Breast Anatomy and Function Quiz

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Questions and Answers

What is a primary function of the breast?

Secretion of hormones

Production and expression of milk (correct)

Protection against infections

Storage of fats

Which structures are primarily involved in the normal anatomy of the breast?

Adipose Tissue and Nerves

Lobules and Ducts (correct)

Cartilage and Ligaments

Arteries and Veins

What type of secretion is observed in a normal breast acinus?

Endocrine secretion

Holocrine secretion

Merocrine secretion

Apocrine secretion (correct)

What characterizes a lobular unit in the breast structure?

Collagenous stroma between structures Signup and view all the answers

What condition is associated with the male breast?

Gynaecomastia Signup and view all the answers

What is a key characteristic of Lobular Carcinoma in Situ (LCIS)?

It typically shows loosely cohesive clusters within the lobules. Signup and view all the answers

Which of the following statements about the prognosis of lobular carcinoma in situ is correct?

Approximately one-third of women with LCIS will develop invasive cancer. Signup and view all the answers

What immunohistochemical feature is commonly observed in lobular carcinoma?

Mucin-positive signet ring cells. Signup and view all the answers

What treatment strategy is typically recommended for patients diagnosed with LCIS?

Regular clinical and radiologic follow-up. Signup and view all the answers

In terms of risk, how does Lobular Carcinoma in Situ (LCIS) affect future breast cancer developments?

LCIS is a marker of increased risk of bilateral carcinoma. Signup and view all the answers

What is a characteristic feature of sclerosing adenosis?

Double number of acini in terminal ducts Signup and view all the answers

Which feature distinguishes complicated sclerosing lesions from other benign lesions?

Formation of irregular masses Signup and view all the answers

What is typically found in the lumen of a duct affected by papillomas?

Fibrovascular cores with connective tissue Signup and view all the answers

What is a typical symptom of intraductal papilloma?

Bloody nipple discharge Signup and view all the answers

Which type of breast condition is characterized by a clonal proliferation without all features of carcinoma in situ?

Atypical hyperplasia Signup and view all the answers

What imaging findings are associated with a radial sclerosing lesion?

Irregular central mass with radiodense projections Signup and view all the answers

In normal duct histology, what is characteristic of myoepithelial cells?

Scant cytoplasm with dark compact nuclei Signup and view all the answers

Which amendment in glandular proliferation refers to the increase in acini and normal lobular arrangement during pregnancy?

Sclerosing adenosis Signup and view all the answers

What percentage of invasive carcinomas are classified as Invasive Carcinoma, No Special Type (NST)?

70-80% Signup and view all the answers

Which of the following is a characteristic of Infiltrating Lobular Carcinoma?

Single file or loose clusters/sheets of cells Signup and view all the answers

What is a possible clinical manifestation of invasive breast carcinoma regarding lymphatic involvement?

Lymphoedema and peau d’orange skin Signup and view all the answers

What is commonly observed in mammography for invasive breast carcinoma?

Radiodense mass significantly smaller than palpable mass Signup and view all the answers

Which of the following signs might indicate nipple involvement due to breast carcinoma?

Nipple retraction Signup and view all the answers

What histological feature separates Invasive Ductal Carcinoma from Infiltrating Lobular Carcinoma?

Grating sound upon cutting Signup and view all the answers

What type of chromosomal rearrangement is indicated by green loops?

Intrachromosomal Signup and view all the answers

What might be the appearance of tissue affected by malignant epithelial tumors infiltrating the breast?

Irregular borders and sclerotic areas Signup and view all the answers

What happens to lobules in the breast during pregnancy and lactation?

Lobules proliferate and enlarge. Signup and view all the answers

Which statement accurately describes the breast tissue in young women?

It has a fibrous interlobular stroma with little adipose tissue. Signup and view all the answers

What is the significance of mammary duct ectasia in post-menopausal women?

It mimics carcinoma but does not increase risk. Signup and view all the answers

What is one potential outcome of acute mastitis in lactating women?

Draining of abscesses. Signup and view all the answers

What is squamous metaplasia of lactiferous ducts characterized by?

Formation of keratin plugs and blockage of ducts. Signup and view all the answers

What type of diagnostic method is most beneficial for detecting small, non-palpable carcinomas?

Mammography. Signup and view all the answers

Which condition involves rapid and disproportionate breast development during puberty?

Juvenile hypertrophy. Signup and view all the answers

Which physiological change occurs in breast tissue with aging?

Replacement of interlobular stroma with adipose tissue. Signup and view all the answers

What is the recommended frequency of screening mammograms for women aged 50-69?

Every 2 years. Signup and view all the answers

Which of the following conditions does NOT increase the risk of breast cancer?

Duct ectasia. Signup and view all the answers

Study Notes

Breast: Normal Structure and Function

The breast's primary function is the production and expression of milk.
The breast is composed of lobules and ducts.
Lobules are comprised of terminal duct lobular units containing acini, which are responsible for milk production.
Myoepithelial cells surround the acini and help in milk expulsion.

Normal Variation

The breast undergoes minor changes during each menstrual cycle.
During pregnancy, lobules proliferate and enlarge, and epithelial cells differentiate to synthesize and secrete milk components.
After lactation ceases, lobules regress and atrophy but remain larger than pre-pregnancy size.
Breast changes with age, as lobules decrease in size and number, and connective tissue is replaced by adipose tissue.
Mammograms become more helpful in detecting abnormalities in older women as the breast tissue is less dense.

