Term
| incidence of fibrocystic change |
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Definition
| most common breast abnormality seen in premenopasusal women, |
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Term
| pathogenesis of fibrocystic change |
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Definition
| nonproliferative changes- increase in fibrous stroms associated with dilation of ducts and formation of variably sized cysts. Proliferative change (epitherlial hyperplasia)-presence of more than two cel layers on the normal ducts and lobules of the breast. |
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Term
| clinical features of fibrocystic change |
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Definition
| bilateral abnormalities appear as ill-definied, diffusely increased densities and discrete nodularities on mammography. Blue domed cysts may appear stroma surrounding the cysts consist of compressed fibrous tissue. |
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Term
| clinical significance of fibrocystic change |
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Definition
| consequence of cyclic breast changes that occur normally in the menstrual cycle. Increased risk for breast carcinoma occurs with moderate to florid hyperplasia(without atypia), ductal papillomatosis, and sclerosing adenosis. Significantly increased risk for breast carcinoma occurs with atypical hyperplasia, whether ductular or lobular. |
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Term
| Incidence of fibroadenoma |
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Definition
| most common benign neoplasm of the femae breast |
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Term
| Clinical features of fibroadenoma |
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Definition
| biphasic tumor composed of fibroblastic stroma and epithelium-lined glands, only the stromal cells are clonal and truly neoplastic. Manifest as solitary, discrete, mobile masses |
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Term
| gross appearance of phyllodes tumor |
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Definition
| stromal elements is cellular and adundant, forming epithelium lined leaflike projections |
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Term
| clinical behavior of phyllodes tumor |
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Definition
| remain localized and are cured by excision, malignant lesions may recur, but they remain localized, only 15% are malignany, metastasizing to distant sites |
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Term
| incidence of Intraductal papilloma |
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Definition
| often seen in premenopausal women |
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Term
| Clinical symptoms of Intraductal papilloma |
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Definition
| serous or bloody nipple discharge, presene of small subareolar tumor, and nipple retraction |
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Term
| Relationship to breast carcinoma of intraductal papilloma |
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Definition
| similar to intraductal papillary carcinoma |
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Term
| Incidence of breast carcinoma |
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Definition
| rarely found before age 25, may occur at any age thereafter, with peak incidence at or after menopause. |
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Term
| Etiology of breast carcinoma |
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Definition
| geography, age (past 30), family history (relative with breast cancer), menstrual history (age at menarche and menopause), age at pregnancy, and history of benign breast disease |
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Term
| Pathogenesis of breast carcinoma |
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Definition
| genetic changes include over expression of Her2/Neu proto-oncogene, amplification of RAS and MYC genes, mutations in BRCA1/BRCA2 genes. Hormonal influences include hormonal imbalances and risk factors that involve increased exposure to estrogen unopposed by progesterone. Environmental variables depend on homogeneous groups and geographic differences in prevalence. |
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Term
| Gross morphology of breast carcinoma |
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Definition
| invasive cancers become adherent or fixed to the pectoral muscles or deep fascia of the chest wall and the overlying skin, with consequent retraction or dimpling of skin or nipple. Thickened skin around exaggerated hair follicles (orange peel) |
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Term
| Clinical course of breast carcinoma |
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Definition
| Breast cancer spread occurs through lymphatic and hematogenous channels, usually to axillary nodes. Favored loctions of spread are lungs, skeleton, liver, adrenals and brain. Prognosis is influenced by tumor invasion and size (small in situ has a better prognosis than invasive and large), extent of lymph node involvement (more involvement is a worse prognosis), distant metastisis (hematogenous spread is incurable), histologic grade (TMN, well differentiated carcinomas have a better prognosis), estrogen/progesterone receptors ( presence gives a better prognosis), type of cancer (specialized types are better), and overespression of her2/neu (associated with poor prognosis). |
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Term
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Definition
| atypical proliferation of ductal cells that eventually completely fills and plugs the duct. May have central area of necrosis (comedocarcinoma) or a cribriform pattern. May produce micro-calcifications on mammogram. Patient may have an invasive component not identified on biopsy and possibly axillary lymph node metastases. Over time, invasive carcinoma develops in about 40% of women.[More common than lung cancer] |
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Term
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Definition
| atypical proliferation of ductal cells that eventually completely fills and plugs the duct. May have central area of necrosis (comedocarcinoma) or a cribriform pattern. May produce micro-calcifications on mammogram. Patient may have an invasive component not identified on biopsy and possibly axillary lymph node metastases. Over time, invasive carcinoma develops in about 40% of women.[More common than lung cancer] |
