Benign/Malignant Pathology of the Breast Flashcards
Symptoms of Breast Disease?
Spectrum of Benign Breast Diseases?
- Cysts
- Duct ectasia
- Fibroadenoma
- Potential for local recurrence (Phyllodes tumor)
- Increased incidence of associated malignancy (Radial scar, Papilloma)
Clinical Presentation/Management of Cysts of the Breast?
Pathology/Causes/Clinical Presentation/Management of Duct Ectasia of the Breast?
Pathology/Clinical Presentation/Management of Radial Scar of the Breast?
Proportion of woman in EU that will develop breast cancer?
⅛ by 85 Years old
Factors that increase breast cancer risk?
- Family History (BRCA1 Gene => 85% Risk)
- Reproductive Profile (Uninterupted estrogen stimulation)
- Exogenous Hormones (Oral Contraception, Hormone Replacement therapy)
- Lifestyle/Environment (alcohol, diet, smoking + Radiation)
- Socioeconomic (Residence in western countries)
- Breast biology (Atypical changes, Ductal carcinoma in situ, Cancer in contralateral breast)
Non-Operative Breast Diagnosis?
Tripple Assessment Approach:
- physical examination
- mammogram
- core biopsy
Prognostic (tumor behavior) and Predictive (response to treatment) Factors of breast cancer?
Prognostic
- Tumour TYPE, GRADE, SIZE
- Lymph Node Status
Predictive
- Hormonal Receptor Status (ER/PR)
- Human Epidermal Growth Factors (HER2)
- Multigene Panel / Mutational Studies
Types of Invasive Breast Carcinoma?
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- 15% breast tumours
- Grade 2 or 3
- More advanced stage at presentation than NST
- Metastases: bone & abdominal viscera
- Prognosis: long term worse than NST
Invasive Lobular Carcinoma:
- 15% breast tumours
- Grade 2 or 3
- More advanced stage at presentation than NST
- Metastases: bone & abdominal viscera
- Prognosis: long term worse than NST
Significance of Breast Tumor Size?
Significance of Lymph Node Status in Breast Cancer?
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- Rare: 1-5% of all breast cancers
- Swelling, redness, dimpling (due to blockage of lymphatic channels by cancer cells in the skin)
- May not form a discrete lump
- Affects younger women
- Locally advanced at diagnosis (More aggressive)
Inflammatory Carcinoma of the Breast:
- Rare: 1-5% of all breast cancers
- Swelling, redness, dimpling (due to blockage of lymphatic channels by cancer cells in the skin)
- May not form a discrete lump
- Affects younger women
- Locally advanced at diagnosis (More aggressive)
What predicts breast cancer responsiveness to endocrine therapy?
Estrogen and Progesterone Receptors (80% of cancers positive)
What predicts breast cancer responsiveness to Trastuzumab Therapy?
HER2 Status (12-15% HER2 positive)
Molecular Classification of Breast Cancers?
Luminal: ER/PR Pos, HER2 Negative (A: Low proliferation; B: High proliferation)
HER2 RICH: HER2 Positive
Triple Negative: ER, PR and HER2 Negative
Cancers that are good candidates for Chemotherapy?
Lymph node-positive
HER2 positive
Triple negative
Cancers that are NOT good candidates for Chemotherapy?
Small tumor
Grade 1
Lymph node negative
ER-positive
HER2 negative
Significance of Oncotype DX?
21 gene recurrence assay that predicts response to chemotherapy & likelihood of tumour recurrence
