Breast Pathology Flashcards
Majority of breast disease is?
benign
young women <40, most palpable masses are?
benign
memmographic lesions dx?
more benign than malignant
what surrounds breast secretory cells?
myoepithelials (can stain brown with actin)
where do most lesions in breast arise from?
terminal duct lobular units
TLDUs
clinical presentation of breast pathology?
lump changed breast shape discomfort/pain nipple changes/discharge skin changes
gold standard for breast lesion dx?
biopsy
tissue/core/true sample
what radiological invesitagations for breast lesions?
ultrasound
mammography
what can show up as benign radiodensities in mammography?
calcifications
what are fibrocystic changes in breast tissue?
common
fibrosis, adenosis
apocrine metaplasia
where are fibrocystic changes in breast tissue? focal?
bilateral
multifocal
who gets fibroadenomas usually?
younger women
describe breast fibroadenomas
solitary, well circumscribed benign mass
what cells can cause fibroadenomas ?
hyperplastic stromal tumour with epithelial component
average age of first breast ca dx?
60
which TSG is commonly mutated in somatic cells in breast carcinomas
p53
what proto-oncogene can have gene amplification in 20% of breast carcinomas?
HER2, neu, c-erbB-2
what does HER2 mutation do?
amplification of excessive HER2 receptors results in over growth/hyperplasia of cells
HER2 mutation familial?
Nope, spontaneous
breast carcinomas how much is familial?
15-20%
how many cases have BRCA 1,2 or p53 mutation?
5-10%
may develop other tumours like ovarian with which mutation?
BRCA1 mutation
risk of cancer at young age, how does familial affect?
if born with one TSG gene knocked out, eg. p53
breast feeding and breast carcinomas?
protective because suppresses lactation
3 big factors that increase breast cancer incidence in developed countries?
- obesity
- alcohol
- fewer pregnancies
how does hyperplasia associate with cancer risk?
usually incidental
atypia predicts risk
severe dysplasia is AKA?
carcinoma in situ (hasn’t invaded past basement membrane)
2 main types of breast carcinoma in situ?
- ductal (common, calcification on imaging)
2. lobular (incidental with biopsy)
what is DCIS?
ductal carcinoma in situ
what is Paget’s disease of nipple?
ductal carcinoma in situ cells extend to nipple (infllammation)
invasive breast carcinoma presentation?
lump, peau d’orange, breast shape
invasive ductal carcinoma most common %?
70-80%
50% of invasive ductal carcinoma where?
upper outer quadrant of breast
what happens to cells in invasive ductal carcinoma
ductal forming cells infiltrate parenchyma
Invasive Carcinoma usually spread where?
axillary lymphatics, supraclavicular, internal mammary nodes
blood, lungs, bone, liver, brain
What is Herceptin?
HER2 receptor antagonist
What kind of surgery for Invasive Carcinoma?
conservation surgery with axillary lymph node samling or sentinal node biopsy
Invasive Carcinoma breast grading?
1 low
2 inermediate
3 high
what does lymphovascular space invasion indicate?
likelihood of nodal metastases
local reoccurence
what do you need to qualify for herceptin of transtuzumab?
HER2 amplification
male breast cancer incidence?
1% of women
