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CORE: Mammo > Breast Cancer > Flashcards

Breast Cancer Flashcards

1
Q

indications for breast MR

A

high risk patients, evaluation of disease extent with newly diagnosed breast cancer, neoadjuvant chemotherapy response, assessment of residual disease with positive surgical margins, evaluation for tumor recurrence, evaluation for occult breast cancer in patient with axillary metastases

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2
Q

progression of invasive ductal breast cancer

A

normal –> flat epithelial atypia –> atypical ductal hyperplasia (ADH) –> DCIS –> IDC

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3
Q

intraductal proliferation with cytological atypia

A

atypical ductal hyperplasia

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4
Q

% of patients with core needle biopsy of FEA which will be upstaged to DCIS or invasive carcinoma upon surgical excision?

A

18%

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5
Q

most often occult cancer detected mammographically?

A

DCIS

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6
Q

is the basement membrane intact with DCIS?

A

yes

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7
Q

% of pts who will develop invasive carcinoma from DCIS?

A

30-50%

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8
Q

Risk factors for breast cancer

A

women
age
BRCA 1/2
first degree relative with breast cancer
prior chest radiation for HL/NHL
long term estrogen exposure (early menarche, late menopause, late first pregnancy, nulliparity, obesity)
prior biopsy result of high risk lesion in lobular neoplasia spectrum (ALH, LCIS)

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9
Q

most common subtype of breast cancer

A

invasive ductal carcinoma

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10
Q

classic mammo appearance of IDC

A

spiculated mass, architectural distortion, pelomorphic calcification

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11
Q

tubular carcinoma presentation, prognosis

A

small spiculated mass; may appear similar to radial scars/complex sclerosing lesions
prognosis better than IDC NOS

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12
Q

muscinous carcinoma alt names

A

colloid carcinoma, mucoid carcinoma, gelatinous carcinoma

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13
Q

mucinous carcinoma imaging appearance US, MR

A

US: low density circumscribed mass, similar to fibroadenoma
MR: hyperintense T2

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14
Q

medullary carcinoma, pt population, prognosis

A

young women; BRCA1 mutation

locally aggressive, better prognosis than IDC NOS

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15
Q

pappilary carcinoma

A

malignant form of intraductal papilloma

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16
Q

adenoid cystic carcinoma –presentation, prognosis

A

palpable firm mass; excellent prognosis with resection

17
Q

5-10% of breast cancer cases?

A

invasive lobular carcinoma

18
Q

does invasive lobular carcinoma form a discrete mass?

imaging characteristics?

A

not usually; spread through breast tissue

one view asymmetry to architectural distortion to spiculated mass

19
Q

tumor invasion of ductal lymphatics

A

inflammatory carcinoma

20
Q

breast erythema, edema, firmness…cancer type?

A

inflammatory carcinoma

21
Q

mammo findings of inflammatory carcinoma

A

trabecular thickening and skin thickening, which may also look like abscess

22
Q

paget disease, presentation

A

form of DCIS that infiltrates into the epidermis of the nipple with erythema, ulceration, eczematoid changes

23
Q

most important prognositc factor in non metastatic breast cancer

A

axillary lymph node status

24
Q

detection of axillary involvement is via?

A

surgical sentinel LN biopsy

25
Q

factors impacting prognosis of breast cancer

A

axillary LN status, tumore receptors, histologic subtyles (presence of necrosis)

26
Q

biologically aggressive tumor receptors

A

ER, PR, HER2-neu negative

27
Q

ER/PR+ tumors have _____ disease free survival

A

longer

28
Q

HER2/neu overexpression may respond to what drugs?

A

trastuzumab or lapatinib (tyrosine kinase inhibitors)

29
Q

triple negative cancers are seen commonly in what mutation?

A

BRCA1

30
Q

cribriform and micropappillary subtypes of DCIS are ____ grade

A

low grade; no necrosis

31
Q

DCIS with necrosis subtypes? grade?

A

poorly differentiatied, comedo, large cell subtypes

high grade

32
Q

mammogram manifestations of high grade DCIS?

A

pleomorphic or fine linear branching calcifications

-calcifications from necrotic debris in the duct lumen

CORE: Mammo (10 decks)

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