Breast Carcinoma Pathology Flashcards
Which type of breast carcinoma has an increased risk with age?
ER+
What are the major genes associated with Familial breast carcinoma?
BRCA1/2, TP53, CHEK2
Which gene is associated with single gene familial breast cancers?
BRCA1/2
Which gene is associated with an increased risk of ovarian carcinoma?
BRCA1
Which gene is associated with male breast cancer?
BRCA2
Which mutations are more likely to be ER+?
BRCA2
Which mutations are associated with increased risk of prostatic and pancreatic carcinoma?
BRCA1/2
Which mutations are associated with Li Fraumeni syndrome?
TP53
What is the most common cancer subtype of BRCA2 mutations?
ER+, HER2-
Which mutations are ER+, HER2- cancers associated with?
PIK3CA
What is the precursor lesion for ER+, HER2- cancers?
Flat epithelial atypia and atpical ductal hyperplasia
What is the most common mutation associated with HER2+ cancers?
TP53
What is the most common type of mutation associated with ER-, HER2- cancers?
BRCA1
African American women have an increased frequency of which subtype of breast cancer?
ER-, HER2-
Def: malignant clonal proliferation of epithelial cells limited to ducts and lobules by the basement membrane with preserved myoepithelial cells
CIS
Morph: clustered or linear and branching areas of calcification defined by tumor cells with pleomorphic high-grade nuclei and areas of central necrosis
Comedo CIS
Morph: cribriform pattern (cookie cutter) with central necrosis and no high-grade nuclei
Non-Comedo CIS
Morph: malignant cells extend from DCIS within the ductal system and into the nipple skin without crossing the basement membrane
Paget disease
Def: clonal proliferation of cells within lobules that grow in a discohesive fashion due to acquired loss of tumor suppressive adhesion via E-cadherin
Lobular CIS
Morph: mucin-positive signet-ring cells with lack of E-cadherin and expression of ER/PR
LCIS
Most breast cancers of older women and men are which type of invasive carcinomas?
ER+, HER2-
Low proliferation
Most common type of BRCA2 associated invasive carcinomas?
ER+, HER2-
High proliferation
Morph: hard, irregular radiodens masses with desmoplastic stromal rxns and retraction of the nipple that makes a grating sound when cut/scraped
ER+, HER2 - breast carcinoma
Which subtype of invasive breast carcinoma is more common in young, non-white women and has TP53 mutations?
HER2+
Morph: well-differentiated invasive breast carcinomas
HER2+
Which subtype of invasive breast carcinoma is more common in AA/Hispanic women and young pre-menopausal women?
ER-, HER2- (triple negative)
Which subtype of invasive breast cancer is more likely to appear in between mammogram appointments?
ER-, HER2- (triple negative)
Morph: poorly differentiated invasive breast carcinoma with very limited/absent DCIS
ER-, HER2- (triple negative)
Def: b/l loss of CDH1 and failure to incited a desmoplastic response
Lobular carcinoma
Lobular carcinoma is associated with an increased risk in which other carcinomas?
Gastric signet-ring cell carcinomas
Morph: hard, irregular masses difficult to palpate with discohesive infiltrating tumor cells including signet-ring cells with intracytoplasmic mucin droplets
Lobular carcinoma
Morph: softer than any other carcinomas and presents as well-circumscribed mass
Medullary carcinoma
Def: anchorage-independent growths with expression of E-cadherin but lacks adhesion to stroma
Micropapillary carcinoma
Morph: hollow ball of cells that float within intercellular fluid
Micropapillary carcinoma
Morph: soft, rubbery mass with pale gray-blue gelatinous appearance and circumscribed borders
Mucinous carcinoma
Morph: Well-formed tubules with apocrine snouts and calcifications in the lumen
Tubular carcinoma
Medullary carcinoma has features similar to which subtype of breast carcinoma?
BRCA1
Morph: mass with true papillae with fronds of fibrovascular tissue lined by tumor cells that overexpress HER2
Papillary carcinoma
Morph: well-circumscribed, rubbery, grayish white nodules that bulge above the surrounding tissue and often contain slit-like spaces
Fibroadenoma (stromal tumor)
Morph: bulbous protrusions with higher cellularity, mitotic rate, nuclear pleomorphism, stromal overgrowth, and infiltrative borders than fibroadenomas
Phyllodes tumor
Which type of tumor arises in intralobular stroma in 60-70 yo women with a palpable mass and overexpression of HOXB13?
Phyllodes tumor
Which breast tumor is the only one equally common in men and women?
Myofibroblastoma
Sx’s = irregular, infiltrating mass that can involve skin and muscle and is associated with prior trauma/surgery
Fibromatosis
Most primary Non-Hodgkin lymphomas of the breast are which cell type?
B-cells
Sx’s = young women with b/l breast involvement who are pregnant or lactating
Burkitt Lymphoma
Which cancers most commonly mets to the breast?
Melanoma
Ovarian cancer
