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Life Cycle Exam 2 > Breast Cancer Pathology > Flashcards

Breast Cancer Pathology Flashcards

1
Q

The incidence of breast cancer increased in the 1980s due to _______________.

A

increased screening

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2
Q

Breast cancer dropped in the early 2000s due to ______________.

A

the stopping of long-term hormone-replacement therapy

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3
Q

The vast majority of breast cancers (70% - 80%) are __________.

A

sporadic

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4
Q

About _____ percent of breast cancer is due to BRCA mutations.

A

10 - 20

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5
Q

Although most hereditary breast cancer is due to BRCA, there are many other genes implicated in familial breast cancer: ___________.

A

PTEN, p53, and CHEK2

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6
Q

The most common tumors of the breast are _______________.

A

epithelial tumors (from the lining of the ducts and lobules) Note: tumors can also arise from the stroma and lymphoid tissue.

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7
Q

What are the three stages of epithelial hyperplasia in the breast?

A

Usual ductal hyperplasia Atypical ductal hyperplasia CIS

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8
Q

Paget’s disease arises from ___________ epithelium.

A

ductal

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9
Q

CIS can be cured with _______________.

A

surgery

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10
Q

Low-grade DCIS often expresses ____________, but is Her2/neu-negative. High-grade DCIS is just the opposite.

A

hormone receptors

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11
Q

Paget’s disease starts out as _____________.

A

crusty, dry nipples

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12
Q

What cells are typical of Paget’s disease?

A

Large cells with cleared-out cytoplasm

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13
Q

LCIS looks really ________________.

A

monotonous

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14
Q

How is lobular carcinoma distinguished from ductal carcinoma?

A

Lobular Lacks E-cadherin and ductal has it.

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15
Q

_____________ is often multicentric and bilateral.

A

LCIS

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16
Q

Invasive carcinoma most often arises in the __________ quadrant.

A

superolateral

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17
Q

_______________ can invade dermal lymphatics.

A

Invasive inflammatory

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18
Q

True or false: ductal carcinoma has a worse prognosis.

A

False. If matched stage for stage, ductal and lobular carcinomas have the same prognosis.

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19
Q

Which carcinoma presents as “Indian file” lines?

A

Invasive lobular carcinoma

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20
Q

_____________ is a type of ductal carcinoma that has an excellent prognosis.

A

Tubular carcinoma

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21
Q

Mucinous carcinoma tends to express ____________.

A

hormone expression

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22
Q

Talk about how hormone receptors and Her2/neu affect prognosis.

A

Best prognosis: hormone receptor positive Intermediate prognosis: Her2/neu positive Worst prognosis: negative for ER, PR, and Her2/neu

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23
Q

_______________ will appear with few epithelial cells and lots of pale material.

A

Mucinous carcinoma

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24
Q

What is the exception to the rule that triple-negative breast cancers have a poor prognosis?

A

Medullary carcinoma It is negative for all, but typically has a good prognosis.

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25
Q

Medullary carcinoma presents with ______________.

A

lymphocytic infiltrate and syncytial growth

26
Q

______________ is not encapsulated but is still strangely well circumscribed.

A

Medullary carcinoma

27
Q

Metaplastic carcinoma typically grows very fast and can present with _______________ on histologic examination. It can develop out of invasive ductal carcinoma.

A

heterologous tissue growth (like bone)

28
Q

Which neoplasm can present with either lack of differentiation or chondroid-like growth?

A

Metaplastic carcinoma

29
Q

Radiation therapy raises future risk of _______________.

A

angiosarcoma, a stromal tumor

30
Q

Where does the name phyllodes come from?

A

Leaf-like! Phylogeny = branching like a leaf

31
Q

Which hematologic malignancy “loves” to home in on carcinomas of the breast?

A

CLL (which can often appear alongside a breast tumor)

32
Q

Most breast neoplasms have what molecular signature?

A

ER + Her2/neu –

33
Q

What molecular signature is associated with breast cancers arising from Li-Fraumeni syndrome?

A

Her2/neu +

34
Q

Which chromosome is the Her2 gene on?

A

17 (Think of the Broken Social Scene song “Anthems for a 17-Year-Old Girl.”)

35
Q

What type of protein is BRCA?

A

Tumor suppressor (both types)

36
Q

_____________ presents with expanded ducts with punched out holes.

A

DCIS

37
Q

In terms of risk, what is the difference between DCIS and LCIS?

A

LCIS raises risk of cancer bilaterally while DCIS raises risk of cancer ipsilaterally.

38
Q

What type of breast cancer presents with sparse stroma, no mucin, and occasional bizarre giant cells?

A

Medullary carcinoma

39
Q

______________ raises risk of breast sarcoma.

A

Radiation (say, from a prior breast cancer)

40
Q

Her2 is found on the _________ chromosome.

A

17th

41
Q

For breast cancer, what’s the difference between stage II and stage III?

A

III has more than 3 lymph nodes involved

42
Q

Which two cancers do not overexpress Her2/neu?

A

Medullary and mucinous

43
Q

What is metaplastic carcinoma?

A

Any carcinoma with non-glandular growth (such as squamous cell, spindle cell, or heterologous cancer) These are usually ER/PR-negative

44
Q

The majority of breast cancers proceed down the ____________ molecular pathway.

A

ER-positive

45
Q

Only about _________ percent of breast cancers are Her2-positive.

A

20

46
Q

list the syndromes associated with heritable breast cancers (4)

A

1) Li-Fraumeni syndrome (TP53 mutation, 5% of familial cancer)
2) Cowden syndrome (PTEN mutation, 1% of familial cancer)
3) Peutz-Jeghers syndrome (STK11/LKB1 mutation, 1% of familial cancer)
4) CHEK2 mutation (5% of familial cancers)

47
Q

what is this imaige?

A

Pagets disease

48
Q

what is in the left and right images

A

left = LCIS

right = DCIS

49
Q

which malignant breast disease has a loss of cadherin?

A

LCIS, invasive lobular carcinoma (ILC)

50
Q

what is this?

A

Invasive lobular carcinoma

-lose e cadherin, express hormone receptors, doesnt express HER2/Neu

51
Q

describe the metastasis pattern of invasive lobular carcinoma (ILC)

A

to the CSF, GI, and ovaries mostly

-less frequent to the lungs and pleura (different from IDC)

52
Q

whats this?

A

tubular carcinoma

53
Q

whats this?

A

mucinous carcinoma

54
Q

whats this?

A

medullary carcinoma

55
Q

whats this?

A

metaplastic carcinoma

56
Q

what cancer typically arises in association with poorly differentiated ductal carcinoma?

A

metaplastic carcinoma

57
Q

whats this?

A

angiosarcoma

58
Q

describe angiosarcomas

A

dervied from blood vessels, most common primary breast sarcoma

arise (1) spontaneously (2) after radiation (3) with chronic edema - Stewart Treves Syndrome

59
Q

what is Stewart Treves syndrome

A

edema from lymphatic destruction (breast cancer treatment)

60
Q

whats this?

A

phyllodes tumor

61
Q

whats this?

A

lymphoma of the breast

Life Cycle Exam 2 (22 decks)

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