B2.031 Big Case Breast Cancer Flashcards
what is neoplasia?
disorder of cell growth triggered by a series of acquired mutations affecting a single cell and its clonal progeny
what are two characteristics of neoplasia?
autonomous growth
escape from normal restraints on cell proliferation
what are the general trends in 5 year survival rates of cancer patients since the 1970s?
survival rates have dramatically increased in some cases
do benign neoplasms progress to malignant neoplasms?
basically never
generally, how are we able to classify benign and malignant neoplasia?
based on things that have been seen many times before
why is knowledge of molecular pathways important?
allow use of targeted therapeutic approaches
how many doublings from an original tumor cell occur before a tumor can be detected?
about 30
1 gm of tumor
is it important to detect single cell mutations?
no, many mutations occur, and most of the time, the body regulates the mutations
rarely do they develop into cancer, and when they do, it is usually caught pretty far into the cancer’s life
describe the process of transformation
nonlethal mutations in critical genes that confer survival advantage
multiple genetic events in series to reach neoplastic potential
what are some major risk factors for cancer?
environmental factors
age
acquired predisposing conditions
genetic predisposition
what is grading?
histologic determination of the degree of differentiation
what is cancer staging?
multi-modality determination of extent of spread of malignant neoplasm
what are the components of staging?
clinical, radiological, pathological, biochemical
describe the TNM system
T- characteristics of primary tumor (size, extent of invasion)
N- involvement of regional lymph nodes
M- distant metastasis
is grading or staging more important?
staging
what areas of the body are susceptible to metastasis?
organs with a lot of blood flow
cancer moves through the bloodstream
what are tumor markers?
biochemical tests for products produced by tumor cells
what is an example of a tumor marker?
alpha fetoprotein in liver cancer
prostate specific antigen (PSA)
what are the steps in cancer diagnosis?
establish lineage
determine cell/site of origin
determine extent and grade
assess prognostic factors
what are the 3 types of breast cancer adenocarcinomas?
ER pos, HER2 neg
Her2 pos
ER neg, HER2 neg
what is HER2?
a growth factor receptor
what is ER?
estrogen receptor
why is a cancer’s ER status important?
if estrogen receptors are present, hormonal therapy such as blocking estrogen in the body may stop the cancer from growing
if estrogen receptors are not present, hormonal therapy is not likely to have an impact
what are types of precursor lesions in breast cancer?
proliferative breast disease
ductal carcinoma in situ
what are the 3 primary genes involved in familial breast cancers?
BRCA1, BRCA2, TP53
is there more sporadic or familial breast cancer?
sporadic
what is the pathogenesis of sporadic breast cancer?
estrogen exposure can function as a promoter
HER2 amplification
not fully determined…multiple other mechanisms
