Breast Pathology 2 Flashcards

1
Q

BRCA___ mutation is relatively more common

A

BRCA1

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2
Q

Li Fraumeni syndrome is associated with a mutation in _____

A

p53

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3
Q

ER positive pathway of breast cancer is the most common and is associated with a germane BRCA___ mutation

A

BRCA2

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4
Q

the main cause of peas d’orange in _______ carcinoma of the breast is due to ______

A

peau d’orange occurs in inflammatory carcinoma and is due to lymphedema

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5
Q

breast cancer can spread to ____, ____ , _____ , or _____

A

lung, bones, liver, or adrenals

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6
Q

all breast carcinomas arise form cells in the ________

A

terminal duct lobular unit

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7
Q

in micro papillary DCIS (non comedo) is there a fibrovascular core?

A

no;

will see a fibrovascular core in the papillary type of intraductal carcinoma

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8
Q

BRCA1 mutations is associated with a ER _____ (+/-) breast cancer

A

ER negative

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9
Q

which breast carcinoma is associated with a mutation in E-cadherin?

A

lobular carcinoma in situ

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10
Q

Paget’s disease has cells that extend from ______ (breast carcinoma) via the ductal system via lactiferous sinuses and into the nipple skin

A

DCIS; look of underlying intraductal or invasive carcinoma

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11
Q

how does Paget’s disease present?

A

unilateral pruriti erthematous reputino with a scale crust; can be mistaken for eczema

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12
Q

is there basement membrane invasion in Paget’s disease?

A

NO;

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13
Q

describe the Paget cells on histology

A
  • hyperchromatic cells with perinuclear halo
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14
Q

_______ stain can be used to strain for Paget cells

A

cytokeratin (epidermal)

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15
Q

lumina A ductal carcinoma is
ER:
HER2/neu:

A

ER +
HER2/neu -

more common

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16
Q

luminal B ductal carincoma is
ER:
HER2/neu:

A

ER +
HER2/neu: +
TRIPLE POSITIVE TUMOR

17
Q

_________ ductal carcinoma of the breast is triple negative

A

basal like; more associtd with BRCA1 mutation and seen in younger females

18
Q

medullary carcinoma is special in that it clinical presents differently than ductal carcinoma. how doe it present on physical examination?

A

fleshy, soft well circumscribed lesion that can be confused with a benign lesion

ductal carcinoma of the breast is hard with irregular borders

19
Q

what is the prognosis for medullary carcinoma of the breast

A

good

20
Q

lobular carcinoma is associated with loss of ______

A

E cadherin

21
Q

signet ring appearance of tumor cells is seen in _______ carcinoma of the breast

A

lobular

22
Q

what are the two microscopic patterns in lobular carcinoma of the breast

A
  1. single file of tumor cells, round and uniform

2. bull’s eye pattern (tumor cells around normal acini and ducts)

23
Q

what are the three uncommonly metastasizing breast cancers

A
  • colloid
  • medullary
  • papillary
24
Q

ER+/PR+ responds to _____ the most often compared to other ER/PR status

A

tamoxifen; (hormone therapy)

25
Q

rank the ER/PR status in order of most likely to respond to tamoxifen to least likely

A
  1. ER+/PR+
  2. ER-/PR+
  3. ER+/PR-
  4. ER-/PR-
26
Q

Her2/neu is a ______ (type of gene)

A

oncogene; over expression of this oncogene is associated with a worse clinical outcome

27
Q

20% of her2 positive patients respond to treatment with ________

A

Herceptin (trastuzumab) aka immunotherapy

28
Q

can Herceptin cross the BB barrier?

A

no; it CANNOT be useful in breast cancer that has metastasized to the brain

29
Q

what are the breast lesions and carcinomas that can be picked up on a mammogram

A
  • intraductal carcinoma
  • FCC proliferative
  • sclerosing adenosis
  • radial scar
30
Q

what are 2 microscopic changes in gynecomastia

A
  • proliferation of glands

- intraductal hyperplasia with intense fibrosis around ducts

31
Q

_____ karyotype is a risk factor for breast carcinoma and gynecomastia in males

A

XXY (Kilnefelter’s)

32
Q

breast carcinoma in males tend to have more association with a BRCA__ mutation and are usually ER____

A

BRCA 2; ER +