Breast

Question 1

Relative risk of developing invasive breast cancer

• non proliferation cystic disease
• proliferative cystic disease
• ALH/ADH
• lobular ca in situ and DCIS

Answer 1

• non proliferation cystic disease : 1 (no increased risk)
• proliferative cystic disease : eg sclerosing adenosis, radial scar, florid duct hyperplasia, papilloma and columnar changes( 1.5-2x)
• ALH/ADH : (4-5x)
• lobular ca in situ and DCIS: (8-10x)

DCIS risk is primarily ipsilateral While ALL other entities - risk is bilateral.

Question 2

Fibroadenoma - syndromic association.

Answer 2

Carney Syndrome - including myxoid fibroadenoma

Question 3

Breast with dense fibrosis, lobular atrophy and aggregates in perivascular and perilobular distribution

Answer 3

Lymphocytic mastitis

• also with Type I DM
• circulating autoantibodies to HLA- DR3, DR4 and DR5.

Question 4

Differential diagnosis of pagets nipple with undergoing DCIS

Answer 4

Nipple adenoma

• benign
• either sex, at any age, usually 30-40
• can be confused with pagets and invasive carcinoma
• HAS MYOEPITHELIAL layer (p63 positive)
• surgery curative

Question 5

Collagenous spherulosis associations are

Answer 5

Sclerosing adenosis
Intraductal papilloma
LCIS

BM like material stains positive for collagen- IV

Question 6

Neoplasm most common to arise in fibroadenoma

Answer 6

LCIS