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BLOCK POSTING 3 > BREAST PATHOLOGY > Flashcards

BREAST PATHOLOGY Flashcards

1
Q

What percentage of breast lesions received in the lab are malignant?

A

25% of breast lesions are malignant.

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2
Q

What is the most common histologic type of breast cancer?

A

Invasive ductal carcinoma (not otherwise specified).

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3
Q

What percentage of invasive ductal carcinoma cases have intraductal carcinoma present?

A

80% of cases have intraductal carcinoma present.

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4
Q

What are the key prognostic factors for breast cancer survival?

A

Node status, tumor size, tumor differentiation, ER/PR status, and tumor angiogenesis.

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5
Q

What does the presence of estrogen receptors (ER) in tumors indicate?

A

It identifies hormone-sensitive tumors and is associated with better survival outcomes.

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6
Q

What is the risk of developing breast cancer by age 70 for individuals with BRCA1 mutation?

A

Up to 85%.

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7
Q

What are the survival rates for medullary carcinoma?

A

80-90% 10-year survival.

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8
Q

Which histologic type of breast cancer has the lowest rate of axillary node metastasis?

A

Mucinous carcinoma (3-15% in pure form).

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9
Q

What is the significance of Cathepsin-D in breast cancer?

A

It is associated with high risk of recurrence and poor survival due to its link with node status.

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10
Q

What is the role of ER and PR in breast cancer prognosis?

A

Important for guiding hormone treatment rather than determining prognosis.

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11
Q

What percentage of breast cancers are ductal carcinomas?

A

97% of malignant breast cancers are ductal carcinomas.

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12
Q

What are the main risk factors for breast cancer?

A

Increasing age, personal/family history, BRCA1 mutation, obesity, and radiation exposure.

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13
Q

What is Bloom-Richardson grading used for?

A

To assess histologic grade based on tubule formation, mitoses, and nuclear pleomorphism.

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14
Q

What histologic types of invasive breast cancer have better prognosis?

A

Pure mucinous, tubular, medullary, and papillary carcinomas.

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15
Q

What are the general staging categories for breast cancer?

A

Localized, regional, and distant metastasis.

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16
Q

What is the most influential predictor of post-treatment recurrence and death in breast cancer?

A

Presence or absence of metastasis to axillary lymph nodes.

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17
Q

What percentage of breast cancers are ER-positive?

A

50-85% of breast cancers are ER-positive.

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18
Q

What is the clinical importance of ER positivity in breast cancer?

A

It identifies hormone-sensitive tumors and predicts favorable response to hormone therapy.

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19
Q

What are the features of invasive lobular carcinoma?

A

Indurated, ill-defined masses with small, ovoid nuclei arranged in single-file patterns.

20
Q

What is tumor angiogenesis and its significance in breast cancer?

A

The growth of blood vessels necessary for tumor growth and metastasis, serving as a prognostic marker.

21
Q

What is the functional unit of the breast?

A

The terminal duct lobular unit, where lobules make milk and ducts drain it to the nipple.

22
Q

What are the two epithelial layers of breast ducts and lobules?

A

The luminal cell layer (responsible for milk production) and the myoepithelial cell layer (responsible for milk propulsion).

23
Q

What causes galactorrhea?

A

Milk production outside lactation caused by nipple stimulation, prolactinomas, or drugs. It is not a symptom of breast cancer.

24
Q

What is the most common cause of acute mastitis?

A

Staphylococcus aureus, often associated with breastfeeding.

25
Q

What is periductal mastitis and its primary risk factor?

A

Inflammation of subareolar ducts, primarily seen in smokers due to vitamin A deficiency.

26
Q

What characterizes mammary duct ectasia?

A

Inflammation and dilation of subareolar ducts, presenting with a periareolar mass and green-brown nipple discharge.

27
Q

What is fat necrosis of the breast?

A

Necrosis of breast fat, often related to trauma, presenting as a mass or abnormal calcifications on mammography.

28
Q

What are fibrocystic changes in the breast?

A

Hormone-mediated fibrosis and cysts, presenting as clumpy breast tissue, often in the upper outer quadrant.

29
Q

Which fibrocystic changes are associated with increased cancer risk?

A

Ductal hyperplasia and sclerosing adenosis (2x risk), atypical hyperplasia (5x risk).

30
Q

What is an intraductal papilloma?

A

A benign papillary growth in a large duct, presenting as bloody nipple discharge in premenopausal women.

31
Q

How is papillary carcinoma distinguished from intraductal papilloma?

A

Papillary carcinoma lacks myoepithelial cells and is more common in postmenopausal women.

32
Q

What is a fibroadenoma?

A

A benign, estrogen-sensitive tumor of fibrous tissue and glands, presenting as a mobile, marble-like mass in premenopausal women.

33
Q

What is a phyllodes tumor?

A

A fibroadenoma-like tumor with leaf-like projections, most commonly seen in postmenopausal women and potentially malignant.

34
Q

What are the risk factors for breast cancer?

A

Female gender, age, early menarche/late menopause, obesity, atypical hyperplasia, family history, and estrogen exposure.

35
Q

What is ductal carcinoma in situ (DCIS)?

A

A malignant proliferation of ductal cells without invasion of the basement membrane, often detected as calcifications on mammography.

36
Q

What is Paget disease of the breast?

A

DCIS extending to the nipple, presenting as nipple ulceration and erythema, often associated with underlying carcinoma.

37
Q

What is invasive ductal carcinoma?

A

The most common type of breast cancer, forming duct-like structures, and presenting as a mass or skin dimpling.

38
Q

What are the subtypes of invasive ductal carcinoma with good prognosis?

A

Tubular carcinoma, mucinous carcinoma, and medullary carcinoma.

39
Q

What is lobular carcinoma in situ (LCIS)?

A

A malignant proliferation of lobular cells without invasion, often multifocal and bilateral, treated with tamoxifen.

40
Q

What is the characteristic pattern of invasive lobular carcinoma?

A

A single-file growth pattern due to lack of E-cadherin, with potential signet-ring morphology.

41
Q

What is the most important prognostic factor in breast cancer?

A

Metastasis, though axillary lymph node spread is the most useful at presentation.

42
Q

What are predictive factors for breast cancer treatment?

A

Estrogen receptor (ER), progesterone receptor (PR), and HER2/neu gene amplification.

43
Q

What are triple-negative tumors?

A

Tumors negative for ER, PR, and HER2/neu, associated with poor prognosis and higher incidence in African American women.

44
Q

What are the features of hereditary breast cancer?

A

Early onset, multiple tumors, and family history, often linked to BRCA1 (breast and ovarian cancer) and BRCA2 (male breast cancer).

45
Q

What are the characteristics of male breast cancer?

A

Rare, presents as a subareolar mass, often invasive ductal carcinoma, associated with BRCA2 mutations and Klinefelter syndrome.

BLOCK POSTING 3 (14 decks)

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