Breast Pathology 2 Flashcards
what part of the tumour is malignant in a malignant phyllodes tumour?
stroma
post operative radiotherapy triggers what malignant breast cancer?
angiosarcoma
what kind of cancers elsewhere can metastasise to the breast - be specific
bronchial carcinoma
ovarian SEROUS carcinoma
clear cell carcinoma of the kidney
malignant melanoma
what soft tissue tumoru can metastasise to the breast?
leimyosarcoma
define a breast carcinoma
malignant tumour of breast epithelial cells
where does a breast carcinoma arise?
glandular epithelium of the TDLU
what kind of cancer is a breast carcinoma?
adenocarcinoma
name the 2 types of precursor lesions to breast cancer
ductal
lobular
what does carcinoma mean?
it’s epithelial
it looks malignant
an in situ carcinoma of the breast is confined to…
basement membrane of acini and ducts
name the 2 types of lobular precursor lesion and what makes them different
atypical lobular hyperplasia (<50% of lobule involved)
lobular carcinoma in situ (>50% of lobule involved)
LCIS neoplasia is usually oestrogen receptor positive/negative
positive
how does LCIS present?
multifocal
bilateral
fertile women
not palpable
risk of cancer is _% if you have LCIS and a family history
20
Ix LCIS
- core biopsy
2. excision/vacuum biopsy to exclude higher grade lesions
intraductal proliferation involves a change in what cells of the breast?
columnar cells of the ducts
what % of breast malignancies are DCIS?
15-20%
where does ductal carcinoma in situ arise?
TDLU
DCIS tends to involve a single/multi duct system
single
a malignancy is classed as DCIS if its located where?
within BM of the duct
high grade DCIS that extends to the nipple is called..
paget’s disease of the nipple
Tx DCIS
surgery
adjuvant radiotherapy
what is microinvasive carcinoma?
basically DCIS with invasion of <1mm
Tx microinvasive carcinoma
surgery
treat like high grade DCIS
if you have high grade DCIS what cancer are you likely to progress to?
grade 3 ductal carcinoma - BAD!
what cancer is LCIS likely to progress to?
lobular carcinoma
what is low grade DCIS likely to progress to?
grade 1 ductal carcinoma
reproductive risk factors for breast carcinoma
age at menarche age at first birth parity breastfeeding age at menopause
risk factors for breast carcinoma?
OCP/HRT use age reproductive factors previous breast disease caucasian weight/low exercise alcohol diet smoking genetics
what FH would double your risk?
affected first degree relative
1 in __ carry a BRCA mutation
450
where will invasive breast carcinoma spread to?
bone liver brain lungs abdo viscera female genital tract
Ix for nodes in invasive carcinoma?
sentinel node biopsy (less likely to cause oedema)
most common type of invasive breast carcinoma?
ductal (non specific types)
what does a tumour grade measure?
tumour differentiation
name 3 ways of measuring breast carcinoma differentiation
presence of tubules
appearance of nucleus
mitotic activity
what does an ER positive tumour tell you?
it will respond to anti-oestrogen therapy
give examples of anti-oestrogen therapy
oophorectomy
tamoxifen
aromatase inhibitors
GnRH antagonists
most common positive hormone receptor in breast carcinoma?
oestrogen receptors
what does HER2 stand for
human epidermal growth factor receptor 2
name a drug that binds to HER2
trastuzamab (herceptin)
Tx HER2+ breast carcinoma
herceptin + chemo
