Malignant Breast Conditions

Question 1

What is the definition of breast carcinoma?

Answer 1

A malignant tumour of breast epithelial cells

Question 2

Where does breast carcinoma arise from?

Answer 2

The terminal duct lobular unit

Question 3

What type of cancer in breast carcinoma?

Answer 3

Adenocarcinoma

Question 4

Where exactly is the hyperplasia in DCIS?

Answer 4

Epithelium

Question 5

What is meant by an in situ carcinoma?

Answer 5

A carcinoma that is within the basement membrane consisting of acini and ducts

Question 6

What is the difference between atypical lobular hyperplasia and lobular carcinoma in situ?

Answer 6

In ALH less than 50% of the lobule is involved; in LCIS more than 50% of the lobule is involved

Question 7

What gene is there a deletiona dn mutation of in lobular in situ neoplasia?

Answer 7

CDH1 gene on chromosome 16

Question 8

What protein marker is lost in lobular in situ neoplasia?

Answer 8

E Cadherin negative

Question 9

Are lobular in situ neplasia’s ER negative or Er positive?

Answer 9

ER positive

Question 10

Does the incidence of lobular in situ neoplasia increase or decrease after menopause?

Answer 10

Decreases

Question 11

What is the management for a lobular in situ neoplasia found on core biopsy?

Answer 11

Excision or vacuum biopsy to exclude higher grade biopsy

Question 12

What are the 4 types of ductal proliferations?

Answer 12

Epithelial hyperplasia of usual type
Columnar cell change
Atypical ductal hyperplasia
Ductal Carcinoma in situ

Question 13

Is LCIS or DCIS more likely to be multifocal?

Answer 13

LCIS

Question 14

Is LCIS or DCIS more likely to be from a single duct system?

Answer 14

DCIS

Question 15

What is the definition of an invasive carcinoma?

Answer 15

Malignant epithelial cells have breached the basement membrane and infiltrated normal tissues.

Question 16

List some of the risk factors for breast carcinoma

Answer 16

1. Age
2. Early menarche, nulliparity, no breastfeeding, late menopause (Due to unopposed oestrogen)
3. OCP, HRT
4. Obesity
5. Alcohol
6. Smoking
7. Genetics

Question 17

Which is the most common type of invasive breast cancer?

Answer 17

Ductal

Question 18

What is meant by tumour grade?

Answer 18

How well differentiated the tumour is

Question 19

What three things are assessed when calculating the histological grade of a breast tumour?

Answer 19

1. Tubular differentiation (scored from 1 - 3)
2. Nuclear pleomorphism (scored from 1 - 3)
3. Mitotic activity (scored from 1 - 3)

Question 20

What hormonal treatment in given to pre menopausal women with ER+ breast cancer?

Answer 20

Tamoxifen

Question 21

What hormonal treatment in given to post menopausal women with ER+ breast cancer?

Answer 21

Aromatase inhibitors such as letrozole

Question 22

What does HER2 stand for?

Answer 22

Human Epidermal Growth Factor 2

Question 23

What drug is given to HER2+ tumours?

Answer 23

Trastuzamab (Herceptin)

Question 24

What three things does the nottingham prognostic indicator take into consideration?

Answer 24

Tumour size
Tumour Grade
Lymph node status

Question 25

Which type of breast cancer, in term of hormone receptors, has the worst prognosis?

Answer 25

Triple negative

Question 26

Who should get an US scan instead of a mammogram in triple assessment?

Answer 26

Women under 40

Question 27

What do patients who have a wide local excision for breast cancer always need?

Answer 27

Adjuvant radiotherapy

Question 28

Where do both ductal and lobular breast cancers arise from?

Answer 28

The terminal duct lobular unit