Breast Pathology 2 Flashcards
BRCA___ mutation is relatively more common
BRCA1
Li Fraumeni syndrome is associated with a mutation in _____
p53
ER positive pathway of breast cancer is the most common and is associated with a germane BRCA___ mutation
BRCA2
the main cause of peas d’orange in _______ carcinoma of the breast is due to ______
peau d’orange occurs in inflammatory carcinoma and is due to lymphedema
breast cancer can spread to ____, ____ , _____ , or _____
lung, bones, liver, or adrenals
all breast carcinomas arise form cells in the ________
terminal duct lobular unit
in micro papillary DCIS (non comedo) is there a fibrovascular core?
no;
will see a fibrovascular core in the papillary type of intraductal carcinoma
BRCA1 mutations is associated with a ER _____ (+/-) breast cancer
ER negative
which breast carcinoma is associated with a mutation in E-cadherin?
lobular carcinoma in situ
Paget’s disease has cells that extend from ______ (breast carcinoma) via the ductal system via lactiferous sinuses and into the nipple skin
DCIS; look of underlying intraductal or invasive carcinoma
how does Paget’s disease present?
unilateral pruriti erthematous reputino with a scale crust; can be mistaken for eczema
is there basement membrane invasion in Paget’s disease?
NO;
describe the Paget cells on histology
- hyperchromatic cells with perinuclear halo
_______ stain can be used to strain for Paget cells
cytokeratin (epidermal)
lumina A ductal carcinoma is
ER:
HER2/neu:
ER +
HER2/neu -
more common
luminal B ductal carincoma is
ER:
HER2/neu:
ER +
HER2/neu: +
TRIPLE POSITIVE TUMOR
_________ ductal carcinoma of the breast is triple negative
basal like; more associtd with BRCA1 mutation and seen in younger females
medullary carcinoma is special in that it clinical presents differently than ductal carcinoma. how doe it present on physical examination?
fleshy, soft well circumscribed lesion that can be confused with a benign lesion
ductal carcinoma of the breast is hard with irregular borders
what is the prognosis for medullary carcinoma of the breast
good
lobular carcinoma is associated with loss of ______
E cadherin
signet ring appearance of tumor cells is seen in _______ carcinoma of the breast
lobular
what are the two microscopic patterns in lobular carcinoma of the breast
- single file of tumor cells, round and uniform
2. bull’s eye pattern (tumor cells around normal acini and ducts)
what are the three uncommonly metastasizing breast cancers
- colloid
- medullary
- papillary
ER+/PR+ responds to _____ the most often compared to other ER/PR status
tamoxifen; (hormone therapy)
rank the ER/PR status in order of most likely to respond to tamoxifen to least likely
- ER+/PR+
- ER-/PR+
- ER+/PR-
- ER-/PR-
Her2/neu is a ______ (type of gene)
oncogene; over expression of this oncogene is associated with a worse clinical outcome
20% of her2 positive patients respond to treatment with ________
Herceptin (trastuzumab) aka immunotherapy
can Herceptin cross the BB barrier?
no; it CANNOT be useful in breast cancer that has metastasized to the brain
what are the breast lesions and carcinomas that can be picked up on a mammogram
- intraductal carcinoma
- FCC proliferative
- sclerosing adenosis
- radial scar
what are 2 microscopic changes in gynecomastia
- proliferation of glands
- intraductal hyperplasia with intense fibrosis around ducts
_____ karyotype is a risk factor for breast carcinoma and gynecomastia in males
XXY (Kilnefelter’s)
breast carcinoma in males tend to have more association with a BRCA__ mutation and are usually ER____
BRCA 2; ER +
