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Pathoma Breast Pathology > Breast Cancer > Flashcards

Breast Cancer Flashcards

(55 cards)

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1
Q

What is the most common carcinoma in women by incidence (excluding skin)?

A

breast

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2
Q

breast cancer is the Xth most common cause of cancer mortality in women

A

2nd

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3
Q

Name six risk factors for breast cancer

A
  1. Female gender
  2. Age
  3. Early menarche/late menopause
  4. Obesity
  5. Atypical hyperplasia
  6. First-degree relative (mother, sister, daughter) with breast cancer
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4
Q

what do you call a malignant proliferation of cells in ducts with no invasion of the basement membrane?

A

ductal carcinoma in situ

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5
Q

how is DCIS usually detected?

A

calcification on mammography; DCIS does not produce a mass

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6
Q

mammographic calcifications can also be associated with benign conditions such as

A

fibrocystic changes (especially sclerosing adenoma) and fat necrosis

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7
Q

how do you know whether mammographic calcifications are benign or malignant?

A

biopsy

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8
Q

histologic subtypes of DCIS are based on

A

architecture

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9
Q

what is the subtype of DCIS that is characterized by high-grade cells with necrosis and dystrophic calcification in the center of ducts

A

comedo

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10
Q

what do you call DCIS that extends up the ducts to involve the skin of the nipple

A

pager’s disease of the breast

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11
Q

Paget disease of the breast presents as

A

nipple ulceration and erythema

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12
Q

paget disease of the breast is almost always associated with an underlying

A

carcinoma

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13
Q

what do you call an invasive breast carcinoma that classically forms duct-like structures?

A

invasive ductal carcinoma

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14
Q

what is the most common type of invasive carcinoma in the breast, accounting for >80% of cases

A

invasive ductal carcinoma

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15
Q

how does invasive ductal carcinoma usually present

A

mass on physical exam or mammography

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16
Q

clinically (PE) detected breast masses are usually at least what size

A

2 cm

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17
Q

mammographically detected breast masses are usually at least what size

A

1 cm

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18
Q

advanced breast tumors may result in

A

dimpling of the skin or retraction of the nipple

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19
Q

biopsy of invasive ductal carcinoma usually shows duct-like structures in a

A

desmoplasic stroma

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20
Q

subtype of invasive ductal carcinoma that is characterized by well-differentiated tubules that lack myopeithelial cells?

A

tubular carcinoma

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21
Q

subtype of invasive ductal carcinoma that is characterized by carcinoma with abundant extracellular mucin (tumor cells floating in a mucus pool)?

A

mucinous carcinoma

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22
Q

what is the typical population of the mucinous subtype of invasive ductal carcinoma?

A

older women (average age is 70)

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23
Q

subtype of invasive ductal carcinoma that is characterized by large, high-grade cells growing in sheets with associated with lymphocytes and plasma cells

Study These Flashcards
A

medullary carcinoma

24
Q

grows as a well-circumscribed mass that can mimic fibroadenoma on mammography; increased incidence in BRCA1 carriers

Study These Flashcards
A

medullary carcinoma (invasive ductal)

25
subtype of invasive ductal carcinoma that is characterized by carcinoma in dermal lymphatics
inflammatory carcinoma
26
presents as an inflamed, swollen breast (tumor cells block drainage of lymphatics) with no discrete mass; can be mistaken for acute mastitis
inflammatory carcinoma (invasive ductal)
27
which subtype of invasive ductal carcinoma has the worst prognosis?
inflammatory
28
malignant proliferation of cells in lobules with no invasion of the basement membrane
LCIS
29
how is LCIS discovered?
incidentally on biopsy (!) - it doesn't produce a mass or calcifications
30
histology of LCIS
dyscohesive cells lacking E-cadherin adhesion protein
31
LCIS is characterized by dyscohesive cells lacking WHAT?
E-cadherin adhesion protein
32
Besides being undetectable except by incidental biopsy, what other features of LCIS make it scary?
usually multifocal and bilateral
33
how do you treat LCIS?
tamoxifen (to reduce the risk of subsequent carcinoma) and close followup
34
LCIS risk of progression to invasive carcinoma?
low
35
invasive carcinoma that characteristically grows in a single-file pattern; cells may exhibit signet-ring morphology
invasive lobular carcinoma
36
why is there no duct formation in invasive lobular carcinoma?
lack of E-caherin
37
what is the most important factor in breast cancer prognosis?
metastasis, but most patients present before metastasis occurs
38
what is the most useful prognostic factor in breast cancer?
spread to axillary lymph nodes; sentinel lymph node biospy is used to assess axillary lymph nodes
39
what do you call factors that predict response to treatment
predictive factors
40
what are the most important predictive factors
``` estrogen receptor (ER), progesterone receptor (PR). Her2/neu amplification (overexpression) status ```
41
Presence of ER and PR is associated with response to
antiestrogenic agents (eg tamoxifen)
42
ER and PR are located where?
in the nucleus
43
HER2/neu amplification with response to
trastuxumab (Herceptin)
44
what is trastuxumab?
a designer antibody directed against the HER2 receptor
45
What is HER2/neu?
a growth factor receipt present on the cell surface
46
what do you call a tumor that is negative for ER, PR, and HER2/neu
triple negative tuomr
47
what is the prognosis of triple negative tumors?
poor
48
what population has increased risk of developing rip negative carcinomas?
African American women
49
Hereditary breast cancer represents what percentage of breast cancer cases?
10%
50
what are three clinical factors that suggest hereditary breast cancer?
1. multiple first-degree relatives with breast cancer 2. tumor at an early age (premenopausal) 3. multiple tumors in a single patient
51
what are the two most important single gene mutations associated with hereditary breast cancer?
BRCA1 and BRAC2
52
Mutation associated with breast and ovarian carcinomas
BRCA1
53
Mutation associated with breast carcinoma in males
BRCA2
54
women with a genetic predisposition to breast cancer may choose to undergo WHAT to reduce the risk of developing carcinoma
bilateral mastectomy
55
why does a small risk for breast cancer remain after bilateral mastectomy?
breast tissue sometimes extends into the axilla or subcutaneous tissue of the chest wall

Pathoma Breast Pathology (3 decks)

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