Clinical Features of Breast Lesions

Palpable masses are often a sign of breast lesions.
Breast masses larger than 2cm are more likely to be malignant, particularly in women over 50.
Pain and nipple discharge can also be signs of breast lesions.

Diagnostic Methods

Mammography detects small, non-palpable carcinomas and identifies calcifications, which indicate areas of cell injury and necrosis.
Ultrasonography differentiates between solid and cystic lesions.
Biopsies, including fine needle aspirate biopsy (FNAB) and core biopsies, are used to obtain tissue samples for diagnosis.
Breast cancer screening through regular mammography plays a vital role in early detection.

Developmental Abnormalities

Rare developmental abnormalities include failure of development, observed in conditions like Turner Syndrome, and juvenile hypertrophy, which requires surgical intervention.
Milkline remnants can manifest as supernumerary nipples and are responsive to hormones.
Nipple inversion can be congenital but usually resolves during pregnancy. Acquired nipple inversion is a cause for concern.

Inflammation

Mastitis, inflammation of the breast, can be caused by infections (e.g., Staphylococcus aureus) or other conditions like mammary duct ectasia and fat necrosis.
Inflammation can mimic breast cancer but does not increase cancer risk.

Acute Mastitis

Occurs most often during lactation due to cracks, fissures, and infection.
Symptoms include swelling, erythema, pain, and potential abscess formation.
Treatment involves antibiotics and drainage if an abscess forms.

Squamous Metaplasia of Lactiferous Ducts (SMoLD)

Affects both women and men and is strongly associated with smoking.
Presents as a painful erythematous subareolar mass.
Keratin plugs obstruct ducts, leading to dilation and rupture, causing chronic inflammation.
Drainage, re-occurrence, and surgical duct removal are common interventions.

Duct Ectasia

Commonly seen in post-menopausal parous women, presenting as a painless periareolar palpable mass.
Mimics carcinoma but does not increase cancer risk.
Involves dilation and rupture of ducts, leading to thick nipple discharge.
Inflammation is characterized by lymphocytes, macrophages, and plasma cells.
Fibrosis can cause nipple retraction.

Fat Necrosis

Results from an inflammatory reaction to damaged adipose tissue.
Can mimic carcinoma but does not increase cancer risk.

Benign Epithelial Lesions

Include non-proliferative and proliferative conditions.
Non-proliferative conditions do not increase cancer risk.
Proliferative conditions increase cancer risk.

Sclerosing Adenosis

Characterized by an increased number of acini in terminal ducts.
Normal lobular arrangement is present.
Can mimic carcinoma, causing a palpable mass, radiologic density, and calcification.

Papillomas

Multiple branching fibrovascular cores lined with luminal and myoepithelial cells grow within a dilated duct.
Can present as a large, solitary growth within the sinus of a duct or as multiple, smaller growths deeper in ducts.
Nipple discharge, sometimes bloody, is a common symptom.
Infarct or torsion can occur.

Complex Sclerosing Lesion

Includes components of epithelial hyperplasia, sclerosing adenosis, and papillomas.

Radial Sclerosing Lesion (Radial Scar)

The only commonly occurring benign lesion that can mimic invasive carcinoma mammographically, grossly, and histologically.

Proliferative Breast Disease with Atypia

Atypical hyperplasia represents a clonal proliferation with some, but not all, features of carcinoma in situ.
Usually associated with estrogen receptor negativity (ER-) and HER2 positivity (HER2+).
Does not usually present as a palpable mass and is often discovered during investigations for ductal carcinoma in situ (DCIS).

Lobular Carcinoma in Situ (LCIS)

A clonal proliferation of cells within ducts and lobules, typically due to acquired loss of E-cadherin.
Often an incidental finding during biopsy, not visible on mammography due to lack of calcifications or densities.
Characterized by loose clusters of cells within lobules, including mucin-positive signet ring cells.
Cells are estrogen receptor positive (ER+), HER2/neu negative, and E-cadherin negative.
Increases risk of developing invasive breast cancer in either breast.
Treatment includes close follow-up, chemoprevention with tamoxifen, and occasionally bilateral prophylactic mastectomy.

Invasive (Infiltrating) Carcinoma

Malignant epithelial tumors that infiltrate the breast and spread to distant sites.
May present as a palpable mass or be detected by mammography.
Often accompanied by axillary lymph node metastases.
Nipple retraction and peau d'orange (skin thickening due to lymphatic blockage) are characteristic signs.

Invasive Carcinoma, No Special Type (NST)

Also known as invasive ductal carcinoma.
Accounts for the majority of breast carcinomas (70-80%).
Often firm with an irregular border, presenting a grating sound when cut.
Chalky areas of stroma and foci of calcification are present.

Infiltrating Lobular Carcinoma

Accounts for approximately 10% of breast carcinomas.
Often poorly defined and may present as a palpable mass or mammographic density.
Cells infiltrate in a diffuse manner, single file, or loose clusters/sheets, often with signet-ring shape.
Loss of E-cadherin is a characteristic feature.

Molecular Classification

Involves analysis of DNA, mRNA, protein, and morphology to identify characteristic changes.
Chromosomal rearrangements, both intrachromosomal and interchromosomal, are indicative of malignant transformation.

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Description

Test your knowledge on the normal structure and function of the breast, including its role in milk production and variations during the menstrual cycle and pregnancy. This quiz also covers clinical features of breast lesions and changes with age.