Anatomy
Physiology
Development
Pathology
100

How many lobes is each breast subdivided into?

12-20

100

What is one function, other than the let-down reflex, caused by oxytocin release?

- Increased breast glandular secretions 

- Increase uterine muscle contractions )(involution) 

- Stimulates digestive and metabolic processes 

- anti-stress effects including decrease BP and cortisol levels 

100

What encodes for testis determining factor on the Y chromosome?

Sry

100

What cell type is not present in invasive carcinoma?

Myoepithelial 

200

Name two anatomical differences in a lactating breast compared to a non-lactating breast

  • Breasts enlarged  
  • Dilated veins visible on surface of breast
  • Nipples and areolar more pigmented
  • Enlarged subcutaneous glands
  • Increased gland:stroma ratio (more glands than stroma) 
200
What movement of the infant is responsible for stimulating the let-down reflex?

Peristaltic motion of the tongue

200

What is the hormone that promotes regression of the paramesonephric duct?

AMH

200

Name three symptoms of breast disease 

- nipple discharge 

- breast pain 

- breast lump 

- axillary mass/lymphadenopathy 

- asymptomatic/screen-detected abnormality

300

Name three sets of lymph nodes that the breast drains to

  • Supraclavicular
  • Internal mammary
  • Axillary nodes
  • Subdiaphragmatic 
300

Name one change that occurs in the breast during each stage of the menstrual cycle (proliferative, secretory and menstrual) 

Proliferative phase 

- rising oestrogen levels stimulate parenchymal proliferation

Secretory phase 

- locular oedema 

- increased mammary blood flow 

- thickening of epithelial basement membrane

Menstrual phase

- degeneration of glandular tissue 

- loss of oedema 

- reduction in blood flow 

300

What is a corrected age and at what point does corrected age stop being used?

Age corrected for gestation

Over 2 years of age don’t tend to correct anymore as kids tend to have caught up by then 

300

Name one chronic (non-lactational) form of mastitis and one histological feature associated with it

Periductal - lymphocytes surround the ducts 

Granulomatous - epithelioid macrophages forming granulomata surrounding ducts and lobules 

400

Where is the lactiferous sinus located and what is its purpose?

Dilation of the lactiferous duct just below nipple. Act as a reservoir for milk during breast feeding

400

There are three stages in lactogenesis, what are they called, when do they occur and what happens during each stage? 

Lactogenesis I - beginning of colostrum production in mid-pregnancy 

Lactogenesis II - initiated following delivery of placenta, withdrawal of progesterone and oestrogen (and infant suckling) causes depression of PIF and stimulation of prolactin releasing factors 

Lactogenesis III (galactopoiesis) - maintenance of milk production 

400

When do primordial germ cells start to differentiate and where do they reside prior to their migration to the gonadal ridge?

During gastrulation 

Yolk sac 

400

What are the two most common subtypes of breast adenocarcinoma and what is the histological pattern of the invasive form of each subtype?

Ductal adenocarcinoma - clump/nest/cord pattern

Lobular adenocarcinoma - slender linear strands (Indian file pattern) 

500

Name one major artery that supplies the breast and the vessel that artery branches from 

Internal thoracic artery (branch of subclavian) 

Lateral thoracic artery (branch of axillary artery) 

500

Describe the let-down reflex

Suckling signals back via spinal cord causing 

- dopamine realse which inhibits lactotroph inhibition in anterior pituitary causing prolactin release and subsequent milk production 

- oxytocin release from paraventricular nucleus and supraoptic nucleus causing oxytocin release from posterior pitutiary which increases milk production and activates contraction of myoepithelial cells to cause milk release 

- inhibits the arcuate nucleus causing less GnRH to be released inhibiting gondaotroph hormone release and therefore ovarian cycle

500

What structure differentiates into the male internal genitalia? What cell produce the hormone that promotes maintenance of this structure?

Mesonephric duct 

Leydig cells producing testosterone 

500

What are the two histological changes that will occur in fibrocystic change that has been present for a long period?

Apocrine metaplasia (simple cuboidal --> simple columnar epithelium) 

Adenosis (increase number of acini per lobule)

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