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Term
| Lobular carcinoma in situ |
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Definition
| constitutes 10% of all breast cancer - proliferation of uniform, monotonous cells in terminal ducts and acini. Does not produce palpable mass or calcifications. Discovered as incidental finding in biopsy for another condition. Strong predictor of future invasive carcinoma -over time, about 30% of women with LCIS will develop invasive carcinoma of either breast, any histologic type. |
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Term
| Pagent's Disease of the Breast |
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Definition
| specialized form of ductal carcinoma that arises in main excretory ducts of breast and extends to involve skin of nipple and areola. Invasion of skin by tumor cells Paget cells) produces an eczematous skin reaction. |
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Term
| carcinoma of the male breast |
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Definition
| rare but rapidly infiltrating tumor, discovered late, with metastases to regional lymph nodes and distant sites. |
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Term
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Definition
| enlargement of the male breast |
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Term
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Definition
| response to absolute or relative estrogen excess |
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Term
| Conditions associated with gynecomastia |
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Definition
| cirrohsis, inability ot the liver to metabolize estrogens, klinefelters syndrome, anabolic steroids, pharmacologic agents |
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Term
| clinical significance of gynecomastia |
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Definition
| can be due to underlying cirrohosis |
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Term
| A well differentiated ductal carcinoma of the breast closely resembles |
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Definition
| normal ductal tissue of the breast. |
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Term
| Of the following, which finding is the BEST indication that a breast neoplasm is malignant? |
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Definition
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Term
| When a fibroadenoma of the breast undergoes massive stromal proliferation, the resulting mass is called a/an: |
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Definition
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Term
| What is the term for enlargement of the male breast? |
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Definition
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Term
| Which of the following is/are considered premalignant lesion(s) of the breast? |
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Definition
| lobular carcinoma in situ and atypical ductal hyperplasia |
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Term
| A typical breast carcinoma feels firm/hard on palpation. This is due to what type of tissue reaction? |
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Definition
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Term
| A malignant breast neoplasm composed predominantly of which type of cancer cells would be MOST sensitive to treatment with radiation/chemotherapy? |
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Definition
| rapidly proliferating cells |
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Term
| Which of the following is NOT associated with fibrocystic change of the breast? |
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Definition
| invasion into surrounding tissue |
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Term
| 3 associations with fibrocystic change of the breast |
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Definition
| cyst formation, premenstrual tenderness and often bilateral |
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Term
| Which factor in a woman's clinical history is MOST significant in assessing that woman's risk of developing breast cancer? |
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Definition
| a positive family history |
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Term
| In a woman with breast carcinoma, the MOST important factor for predicting prognosis is |
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Definition
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Term
| Which of the following is the fastest and easiest breast biopsy method for detection of breast cancer and is also ideal for evaluating cysts? |
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Definition
| fine needle aspiration (FNA) |
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Term
| Which of the following is TRUE regarding fibrocystic change of the breast? |
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Definition
| fibrocystic change is a response to repeated fluctuations in levels of estrogen and progesterone |
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Term
| Due to the importance of correct staging for breast cancer treatment, an axillary lymph node is usually surgically sampled for possible metastasis. This node is called the |
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Definition
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Term
| Inflammatory breast cancer clinically presents with reddened, inflamed skin because |
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Definition
| cancer cells have obstructed dermal lymphatic channels causing local edema and erythema |
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Term
| Which of the following is the most common site of metastasis of breast cancer? |
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Definition
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Term
| the most frequent breast tumor in females under the age of 25 |
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Definition
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Term
| most common cause of a bloody nipple discharge |
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Definition
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Term
| typically presenting as an exzematous areolar skin lesion |
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Definition
| an underlying ductal carcinoma called Paget disease with infiltration of the epidermis by malignant glandular cells. |
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