Pathology Exam 3 – 2025-2026 Comprehensive Study Guide with
Detailed Notes, Concepts, and Practice Questions with Correct
Detailed Answers for Nursing and Medical Students||Latest
Version!!!
A study of breast carcinomas is conducted. Some of these carcinomas
are found to be 'triple negative' for estrogen receptor, progesterone
receptor, and HER2. Which of the following microscopic findings is
most characteristic for these triple negative breast carcinomas?
A Inflammatory component
B Multifocality
C High grade
D Tubular growth pattern
E Desmoplasia
C High grade
invasive ductal carcinoma
visualized
firm, hard mass that does not wax/wane in size
invasive lobular carcinoma are characteristic in that cells
diffusely invade in ________ & without _________, which is why
they are difficult to detect. what do almost all of them express &
where do they typically metastasize to?
single files ("Indian filing" ; "cords or chains") ; without desmoplasia
almost all express estrogen/progesterone receptors (Her2neu rare)
CSF, serosal surfaces, GI tract, ovary & bone marrow
(breast webpath)
A 61-year-old woman has increasing dyspnea with chest pain for the
past 4 months. On physical examination there is dullness to
percussion over both lungs. A chest x-ray shows bilateral pleural
effusions. A thoracentesis yields bloody fluid that cytologically
contains small malignant cells forming long rows or rings. A
mammogram shows an irregular area of architectural disortion in her
pg. 1
,left breast. Which of the following histologic types of breast cancer is
most likely to be present in this woman?
A Lobular
B Ductal
C Medullary
D Tubular
E Papillary
A Lobular
rows is the giveaway
why are invasive lobular carcinomas difficult to detect in
comparison to invasive ductal carcinomas?
they do not cause a desmoplastic stromal response
which type of breast carcinoma is described as having a peau
d'orange appearance clinically?
inflammatory carcinoma
patient will present with erythema or breast skin & look like
dermatitis
inflammatory breast carcinoma
histological view
(breast webpath)
A 61-year-old woman has noted a rough, reddened appearance
increasing in size over the skin of her right breast for the past 5
months. This persists despite application of a corticosteroid cream. On
physical examination the skin over the right breast is indurated,
roughened, and reddish-orange. There is nipple retraction. A firm,
irregular 5 cm mass is palpable in this breast. Which of the following
is the most likely risk factor for this woman's condition?
pg. 2
,A Cigarette smoking
B Prior fibrocystic disease
C Multiparity
D Family history
E Human papillomavirus infection
D Family history
A The findings point to breast carcinoma with invasion of the
overlying skin ('inflammatory carcinoma'). A family history of breast
cancer increases the risk for breast cancer the most.
what is the most important prognostic factor of an invasive breast
carcinoma?
lymph node involvement
what is the size of an invasive breast carcinoma that predicts lymph
node involvement?
2 cm
if less than 2 cm, sentinel node biopsy is not performed
what do you know about the staging of a breast carcinoma if it
produces a peau d'orange appearance?
tumor has invaded lymphatics
(breast webpath)
A 52-year-old woman feels a lump in her right breast on self-
examination and goes to her physician. On physical examination the 4
cm mass is not freely movable and feels quite hard. A fine needle
aspirate is performed and cytologic examination shows cells are
present consistent with carcinoma. Which of the following features of
this carcinoma is most likely to suggest a worse prognosis?
A Estrogen receptor positivity
B Family history of breast carcinoma
C Presence of an in-situ component
D Axillary lymph node metastases
E Lack of aneuploidy
pg. 3
, D Axillary lymph node metastases
prognosis of a breast carcinoma is dependent on number of
factors. what are those factors?
estrogen receptor
progesterone receptor
Her2neu family
oncotype diagnostic testing
other factors:
grade/type/size
lymph node involvement
distant metastasis
Family history, age of the patient & unopposed estrogen exposure are
the most important risk factors for developing breast cancer.
a. TRUE
b. FALSE
a. TRUE
stage 1 breast carcinoma vs stage 2 breast carcinoma
Stage 1: invasive tumor 2cm or less, w/o lymph node involvement
Stage 2: invasive tumor 2cm or greater w/ lymph node involvement
(breast webpath)
A 69-year-old woman has a screening mammogram that shows an
irregular 1 to 2 cm density in her right breast. She has no axillary
lymphadenopathy. A needle biopsy is performed and on microscopic
examination shows malignant cells floating in mucinous lakes. The
nuclei show minimal pleomorphism and no mitoses are seen. The
cells are positive for estrogen receptor and negative for HER2 (c-erb
B2). A chest x-ray shows no abnormal findings. A bone scan is
negative. What is the most likely designation for grade and stage of
this neoplasm?
