Pathology: Breast Cancer Flashcards Preview

Block I: Reproduction & Sexuality > Pathology: Breast Cancer > Flashcards

Flashcards in Pathology: Breast Cancer Deck (40):
1

2  family history risk factors for breast cancer

  • Breast cancer
  • Ovarian cancer

2

5 personal history risk factors for breast cancer

  • BRCA 1/2 mutations
  • Bx with ADH
  • LCIS or DCIS
  • Dense breast tissue (mammogram)
  • Radiation

3

5 reproductive history risk factors for breast cancer

  • Early menarche (<12)
  • Late menopause
  • Late age at first term pregnancy
  • Nulliparity
  • HRT

4

3 lifestyle risk factors for development of breast cancer

  • Weight
  • Sedentary life
  • Alcohol consumption

5

3 precursors to breast cancer

  • Ductal epithelial hyperplasia
  • Atypical ductal hyperplasia
  • Ductal carcinoma in situ - invasive carcinoma

6

3 minor lesions of the breast

  • Supernumerary nipple
  • Congenital inversion of the nipple
  • Galactocele

7

Findings of nonproliferative fibrocytic changes on histology 

  • Cysts (blue dome)
  • Fibrosis

8

4 moderate risk (1.5x) findings of proliferative fibrocytic changes in histology

  • Hyperplasia
  • Sclerosing adenosis (mimicking carcinoma)
  • Florid hyperplasia
  • Sclerosing adenosis

9

2 high risk (5x) findings of proliferative fibrocytic changes

Atypical hyperplasia

Ductal/lobular

10

3 types of in-situ carcinomas of the breast

  • Ductal carcinoma in-situ (DCIS)
  • Lobular carcinoma in-situ (LCIS)
  • Mammary Paget Disease

11

7 types of invasive carcinomas

  • Ductal
  • Lobular
  • Medullary
  • Tubular
  • Mucinous
  • Micropapillary
  • Metaplastic Breast Cancer

12

Most common invasive breast carcinoma

Ductal NOS

13

Profile of lobular invasive carcinoma (5)

  • E-cadherin negative
  • ER+
  • PR+
  • Her2 -
  • May not feel as mass

14

Profile of medullary invasive carcinoma

  • Good prognosis
  • Triple negative

15

Profile of tubular invasive carcinoma (4)

  • Very good prognosis
  • ER+
  • PR-
  • Her2-

16

Profile of mucinous invasive carcinoma (5)

  • Good prognosis
  • Older patients
  • ER+
  • PR+
  • Her2-

17

Type of invasive carcinoma that has frequent lymph node metastasis

Micropapillary

18

Profile of metaplastic breast cancer (2)

  • Heterogenous group
  • Usually triple negative

19

Modified Scharff-Bloon-Richardson Grading System

  • Well-differentiated / low grade (I/III)
  • Intermediate grade (II/III)
  • Poorly differentiated / high grade (III/III)

20

If e-cadherin positive, what is the type of breast cancer?

Ductal

21

If e-cadherin is negative, what is the type of breast cancer?

Lobular

22

Profile of breast cancer that tends to metastasize to brain

  • Triple negative
  • Her2+

23

3 other common breast lesions aside from carcinomas

  • Fibroepithelial lesions
    • Fibroadenoma
    • Phyllodes tumor
  • Papilloma

24

Most common breast tumor in young women

Fibroadenoma

NOTE: Usually appears before 30 and can regress after menopause

25

Gross appearance of fibroadenoma

  • Round
  • Rubbery (can compress it)
  • Well-circumscribed

26

Risk of cancerous progression of fibroadenoma

None

27

Histological profile of fibroadenoma

Biphasic (stromal and epithelial)

NOTE: Carcinoma = epithelial only

28

Histological profile of phyllodes tumor

More pronounced stroma; very cellular (can make a sarcoma)

29

7 prognostic factors of breast cancer

  • Axillary lymph node status
  • Tumor size
  • Vascular invasion
  • Grade
  • Tumor subtype
  • ER/PR expression
  • Her2
  • Overexpression/amplification

30

3 predictive factors of breast cancer

  • ER/PR
  • HER2
  • Oncotype DX (RT-PCR -- 21 GENES, RECURRENCE SCORE)
    • Predict benefit from chemotherapy and hormonal therapy

31

5 treatments for breast cancer

  • Surgery
  • Radiation therapy
  • Hormonal therapy
  • Chemotherapy
  • Targeted therapy: herceptin, lapatinib

32

4 intrinsic subtypes of breast cancer

  • Luminal A (ER+ and/or PR+, HER2-)
  • Luminal B (ER+ and/or PR+, HER2+)
  • HER2 (ER-)
  • Basal-Like (Triple negative, cytokeratin 5/6+ and or/ EGFR+)

33

Most common subtype of breast cancer

Luminal A

34

Prognosis of Luminal A breast cancer subtype

  • Less aggressive
  • Lower histological grade
  • Good prognosis
  • Hormone responsive

35

Risk factor for Luminal A breast cancer

Associated with increasing age

36

Which Luminal subtype has a worse outcome?

Luminal B

37

Prognosis of HER2+ (ER-) breast cancer subtype

  • Highly aggressive
  • High grade histology
  • Outcome improved with HER2

38

2 risk factors for HER2+ (ER-) breast cancer subtype

Risk as young age greater than luminal subtypes

African American ethnicity may be factor

39

Prognosis of basal-like breast cancer

Aggressive

High-grade histology

High mitotic rate

40

Risk factors for basal-like breast cancer

Younger age (<40)

More likely premenopausal African American women