Breast Pathology II Flashcards Preview

REPRO II Exam 1 > Breast Pathology II > Flashcards

Flashcards in Breast Pathology II Deck (67):
1

fibrocystic change

exaggerated physio response
-1/3 women age 30-50

stops at menopause

mass, pain, microcalcifications

no increased risk for carcinoma**

2

usual epithelial hyperplasia

like FCC - but >4 cells thick

3

radial scar

complex sclerosing lesion
-central fibroelastic scar with entrapped glands

mimic carcinoma

4

intraductal papilloma

benign epithelial cells on stalk

polyp obstructing lumen

5

atypical ductal hyperplasia

low grade neoplastic
-overlap with DCIS

DCIS - when duct completely filled and lesion is >2mm

6

atypical lobular hyperplasia

proliferation of low grade neoplastic cells in lobule

e-cadherin negative

overlap with LCIS

7

lobular carcinoma in situ

just a risk for DCIS

8

DCIS

needs to be removed

9

comido necrosis

in DCIS

10

medial breast drainage

to thoracic nodes

11

lateral breast drainage

to axillary nodes

12

stromal breast neoplasms

fibroadenoma
phyllodes tumors

13

difference between ductal and lobular carcinoma of breast

different gene expression

e-cadherin

14

invasion of ductal and lobular carcinoma

invasion diagnosed by absence of myoepithelial cells

15

comedonecrosis

with high grade DCIS

squeeze tissue and toothpaste squirts out

prone to dystrophic calcification

16

microinvasion

<2mm in dimension

17

high grade DCIS

microinvasion and comedonecrosis

18

dyshesive and mucin +

LCIS

19

e-cadherin positive

DCIS

20

eczema/red skin around nipple and areola

paget disease
-due to underlying DCIS +/- invasion

infiltration by malignant glandular cells

21

micropapillary, cribriform, mild atypia

low grade DCIS

22

e-cadherin negative

LCIS

23

upward infiltration of epidermis by glandular neoplastic cells

pagetoid

24

CK7

useful in diagnosis of pagets

25

risk factors for invasive carcinoma of breast

estrogen exposure
radiation exposure
breast density
proliferative fibrocystic changes
alcohol, obesity, sedentary
familial
increasing age

26

inhibits at G1>S and G2>M to allow DNA repair

GADD45

27

BRCA1

ER negative
no precursor lesion

basal like

tp53 mutations

28

BRCA2

ER positive
flat epithelial atypia
atypical ductal hyperplasia

luminal

16q loss and 1q gain

29

her2 positive cancers

ER positive or negative

HER2 enriched

30

p53 action

inhibits neoplastic transformation by:
-induces transient cell cycle arrest
-induces permanent cell cycle arrest
-induces apoptosis

31

genetic testing for breast cancer

family genetic disease
early age of onset
high risk breast cancer
positive family hx

32

li fraumeni syndrome

p53 - with 85-90% increased risk

associated cancers - soft tissue, brain, bone, adrenal, leukemia, etc.

multiple early onset cancers**

33

BRCA1 and 2

hereditary breast cancer

associated - ovarian, male breast, prostate, pancreatic, melanoma

34

cowden syndrome

PTEN

35

peutz jeghers syndrome

STK1

36

peau d'orange

inflammatory carcinoma

due to invasion of dermal lymphatics and coopers ligaments

37

invasive ductal carcinoma

50% RUQ

stellate mass with gritty hard surface

38

invasive lobular carcinoma

hard to detect
-indian filing pattern
-e-cadherin negative
-spread to mesothelial surfaces and leptomeninges

39

indian filing

invasive lobular carcinoma

40

worst of all breast cancer

inflammatory

41

undifferentiated

so poor original tissue cannot be ID'd

aka anaplastic

42

pTis

CIS

43

pT1

tumor <0.1cm

44

pT2

tumor 2cm-5cm

45

pT3

tumor >5cm

46

pT4

tumor any size and spread to chest wall/breast tissue

47

PET scan

or mets

utilizes warburg effect

should not be restricted by cancer type or testing indication

48

Her2/neu

membrane bound protein that phosphorylates tyrosine and initiates number of signalling pathways and inhibits apoptosis

overexpresion in 30% of breast cancer

conveys bad prognosis

49

herceptin

to tx her2/neu cancers - better prognosis

50

75% breast ca

ER positive

51

65% breast ca

PR positive

52

tamoxifen

competitive antagonist for ER receptor

53

aromatase inhibitors

inhibit conversion of androgen to estrogen

used in post menopausal women

54

patient with high risk of recurrence

given chemotherapy

55

radiation

for local control

56

stage 1 and 2

node negative - tamoxifen

node positive - tamoxifen and chemotherapy

57

mammaprint

test for risk of recurrence

to assess risk of mets

to determine benefit of chemo

58

hormone responsive tx

first line hormone therapy
second line
third line

59

hormone unresponsive tx

first line chemo
second line
third line

60

favorable histo

ER and PR positive

61

trastuzumab

tx of her2neu positive

62

post radiation

angiosarcoma

63

lobular stromal breast tumors

phyllodes
fibroadenoma

64

most common b9 breast tumor

fibroadenoma

age 20-40yo

mass with calcification after involution

india rubber balls

biphasic

65

most common soft tissue tumor of adulthood

lipoma

round, circumscribed, soft, mobile, painless

66

phyllodes tumor

50-60yo

palpable mass

large, rubbery rounded mass

low grade - local recurrence
high grade - aggressive local invasion with heme mets

67

gynecomastia

breast in males
-hyperestrogen

cirrhosis, klinefelter, estrogen producing tumors, meds, marijuana, heroin, exogenous