2.  The term adenosis refers to which of the following changes?

  3.  Which of the following elements in fibrocystic change is related to increased risk of breast cancer?

  4.  Mammographic and gross examination of a breast mass reveals a stellate-shaped lesion containing a central core of fibrosis, as shown in this gross picture. Histologically, on low-power examination, the lesion resembles the head of a flower. The central fibrotic core contains distorted tubules and lobules and is surrounded by glandular elements showing varying degrees of dilatation, hyperplasia, adenosis, and occasional papillomatous formations. Which of the following is it?

  5.  Which of the following breast lesions lacks a myoepithelial lining in spite of its benign nature?

  6.  A breast biopsy shows alterations of the lobular architecture diagnosed as blunt duct adenosis. Which of the following changes is most likely to be associated with this condition?

  7.  A breast biopsy shows foci of extensive epithelial hyperplasia, with obliteration of the ductal lumina. Some of these foci are suspicious for ductal carcinoma in situ (DCIS). Which of the following morphologic features favors a diagnosis of DCIS?

  8.  A biopsy of a breast nodule shows preservation of the lobular architecture, but several lobules are filled with sheets of large and pleomorphic cells, as shown in this photomicrograph. The change shown here is referred to as:

  9.  Which of the following biologic markers is most consistent with low-grade (well-differentiated) DCIS?

10.  A 35-year-old female presents with bloody nipple discharge and an ill-defined subareolar nodule. This photomicrograph demonstrates the low-power architecture of the lesion. All of the following histologic features are consistent with a diagnosis of solitary intraductal papilloma, except:

11.  A breast biopsy shows histopathologic changes diagnostic of lobular carcinoma in situ (LCIS). This diagnosis implies that:

12.  A breast biopsy shows several acini filled with sheets of malignant cells that expand and distort the lobular architecture. Neoplastic cells are immunoreactive for E-cadherin and negative for high molecular weight keratin. Besides the immunohistochemical profile, which of the following features is most helpful in the differential diagnosis of this change?

13.  Which of the following breast changes is associated with a relative risk of developing cancer four to five times that of the general population?

14.  Histologic evaluation of a breast cancer demonstrates an infiltrating ductal carcinoma. Neoplastic cells form solid trabeculae, whereas tubule formation is negligible. Nuclear pleomorphism is minimal, and the mitotic rate is 3/high-power field. Which of the following is the grade according to the criteria of the Bloom-Richardson system?

15.  Which of the following is the most significant predictive factor in breast carcinoma?

16.  A breast lesion is composed of malignant cells distributed as shown in this picture. The most likely diagnosis is:

17.  A 40-year-old woman presents with a breast nodule. After excision, histologic examination reveals a lesion composed of well-developed tubular structures with an angulated profile within a desmoplastic stroma. Apical snouts are noted in epithelial cells. No metastases are found in axillary lymph nodes. Markers for myoepithelial cells are negative. Which of the following is the most likely diagnosis?

18.  Mucinous carcinoma of the breast is characterized by:

19.  Foci of mucinous differentiation are not infrequent in infiltrating ductal carcinoma NOS. Which of the following percentages of mucinous pattern should be present for a breast carcinoma to have a good prognosis?

20.  The medullary variant of breast carcinoma is characterized by:

21.  Which of the following patterns of differentiation is associated with a pronounced tendency for lymphatic invasion and a poor prognosis?

22.  Of the breast tumors similar to neoplasms of salivary glands, which of the following is the most common?

23.  A 14-year-old female presents with a well-circumscribed 0.8-cm breast nodule. Fine-needle aspiration shows evidence of malignancy. Which of the following tumor types is most likely to be found on biopsy?

24.  Upon histologic examination, an infiltrating breast tumor shows large cell size, prominent cytoplasmic eosinophilia, conspicuous nucleoli, and apical snouts. These changes are homogeneously present throughout the neoplasm. EM reveals abundant mitochondria. Which of the following is the most likely diagnosis?

25.  Which of the following is the pathologic substrate underlying the clinical appearance of inflammatory breast carcinoma?

26.  A biopsy of an ulcerated, crusted skin lesion of the nipple shows large cells infiltrating the epidermis. Which of the following is characteristic of this lesion?

27.  Which of the following statements applies to carcinoma of the male breast?

28.  Which of the following histologic features or patterns are associated with increased risk of malignancy in fibroadenomas?

29.  This low-power photomicrograph demonstrates the salient histologic features of a large (14-cm) mass excised from the breast of a young woman. The most likely diagnosis is:

30.  A breast tumor from a 46-year-old woman shows the features in this low-power photomicrograph. Which of the following is the most likely diagnosis?

31.  A breast angioma is usually an incidental microscopic finding. Its most typical histologic feature is:

32.  Which of the following is the most common predisposing factor for lymphangiosarcomas?

33.  A 40-year-old woman undergoes resection of a poorly circumscribed nodule of the subareolar region. Histologically, the lesion appears round and consists of aggregates of tubular structures that extend up to the epidermis, where the junction with the squamous epithelium is abrupt. The stroma is fibrous and focally sclerotic. The glands have irregular outlines and a two-cell layer. The most likely diagnosis is: