashion, may invade locally, but rarely _______.

_______ = the only sarcoma that occurs with any frequency in the breast, but it accounts for <0.05% of breast malignancies; it can be _______ or a complication of therapy. Most sporadic angiosarcomas occur in ______ women (mean age ____), are of _____ grade, and have a ____ prognosis. Treatment-related tumors arise _____ to radiation in about 0.3% of women, in breast skin, most cases ___ to ___ years after treatment.

Angiosarcomas have _____ channels lined by large _____ endothelial cells.

What do pathologists call something that looks very much like adenocarcinoma but isn't.

The number of acini is _____ and they are compressed and ______ in the _____ portion of the lesion. Stromal ______ may completely compress the lumens to create the appearance of solid cords or _____strands of cells lying within dense _____, a histologic pattern that at times closely mimics _____ carcinoma. Sclerosing adenosis can come to attention as a _____ mass, a radiologic density, or calcifications.

What is this?

The involved terminal duct lobular unit is _____, and the acini are compressed and distorted by ______stroma, with _______ in some of the lumens. Unlike carcinomas, the acini are arranged in a ______ pattern, and the outer border is well circumscribed.
Complex _____ lesions have components of sclerosing ______, papillomas, and epithelial _____. One member of this group, the radial _______ lesion (“radial _____”), has an irregular shape and can closely mimic invasive _______ mammographically, grossly, and histologically. A central ______ of entrapped glands in a ______ stroma is surrounded by long _____ projections into stroma.

Fibrocystic changes = _____ non-proliferative cysts with associated _____, commonly “_______” breasts on palpation, dense breast with ______ on mammography. Small cysts form by dilation of _____ and may coalesce to form larger cysts. Unopened cysts contain ______, semi-translucent fluid of a ______ or blue color (“blue-dome cysts”). Calcifications are _____ and may be detected by ______.

Cysts are lined either by _____ atrophic epithelium or by _______ apocrine cells with abundant _____, eosinophilic cytoplasm and _____ nuclei. The diagnosis is confirmed by the ______ of the mass after fine-needle aspiration of its contents. Cysts frequently ______, releasing _____ material into the adjacent stroma. The resulting chronic inflammation and _____ contribute to the palpable ______ of the breast.

What is this?