Breast Cancer Pathology I

Question 1

What is the most common cancer among women?

What cancer causes the most deaths among women?

Answer 1

• Breast cancer is most common cancer in women
• Lung cancer accounts for most cancer deaths in women

Question 2

What is the most common cancer in men?

What cancer causes the most deaths among men?

Answer 2

• Prostate is most common cancer in men
• Lung cancer causes most death among men

Question 3

What is one broad risk factor for breast cancer?

What race places you at higher risk?

Answer 3

• Increased estrogen exposure (obesity, early menarche, etc)
• African Americans have increased risk for triple negative cancer

Question 4

What is the defect in Li-Fraumeni syndrome?

Name 4 cancers that are more common in this condition.

Answer 4

• p53 mutation
• Sarcoma, Breast, Leukemia, Adrenal

Question 5

What is DCIS’s typical receptor profile?

What does it look like on mammogram?

Answer 5

• Low grade often expresses ER/PR
• Microcalcifications on mammogram

Question 6

What is Paget’s Disease? (2)

Answer 6

• Eczema-like rash on the nipple (b/c cancer is affecting the nipple skin)
• Associated with underlying DCIS or invasive carcinoma

Question 7

What stain can identify LCIS? (1)

How does it typically present? (4)

Answer 7

• Stains + for e-cadherin
• Often bilateral, multifocal, without calcification
• Does not form a mass

Question 8

Where does invasive breast carcinoma most commonly present?

Answer 8

Upper outer quadrant

Question 9

What is the most common breast cancer?

Answer 9

Invasive ductal carcinoma

Question 10

Invasive Lobular Carcinoma

• Unilateral or bilateral?
• Decreased _________ expression

Answer 10

Invasive Lobular Carcinoma

• Bilateral
• Decreased E-cadherin expression

Question 11

What is the prognosis for Medullary Carcinoma?

Answer 11

• Better prognosis, despite being triple negative

Question 12

What are the components of a Phyllodes tumor?

Which part is typically malignant?

Answer 12

Stroma + Epithelium

Malignant part is stroma

Question 13

What age group gets fibroadenomas?

How do they affect cancer risk?

Answer 13

Young women

Does not increase risk of cancer

Question 14

What is the most common receptor expression for breast cancers?

What cancers usually display this?

Answer 14

ER positive, HER2 negative

*Usually seen in atypical ductal hyperplasia, DCIS, and invasive ductal carcinoma

Question 15

Define prognostic and predictive factors

Answer 15

• Prognostic = how patient will fare regardless of treatment
• Predictive = how patient will respond to specific therapies

*ER, PR, HER2 are all both prognositc and predictive factors

Question 16

What mutation increases the risk of breast cancer in men?

Answer 16

BRCA2

Question 17

What is the prognosis for triple negative tumors?

Answer 17

Triple negative tumors have a worse prognosis

(are more aggressive)

Question 18

How do DCIS and LCIS affect your cancer risk?

Answer 18

• DCIS: increases risk of invasive carcinoma in IPSILATERAL breast
• LCIS: increases risk of invasive carcinoma in BOTH breasts

Question 19

What breast cancer classicaly has a “stellate” infiltration?

Answer 19

Invasive ductal carcinoma

Question 20

Which invasive carcinoma most commonly causes skin dimpling?

Answer 20

Ductal

Question 21

Which breast carcinoma typically has a lymphocytic infiltrate?

Answer 21

Medullary carcinoma

Question 22

Which breast carcinoma has lines of cells?

Answer 22

Lobular carcinoma

Question 23

What causes peau d’orange skin?

How does this affect prognosis?

Answer 23

1. Breast cancer invades the dermal lymphatics
2. lymphatic drainage blocked
3. edema
4. tightening of suspensory ligaments
5. Peau d’orange skin

Poor prognostic factor