33. Mastitis and benign breast disease
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Questions and Answers

What is the approximate incidence of polythelia in the general population?

  • 1%–5% (correct)
  • 10%–15%
  • 20%–25%
  • 30%–35%

    • Where is the most common site for an extra breast to occur?

  • Abdomen
  • Back
  • Axilla (correct)
  • Chest

    • What is the term for the complete absence of nipple and areola?

  • Amastia
  • Polymastia
  • Polythelia
  • Athelia (correct)

    • What is the significance of congenitally inverted nipples?

    <p>Usually of little significance, correct spontaneously during pregnancy</p> Signup and view all the answers

    What is the most common bacterium isolated from milk cultures in lactating mastitis?

    <p>Staphylococcus aureus</p> Signup and view all the answers

    What is the characteristic age range for non-lactating mastitis (periductal mastitis)?

    <p>19-50 years</p> Signup and view all the answers

    What is the characteristic presentation of lactating mastitis on physical examination?

    <p>Wedge-shaped red area of the breast</p> Signup and view all the answers

    What should always be considered in a woman with an erythematous swollen breast, mimicking inflammation?

    <p>Inflammatory breast cancer</p> Signup and view all the answers

    Which condition presents with a poorly defined palpable periareolar mass and thick, white nipple secretions?

    <p>Mammary duct ectasia</p> Signup and view all the answers

    Which of these does not cause granulomatous mastitis?

    <p>Breast trauma</p> Signup and view all the answers

    Which condition is associated with dense fibrous stromal proliferation in women with long-standing type 1 diabetes mellitus?

    <p>Lymphocytic mastopathy</p> Signup and view all the answers

    Which organism is NOT commonly isolated in non-lactating mastitis?

    <p>Streptococcus pneumoniae</p> Signup and view all the answers

    What is the characteristic appearance of fat necrosis on mammography?

    <p>An oil cyst with a calcified rim</p> Signup and view all the answers

    Which condition is hypothesized to be secondary to periductal inflammation?

    <p>Mammary duct ectasia</p> Signup and view all the answers

    Which condition must be distinguished from breast cancer due to its mammographic appearance?

    <p>Lymphocytic mastopathy</p> Signup and view all the answers

    What is the principal significance of breast fat necrosis?

    <p>It mimics the mammographic appearance of carcinoma</p> Signup and view all the answers

    Which condition is associated with a dense keloid-like fibrosis and a prominent lymphocytic infiltrate surrounding atrophic ducts?

    <p>Lymphocytic mastopathy</p> Signup and view all the answers

    Which condition is commonly associated with trauma or prior surgery?

    <p>Breast fat necrosis</p> Signup and view all the answers

    Which condition may form a fistula tract opening at the edge of the areola?

    <p>Non-lactating mastitis</p> Signup and view all the answers

    Which condition is associated with an isodense, well-delimited nodule on mammography in association with calcifications?

    <p>Lymphocytic mastopathy</p> Signup and view all the answers

    What is the term for the proliferation of ductules within the terminal duct unit, resulting in an increased number of ductules?

    <p>Adenosis</p> Signup and view all the answers

    What contributes to the palpable firmness of the breast in the context of cyst rupture in fibrocystic breast disease?

    <p>Chronic inflammation and fibrous scarring</p> Signup and view all the answers

    What is implicated in the induction of extensive stromal fibrosis leading to the obliteration of terminal ducts in fibrocystic breast disease?

    <p>Hyperestrogenism</p> Signup and view all the answers

    What represents ectatic ductules and can be microscopic or up to 2 inches in diameter in the context of fibrocystic breast disease?

    <p>Cysts</p> Signup and view all the answers

    Which of the following is a characteristic morphologic change seen in fibrocystic breast disease?

    <p>Cysts lined by flattened atrophic epithelium</p> Signup and view all the answers

    Which of the following is a characteristic feature of apocrine metaplasia in fibrocystic breast disease?

    <p>Metaplasia of cyst epithelium into apocrine epithelium resembling sweat glands</p> Signup and view all the answers

    What is the predominant color of the fluid in unopened cysts in fibrocystic breast disease?

    <p>Brown or blue</p> Signup and view all the answers

    What is the characteristic appearance of apocrine cells in fibrocystic breast disease?

    <p>Columnar with granular, strongly eosinophilic cytoplasm and vesicular nuclei</p> Signup and view all the answers

    Which of the following is a characteristic of usual ductal hyperplasia (UDH)?

    <p>Presence of more than two cell layers without mitotic activity or atypia</p> Signup and view all the answers

    What is the defining characteristic of sclerosing adenosis?

    <p>Increase in the number of acini per terminal duct and stromal proliferation</p> Signup and view all the answers

    What is the distinguishing feature of proliferative breast disease without atypia?

    <p>Proliferation of ductal epithelium and/or stroma without cytologic or architectural features suggestive of carcinoma in situ</p> Signup and view all the answers

    What is the defining factor of mild intraductal hyperplasia?

    <p>2 to 4 epithelial layers</p> Signup and view all the answers

    Which of the following lesions forms irregular masses and can closely mimic invasive carcinoma?

    <p>Complex sclerosing lesion</p> Signup and view all the answers

    What is the characteristic mammographic appearance of a complex sclerosing lesion?

    <p>Focal area of architectural distortion with 'dark' spicules radiating from the center</p> Signup and view all the answers

    What is the distinguishing feature of intraductal papilloma?

    <p>Polypoid growth within the duct lumen</p> Signup and view all the answers

    Where are large duct papillomas usually situated?

    <p>Solitary and situated in the lactiferous sinuses</p> Signup and view all the answers

    Which of the following lesions is commonly associated with fibrocystic disease and can closely mimic invasive carcinoma?

    <p>Complex sclerosing lesion</p> Signup and view all the answers

    Which condition is composed of multiple branching fibrovascular cores, each having a connective tissue axis and an epithelium containing both luminal and myoepithelial cells?

    <p>Intraductal papilloma</p> Signup and view all the answers

    What is the defining feature of a complex sclerosing lesion in the breast?

    <p>Prominent fibroelastosis and epithelial hyperplasia</p> Signup and view all the answers

    What is the relative risk of breast cancer associated with atypical lobular hyperplasia (ALH)?

    <p>5 times greater than normal</p> Signup and view all the answers

    Which of the following accurately describes the cellular proliferation in atypical lobular hyperplasia (ALH)?

    <p>Identical to lobular carcinoma in situ (LCIS) cells and fills or distends less than 50% of the acini within a lobule</p> Signup and view all the answers

    What is the distinguishing factor between atypical ductal hyperplasia (ADH) and ductal carcinoma in situ (DCIS)?

    <p>Size of the lesion</p> Signup and view all the answers

    What is the characteristic feature of atypical lobular hyperplasia (ALH) in terms of acini involvement within a lobule?

    <p>Fills or distends more than 50% of the acini within a lobule</p> Signup and view all the answers

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