breast cancer

Question 1

risk factors for breast cancer? genetic mutations?

Answer 1

early menarche, late menopause
obesity
hormone replacement
smoking
old age
nulliparity
previous hx of breast cancer/ family hx

tumor suppressor genes: BRCA1,BRCA2 increase risk of breast and ovarian cancer, autosomal dominant mutations
-oncogenes: RAS
-receptor overexpression: ERBB22

Question 2

types of breast cancer?

Answer 2

ductal carcinoma in situ, invasive ductal carcinoma, invasive lobular carcinoma, paget disease, inflammatory breast cancer

Question 3

features of breast cancer on clinical exam?

Answer 3

-firm, non tender lump with irregular borders typically in upper outer quadrant
-nipple inversion with bloody discharge
-skin retractions/dimpling due to fixation to the chest
-breast asymmetry
-peau d’orange
-enlarged lymph nodes

Question 4

characteristic of ductal carcinoma in situ, invasive ductal carcinoma, invasive lobular carcinoma in BIOPSIES?

Answer 4

ductal carcinoma in situ:
*comedonecrosis (central necrosis)

invasive ductal:
*malignant cells in lactiferous duct
*stromal invasion, microcalcifications, fibrosis of surrounding tissues

invasive lobular:
*malignant cells in lobules
*cells arranged in single file pattern

Question 5

characteristic of paget disease clinically and diagnosis?

Answer 5

-vasicular, erythematous, scaly rash over the nipple, ulceration -> bloody nipple discharge, burning sensation

-biopsy: paget cells

Question 6

characteristic of inflammatory breast cancer and which stage T?

Answer 6

it’s invasion of skin lymphatics by tumor cells

-peau d’orange (edema, erythema, prominent hair follices), bloody nipple discharge
-staged as T4 bcz involves the skin