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REPRO II Exam 1 > Breast Pathology II > Flashcards

Breast Pathology II Flashcards

1
Q

fibrocystic change

A

exaggerated physio response
-1/3 women age 30-50

stops at menopause

mass, pain, microcalcifications

no increased risk for carcinoma**

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2
Q

usual epithelial hyperplasia

A

like FCC - but >4 cells thick

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3
Q

radial scar

A

complex sclerosing lesion
-central fibroelastic scar with entrapped glands

mimic carcinoma

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4
Q

intraductal papilloma

A

benign epithelial cells on stalk

polyp obstructing lumen

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5
Q

atypical ductal hyperplasia

A

low grade neoplastic
-overlap with DCIS

DCIS - when duct completely filled and lesion is >2mm

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6
Q

atypical lobular hyperplasia

A

proliferation of low grade neoplastic cells in lobule

e-cadherin negative

overlap with LCIS

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7
Q

lobular carcinoma in situ

A

just a risk for DCIS

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8
Q

DCIS

A

needs to be removed

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9
Q

comido necrosis

A

in DCIS

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10
Q

medial breast drainage

A

to thoracic nodes

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11
Q

lateral breast drainage

A

to axillary nodes

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12
Q

stromal breast neoplasms

A

fibroadenoma

phyllodes tumors

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13
Q

difference between ductal and lobular carcinoma of breast

A

different gene expression

e-cadherin

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14
Q

invasion of ductal and lobular carcinoma

A

invasion diagnosed by absence of myoepithelial cells

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15
Q

comedonecrosis

A

with high grade DCIS

squeeze tissue and toothpaste squirts out

prone to dystrophic calcification

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16
Q

microinvasion

A

<2mm in dimension

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17
Q

high grade DCIS

A

microinvasion and comedonecrosis

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18
Q

dyshesive and mucin +

A

LCIS

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19
Q

e-cadherin positive

A

DCIS

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20
Q

eczema/red skin around nipple and areola

A

paget disease
-due to underlying DCIS +/- invasion

infiltration by malignant glandular cells

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21
Q

micropapillary, cribriform, mild atypia

A

low grade DCIS

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22
Q

e-cadherin negative

A

LCIS

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23
Q

upward infiltration of epidermis by glandular neoplastic cells

A

pagetoid

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24
Q

CK7

A

useful in diagnosis of pagets

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25
Q

risk factors for invasive carcinoma of breast

A 
estrogen exposure
radiation exposure
breast density
proliferative fibrocystic changes
alcohol, obesity, sedentary
familial
increasing age
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26
Q

inhibits at G1>S and G2>M to allow DNA repair

A

GADD45

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27
Q

BRCA1

A

ER negative
no precursor lesion

basal like

tp53 mutations

28
Q

BRCA2

A

ER positive
flat epithelial atypia
atypical ductal hyperplasia

luminal

16q loss and 1q gain

29
Q

her2 positive cancers

A

ER positive or negative

HER2 enriched

30
Q

p53 action

A

inhibits neoplastic transformation by:

  • induces transient cell cycle arrest
  • induces permanent cell cycle arrest
  • induces apoptosis
31
Q

genetic testing for breast cancer

A

family genetic disease
early age of onset
high risk breast cancer
positive family hx

32
Q

li fraumeni syndrome

A

p53 - with 85-90% increased risk

associated cancers - soft tissue, brain, bone, adrenal, leukemia, etc.

multiple early onset cancers**

33
Q

BRCA1 and 2

A

hereditary breast cancer

associated - ovarian, male breast, prostate, pancreatic, melanoma

34
Q

cowden syndrome

A

PTEN

35
Q

peutz jeghers syndrome

A

STK1

36
Q

peau d’orange

A

inflammatory carcinoma

due to invasion of dermal lymphatics and coopers ligaments

37
Q

invasive ductal carcinoma

A

50% RUQ

stellate mass with gritty hard surface

38
Q

invasive lobular carcinoma

A

hard to detect

  • indian filing pattern
  • e-cadherin negative
  • spread to mesothelial surfaces and leptomeninges
39
Q

indian filing

A

invasive lobular carcinoma

40
Q

worst of all breast cancer

A

inflammatory

41
Q

undifferentiated

A

so poor original tissue cannot be ID’d

aka anaplastic

42
Q

pTis

A

CIS

43
Q

pT1

A

tumor <0.1cm

44
Q

pT2

A

tumor 2cm-5cm

45
Q

pT3

A

tumor >5cm

46
Q

pT4

A

tumor any size and spread to chest wall/breast tissue

47
Q

PET scan

A

or mets

utilizes warburg effect

should not be restricted by cancer type or testing indication

48
Q

Her2/neu

A

membrane bound protein that phosphorylates tyrosine and initiates number of signalling pathways and inhibits apoptosis

overexpresion in 30% of breast cancer

conveys bad prognosis

49
Q

herceptin

A

to tx her2/neu cancers - better prognosis

50
Q

75% breast ca

A

ER positive

51
Q

65% breast ca

A

PR positive

52
Q

tamoxifen

A

competitive antagonist for ER receptor

53
Q

aromatase inhibitors

A

inhibit conversion of androgen to estrogen

used in post menopausal women

54
Q

patient with high risk of recurrence

A

given chemotherapy

55
Q

radiation

A

for local control

56
Q

stage 1 and 2

A

node negative - tamoxifen

node positive - tamoxifen and chemotherapy

57
Q

mammaprint

A

test for risk of recurrence

to assess risk of mets

to determine benefit of chemo

58
Q

hormone responsive tx

A

first line hormone therapy
second line
third line

59
Q

hormone unresponsive tx

A

first line chemo
second line
third line

60
Q

favorable histo

A

ER and PR positive

61
Q

trastuzumab

A

tx of her2neu positive

62
Q

post radiation

A

angiosarcoma

63
Q

lobular stromal breast tumors

A

phyllodes

fibroadenoma

64
Q

most common b9 breast tumor

A

fibroadenoma

age 20-40yo

mass with calcification after involution

india rubber balls

biphasic

65
Q

most common soft tissue tumor of adulthood

A

lipoma

round, circumscribed, soft, mobile, painless

66
Q

phyllodes tumor

A

50-60yo

palpable mass

large, rubbery rounded mass

low grade - local recurrence
high grade - aggressive local invasion with heme mets

67
Q

gynecomastia

A

breast in males
-hyperestrogen

cirrhosis, klinefelter, estrogen producing tumors, meds, marijuana, heroin, exogenous

REPRO II Exam 1 (14 decks)

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