Flashcards in Malignant Breast Disease Deck (32):
What is a sarcoma?
malignant tumour of connective or non epithelial tissue
What is a carcinoma?
malignant tumour arising from epithelial tissue
What is a malignant phyllodes tumour?
malignant growth of breast stroma (sarcoma)
What are the common cancers that metastasise to the breast?
kidney clear cell
What is a breast carcinoma?
malignant tumour of breast epithelial cells commonly arising in the glandular epithelium of the TDLU (technically an adenocarcinoma)
What is meant by an in situ carcinoma and what are the two types found in the breast?
cytologically malignant cells that are confined within the basement membrane therefor non invasive
What are the two types of lobular in situ neoplasia?
atypical lobular hyperplasia: <50% of lobule involved
lobular carcinoma in situ: >50% of lobule involved
What is neoplasia?
the abnormal growth and proliferation of abnormal cells or abnormal number of cells due to a benign or malignant process
What is a carcinoma in situ?
(in situ neoplasm) Abnormal cells growing in a normal place and within the confinements of the basal membrane
What are the abnormal cells from lobular in situ neoplasia missing?
What does e-cadherin do?
act as adhesions between cells
What is tamoxifen?
selective eostrogen receptor modulator (anti-oestrogen) that decrease factors that increase growth of breast cells and increases factors that decrease growth of breast cells
What is loss of e-cadherin associated with?
development of abnormal less differentiated cells with invasive characteristics
How is lobular in situ neoplasia commonly noticed?
Usually an incidental finding through biopsy for another reason. Mammography can be abnormal but rare to calcify
When is lobular neoplasia commonly diagnosed?
How do you manage lobular in situ neoplasia?
excision or vacuum biopsy to determine affected areas and exclude higher grade lesion
tamoxifen (reduce risk of Ca)
prohpylactic mastectomy (dependant on risk factors)
What are the 4 main types of intraductal proliferation and why are they significant?
epithelial hyperplasia of usual type
columnar cell change
atypical ductal hyperplasia
ductal carcinoma in situ
increase likely hood of developing on to breast cancer
What is the main sign for pagets disease of the nipple?
eczema like rash on the nipple
What is pagets disease of the nipple highly suggestive of?
other cancer in the breast eg DCIS or invasive breast cancer
What is pagets disease of the nipple?
high grade DCIS extending along ducts to reach epidermis of nipple (still in situ)
What are two true precursor lesions for invasive carcinoma?
What is the management for DCIS?
What is invasive breast carcinoma?
malignant epithelial cells that have breached the basement membrane
What are some risk factors for breast cancer?
hormones- OCP, HRT
What genetics are associated with an increased risk of breast and ovarian cancer?
BRCA1 and BRCA 2 mutation
(genes that normally produce tumour suppressor proteins mutated form cannot produce working proteins)
What is the spread of breast Ca?
local invasion (T) stroma, skin, muscles
lymphatics (N) regional draining nodes
blood (M)- bone, liver, brain, lungs
What receptors can breast cancer cells express?
If a cancer show to express ER what treatment may be useful?
What is meant by triple negative and what is the prognosis?
none of the receptors are present
What is HER 2?
humar epidermal growth factor receptor 2
What treatment is available for HER 2 expressing Ca?