A Grade I, Stage T1 N0 M0
pg. 4
Detailed Notes, Concepts, and Practice Questions with Correct
Detailed Answers for Nursing and Medical Students||Latest
Version!!!
A study of breast carcinomas is conducted. Some of these carcinomas
are found to be 'triple negative' for estrogen receptor, progesterone
receptor, and HER2. Which of the following microscopic findings is
most characteristic for these triple negative breast carcinomas?
A Inflammatory component
B Multifocality
C High grade
D Tubular growth pattern
E Desmoplasia
C High grade
invasive ductal carcinoma
visualized
firm, hard mass that does not wax/wane in size
invasive lobular carcinoma are characteristic in that cells
diffusely invade in ________ & without _________, which is why
they are difficult to detect. what do almost all of them express &
where do they typically metastasize to?
single files ("Indian filing" ; "cords or chains") ; without desmoplasia
almost all express estrogen/progesterone receptors (Her2neu rare)
CSF, serosal surfaces, GI tract, ovary & bone marrow
(breast webpath)
A 61-year-old woman has increasing dyspnea with chest pain for the
past 4 months. On physical examination there is dullness to
percussion over both lungs. A chest x-ray shows bilateral pleural
effusions. A thoracentesis yields bloody fluid that cytologically
contains small malignant cells forming long rows or rings. A
mammogram shows an irregular area of architectural disortion in her
pg. 1
,left breast. Which of the following histologic types of breast cancer is
most likely to be present in this woman?
A Lobular
B Ductal
C Medullary
D Tubular
E Papillary
A Lobular
rows is the giveaway
why are invasive lobular carcinomas difficult to detect in
comparison to invasive ductal carcinomas?
they do not cause a desmoplastic stromal response
which type of breast carcinoma is described as having a peau
d'orange appearance clinically?
inflammatory carcinoma
patient will present with erythema or breast skin & look like
dermatitis
inflammatory breast carcinoma
histological view
(breast webpath)
A 61-year-old woman has noted a rough, reddened appearance
increasing in size over the skin of her right breast for the past 5
months. This persists despite application of a corticosteroid cream. On
physical examination the skin over the right breast is indurated,
roughened, and reddish-orange. There is nipple retraction. A firm,
irregular 5 cm mass is palpable in this breast. Which of the following
is the most likely risk factor for this woman's condition?
pg. 2
,A Cigarette smoking
B Prior fibrocystic disease
C Multiparity
D Family history
E Human papillomavirus infection
D Family history
A The findings point to breast carcinoma with invasion of the
overlying skin ('inflammatory carcinoma'). A family history of breast
cancer increases the risk for breast cancer the most.
what is the most important prognostic factor of an invasive breast
carcinoma?
lymph node involvement
what is the size of an invasive breast carcinoma that predicts lymph
node involvement?
2 cm
if less than 2 cm, sentinel node biopsy is not performed
what do you know about the staging of a breast carcinoma if it
produces a peau d'orange appearance?
tumor has invaded lymphatics
(breast webpath)
A 52-year-old woman feels a lump in her right breast on self-
examination and goes to her physician. On physical examination the 4
cm mass is not freely movable and feels quite hard. A fine needle
aspirate is performed and cytologic examination shows cells are
present consistent with carcinoma. Which of the following features of
this carcinoma is most likely to suggest a worse prognosis?
A Estrogen receptor positivity
B Family history of breast carcinoma
C Presence of an in-situ component
D Axillary lymph node metastases
E Lack of aneuploidy
pg. 3
, D Axillary lymph node metastases
prognosis of a breast carcinoma is dependent on number of
factors. what are those factors?
estrogen receptor
progesterone receptor
Her2neu family
oncotype diagnostic testing
other factors:
grade/type/size
lymph node involvement
distant metastasis
Family history, age of the patient & unopposed estrogen exposure are
the most important risk factors for developing breast cancer.
a. TRUE
b. FALSE
a. TRUE
stage 1 breast carcinoma vs stage 2 breast carcinoma
Stage 1: invasive tumor 2cm or less, w/o lymph node involvement
Stage 2: invasive tumor 2cm or greater w/ lymph node involvement
(breast webpath)
A 69-year-old woman has a screening mammogram that shows an
irregular 1 to 2 cm density in her right breast. She has no axillary
lymphadenopathy. A needle biopsy is performed and on microscopic
examination shows malignant cells floating in mucinous lakes. The
nuclei show minimal pleomorphism and no mitoses are seen. The
cells are positive for estrogen receptor and negative for HER2 (c-erb
B2). A chest x-ray shows no abnormal findings. A bone scan is
negative. What is the most likely designation for grade and stage of
this neoplasm?
A Grade I, Stage T1 N0 M0
pg. 4
