BREAST II Flashcards
(20 cards)
MOLECULAR CLASSIFICATION AND PATHOGENESIS
Mutations in ______ and ______ are responsible for 80-90% of single gene familial breast cancers and about 3%-6% of all breast cancers
Mutations in BRCA 1 and BRCA 2
PATHOGENESIS OF SPORADIC BREAST CANCER
______ (ER-positive/HER2-negative) cancers arise via the dominant pathway of breast cancer development constituting 50-65% of cases
luminal
PATHOGENESIS OF SPORADIC BREAST CANCER
______ positive cancers arise through a pathway that is strongly associated with amplification of the ______ gene on chromosome 17-q
HER2 positive
HER2 gene on chromosome 17q
TYPES OF BREAST CARCINOMA
Carcinoma in situ refers to cancer cells confined within ducts and lobules by a basement membrane
carcinoma in situ
TYPES OF BREAST CARCINOMA
______ is a clonal proliferation of epithelial cells limited to ducts and lobules by the basement membrane
ductal carcinoma in situ
TYPES OF BREAST CARCINOMA
morphology
________— may occasionally produce a vague nodularity, but more often is detected as clustered or linear and branching areas of calcification
- tumor cells with pleomorphic and high grade nuclei
- areas of central necrosis
COMEDO DCIS
TYPES OF BREAST CARCINOMA
morphology
______ has rounded cookie-cutter spaces filled with calcified secretory material
______ produces complex bulbous protrusions without fibrovascular cores
______produces true papillae with fibrovascular cores that lack a myoepithelial layer
cribriform DCIS
micropapillary DCIS
papillary DCIS
TYPES OF BREAST CARCINOMA
morphology
_________ of the nipple is a rare manifestation of breast cancer that presents as a unilateral erythematous eruption with a scale crust
pruritus is common and the lesion may be mistaken for eczema
Paget Disease
TYPES OF BREAST CARCINOMA
morphology
______ is a clonal proliferation of cells within ducts and lobules that grow in a dyscohesive fashion
classically it consists of a uniform population of cells with oval or round nuclei and small nucleoli involving ducts and lobules
Lobular carcinoma in situ
TYPES OF BREAST CARCINOMA
morphology
invasiva carcinoma is graded using the nottingham histologic score
_____________ carcinomas grow in a tubular or cribriform pattern have small uniform nuclei and have a low proliferative rate
grade I
TYPES OF BREAST CARCINOMA
morphology
NOTTINGHAM
_______ carcinomas have areas where cells grow as solid clusters or single infiltrating cells and show grow greater nuclear pleomorphism and high numbers of mitotic figures
grade 2 moderately differentiated
TYPE OF BREAST CARCINOMA
morphology
NOTTINGHAM
______ carcinomas invade as ragged nests or solid sheets of cells and have enlarged irregular nuclei
grade 3 poorly differentiated
TYPES OF BREAST CARCINOMA
special histologic types of invasive carcinoma
morphology
__________ often insidiously infiltrates the breast while producing desmoplasia
___________ is soft-rubbery and has the appearance of pale gray-blue gelatin
______ consists exclusively of well-formed tubules and is sometimes mistaken for a benign sclerosing lesion
___________ as the name implies produces true papillae fronds of fibrovascular tissue lined by tumor cells
lobular carcinoma
mucinous (colloid) carcinoma
tubular carcinoma
papillary carcinoma
TYPES OF BREAST CARCINOMA
special histologic types of invasive carcinoma
morphology
TWO-SPEICAL HISTOLOGIC TYPES FREQUENTLY OVEREXPRESS HER2
tumor cells of ________- resemble the cells that line the sweat glands; these cells have enlarged round nuclei with prominent nucleoli and abundant eosinophilic occasionally granular cytoplasm
__________ forms hollow balls of cells that float within intercellular fluid creating structures that mimic the appearance of true papillae
apocrine carcinoma
micropapillary carcinoma
TYPES OF BREAST CARCINOMA
special histologic types of invasive carcinoma
morphology
TNBC (ER-negative, HER-2 negative) often corresponds to one of several special histologic types
Chief among these is ___________________
Histologic features:
1. solid sheets of of large cells with pleomorphic nuclei and prominent nucleoli
2. frequent mitotic figures
3. moderate to marked lymphoplasmacytic infiltrate surrounding and within the tumor
carcinoma with medullary pattern
TYPES OF BREAST CARCINOMA
special histologic types of invasive carcinoma
morphology
________ includes spindle cell carcinomas and matrix producing carcinomas
metaplastic carcinoma
TYPES OF BREAST CARCINOMA
special histologic types of invasive carcinoma
morphology
_________ mimics lactating breasts by forming dilated spaces with eosinophilic material
another special subtype that merits mention is ___________
inflammatory carcinoma
MALE CARCINOMA
the most important familial factor conferring an increased risk for male breast cancer is germline mutation of the ________ tumor suppressor gene
BRCA2
STROMAL TUMORS
most common tumor
mutations of MED-12
delicate and often myxoid stroma resembles normal intralobular stroma
epithelium may be surrounded by stroma (pericanalicular) or compressed and distorted (intracanalicular)
FIBROADENOMA
STROMAL TUMORS
MED-12 MUTATIONS
larger lesions often have bulbous protrusions (phyllodes/leaf like) due to presence of nodules of proliferating stroma covered by epithelium
PHYLLODES TUMOR
