Breast Pathology

Question 1

Majority of breast disease is?

Answer 1

benign

Question 2

young women <40, most palpable masses are?

Answer 2

benign

Question 3

memmographic lesions dx?

Answer 3

more benign than malignant

Question 4

what surrounds breast secretory cells?

Answer 4

myoepithelials (can stain brown with actin)

Question 5

where do most lesions in breast arise from?

Answer 5

terminal duct lobular units

TLDUs

Question 6

clinical presentation of breast pathology?

Answer 6

lump
changed breast shape
discomfort/pain
nipple changes/discharge
skin changes

Question 7

gold standard for breast lesion dx?

Answer 7

biopsy

tissue/core/true sample

Question 8

what radiological invesitagations for breast lesions?

Answer 8

ultrasound

mammography

Question 9

what can show up as benign radiodensities in mammography?

Answer 9

calcifications

Question 10

what are fibrocystic changes in breast tissue?

Answer 10

common
fibrosis, adenosis
apocrine metaplasia

Question 11

where are fibrocystic changes in breast tissue? focal?

Answer 11

bilateral

multifocal

Question 12

who gets fibroadenomas usually?

Answer 12

younger women

Question 13

describe breast fibroadenomas

Answer 13

solitary, well circumscribed benign mass

Question 14

what cells can cause fibroadenomas ?

Answer 14

hyperplastic stromal tumour with epithelial component

Question 15

average age of first breast ca dx?

Answer 15

60

Question 16

which TSG is commonly mutated in somatic cells in breast carcinomas

Answer 16

p53

Question 17

what proto-oncogene can have gene amplification in 20% of breast carcinomas?

Answer 17

HER2, neu, c-erbB-2

Question 18

what does HER2 mutation do?

Answer 18

amplification of excessive HER2 receptors results in over growth/hyperplasia of cells

Question 19

HER2 mutation familial?

Answer 19

Nope, spontaneous

Question 20

breast carcinomas how much is familial?

Answer 20

15-20%

Question 21

how many cases have BRCA 1,2 or p53 mutation?

Answer 21

5-10%

Question 22

may develop other tumours like ovarian with which mutation?

Answer 22

BRCA1 mutation

Question 23

risk of cancer at young age, how does familial affect?

Answer 23

if born with one TSG gene knocked out, eg. p53

Question 24

breast feeding and breast carcinomas?

Answer 24

protective because suppresses lactation

Question 25

3 big factors that increase breast cancer incidence in developed countries?

Answer 25

1. obesity
2. alcohol
3. fewer pregnancies

Question 26

how does hyperplasia associate with cancer risk?

Answer 26

usually incidental

atypia predicts risk

Question 27

severe dysplasia is AKA?

Answer 27

carcinoma in situ (hasn’t invaded past basement membrane)

Question 28

2 main types of breast carcinoma in situ?

Answer 28

1. ductal (common, calcification on imaging)

2. lobular (incidental with biopsy)

Question 29

what is DCIS?

Answer 29

ductal carcinoma in situ

Question 30

what is Paget’s disease of nipple?

Answer 30

ductal carcinoma in situ cells extend to nipple (infllammation)

Question 31

invasive breast carcinoma presentation?

Answer 31

lump, peau d’orange, breast shape

Question 32

invasive ductal carcinoma most common %?

Answer 32

70-80%

Question 33

50% of invasive ductal carcinoma where?

Answer 33

upper outer quadrant of breast

Question 34

what happens to cells in invasive ductal carcinoma

Answer 34

ductal forming cells infiltrate parenchyma

Question 35

Invasive Carcinoma usually spread where?

Answer 35

axillary lymphatics, supraclavicular, internal mammary nodes

blood, lungs, bone, liver, brain

Question 36

What is Herceptin?

Answer 36

HER2 receptor antagonist

Question 37

What kind of surgery for Invasive Carcinoma?

Answer 37

conservation surgery with axillary lymph node samling or sentinal node biopsy

Question 38

Invasive Carcinoma breast grading?

Answer 38

1 low
2 inermediate
3 high

Question 39

what does lymphovascular space invasion indicate?

Answer 39

likelihood of nodal metastases

local reoccurence

Question 40

what do you need to qualify for herceptin of transtuzumab?

Answer 40

HER2 amplification

Question 41

male breast cancer incidence?

Answer 41

1% of women