Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pathology/microbiology > Breast cancer > Flashcards

Breast cancer Flashcards

You may prefer our related Brainscape-certified flashcards:
Biology 101 flashcards
1
Q

What are common benign neoplastic ddx for breast lump?

A
  • Fibrocystic changes (proliferative vs. non-proliferative)
  • Fibroadenoma
  • Atypical hyperplasia
  • Mastitis (milk stasis)
  • Lipoma
  • Intraductal papilloma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are malignant neoplastic changes?

A
  • ductal carcinoma in situ
  • lobular carcinoma in situ
  • Paget’s disease of the breast
  • invasive ductal carcinoma
  • invasive lobular carcinoma
  • inflammatory carcinoma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Order 1-4 in terms of 1-best prognostic outcome to 4-worst prognostic neoplastic changes.

  • DCIS
  • LCIS
  • Invasive lobular carcinoma
  • Invasive ductal carcinoma
A

1 - LCIS
2 - DCIS
3 - Invasive lobular carcinoma
4 - Invasive ductal carcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is pathogenesis of invasive ductal carcinoma?

A

Normal secretory ductal epithelium of the breast mutates due to age, oestrogen, radiation, etc.

Then it becomes neoplastic cell, rapidly dividing to atypical ductal hyperplasia. –> rapid ductal cell growth –> DCIS

Increased N:C ratio, nuclear pleomorphism, mitotic figures.

DCIS produces microcalcifications that show up on mammograms.

Further replication leads to genetic mutations enabling the tumour to invade past the basement membrane –> invasive ductal carcinoma.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What’s Paget’s disease of the nipple?

A

Neoplastic cells spread to the nipple, causing rash to form, stroma becomes scar tissue, and a hard palpable lump around the breast forms.
Then nipple retracts.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are some risk factors of breast cancer?

A

Non-modifiable:

  • Age >30
  • Female
  • Nullparity, or 1st birth >35
  • Early menarche, late menopause
  • Past hx of LCIS, DCIS, breast cancer
  • Family hx of BRCA genes, p53 or HNPCC, ovarian, prostate or CRC
  • Lack of hormone receptor status

Modifiable:

  • Smoking
  • Alcohol
  • Obesity
  • Previous radiation exposure
  • HRT and OCP
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is triple assessment?

A

Assessment of removal of the lump via 2/3 assessment seem fit to:

  • Physical examination
  • Mammogram/ U/S imaging
  • FNA
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is Van Nuys criteria system?

A

It incorporates nuclear grade and necrosis into a pathology score, combined with cancer margin size, age and tumour size.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Why would you use mammogram instead of U/S?

A

If the patient is >35 years of age, then it is better to use mammogram. It is also free for those between ages of 50-70. U/S is used for women <35 years, as their breasts would have greater fatty tissue that mammogram would not be accurate in scanning for any masses.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What information can you gather from FNA?

A
  • Grading (degree of differentiation)
  • Hormone receptor status
  • Cancer type
  • Staging (somewhat)
  • Rapid cell growth, N:C ratio, pleomorphic nucleus, mitotic figures
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Which biopsy is preferred in breast cancer investigations?

  1. Fine needle aspirate
  2. Core biopsy
  3. Punch biopsy
  4. Excision biopsy
A

Answer: core biopsy

  1. It does not allow histology evaluation and extent of tumour invasion
  2. Core biopsy is the preferred method.
  3. Punch biopsy should only be used when there is concern for Paget’s disease of nipple or skin involvement with invasive breast cancer
  4. Excision biopsy should involve consent and proceed to definitive therapy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is ‘frozen section’ and why is it useful?

A

It is used intra-operatively when the breast tissue is removed, frozen with liquid nitrogen on the spot, and dissected into 4 slices. These slices are then quickly stained and evaluated for cytology. This allows for immediate diagnosis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is sentinel node biopsy?

A

Blue dye or radioactive isotope is injected into the tissue, and the first lymph node that it drains into is removed (sentinel lymph node). If this lymph node shows neoplastic changes, next lymph node is removed. It reduces the risk of re-operation and excess removal of lymph nodes unnecessarily.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are some characteristics of DCIS?

A
  • 80% of in situ carcinomas
  • Includes Paget’s disease of the nipple
  • More frequently diagnosed as it can be picked up via microcalcifications on the mammograms
  • 30% develop into invasive ductal carcinoma
  • It contains E-cadherin and myoepithelial cell layer
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are some characteristics of LCIS?

A
  • Only 1% progress to invasive carcinoma
  • Mostly conservative treatment due to low risk of malignant cancer development
  • Doesn’t produce any calcifications on biopsy or mammogram
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Why is histological typing and classification important?

A

Patient prognosis and

management (e.g. hormonal treatment can be given if they are receptor sensitive)

17
Q

Do fibrocysts progress to malignancy?

A

Depends.

There are non-proliferative and proliferative types. Non-proliferative have no increased risk of carcinoma and it fluctuates with menstrual cycle.

Proliferative fibrocysts are more potent to become malignant.

18
Q

What do you test for with hormonal receptor status?

A

1) Oestrogen – treatment options are bigger
2) Progesterone
3) Human epidermal growth factor receptor 2 (HER2) oncogene expression – these tend to be associated with more aggressive malignant growth but also better targetted therapy

19
Q

List the different axillary lymph nodes and areas of drainage for each. (5) List any extra lymph nodes it may drain to other than axillary lymph nodes.

A
  1. Anterior: pectoral – drains anterior thoracic wall and abdomen
  2. Posterior: subscapular – drains posterior aspect of thoracic wall
  3. Lateral: humeral – drains all of upper arm
  4. Central – receives lymph from lateral, posterior and anterior lymph nodes
  5. Apical – receives all the lymph

It may also drain to abdominal, internal mammary nodes, and subclavicular nodes.

20
Q

What is sentinel lymph node?

A

Sentinel lymph node is most likely to be the first node where the deposits would spread from the primary tumour.

21
Q

What are some agents that can be given for breast cancer?

A
  1. Tamoxifen (SERM): useful in oestrogen receptor positive cancers; it blocks oestrogen receptors
  2. Aromatase: blocks aromatase enzyme, which converts androgens to oestrogen in peripheral fat
  3. Herceptin: good for HER2 receptor positive cancers.
    Monoclonal antibody interferes with HER2 receptor, regulating cell growth, survival, etc.

Pathology/microbiology (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions