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ENRP > Breast Pathology part 3 > Flashcards

Breast Pathology part 3 Flashcards

1
Q

The Incidence of breast cancer rises rapidly after what age?

A

30

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2
Q

What 2 cancer types plateau in middle age with their incidence?

A

HER2

TNBC

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3
Q

What cancer type peaks later in life with its incidence?

A

Luminal

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4
Q

What geographic location has the highest incidence of breast cancer?

A

United states and Europe

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5
Q

What race of women have the highest mortality rate with breast cancer?

A

Black women

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6
Q

What are 2 risk factors that DECREASE your risk for breast cancer?

A
  • Pregnancy BEFORE age 20

- Prolonged breast feeding

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7
Q

What are 2 risk factors that DECREASE your risk for breast cancer?

A
  • Pregnancy BEFORE age 20

- Prolonged breast feeding

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8
Q

What are the 3 main groups of breast cancer?

A
  1. Luminal
  2. HER2
  3. TNBC (basal-like)
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9
Q

Familial breast cancer only accounts for less than 1/3 of breast cancers. What are the most important high penetrance susceptibility genes?

A

Tumor suppressor genes

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10
Q

The risk for Familial breast cancer is inherited in what fashion?

A

AD

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11
Q

Mutations in what genes make up a majority of the single gene carriers for Familial breast cancer?

A

BRCA1

BRCA2

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12
Q

What chromosome is BRCA1 on? What other cancer does it carry a risk of?

A

Chromosome 17

–> Ovarian carcinoma

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13
Q

What chromosome is BRCA2 on? What other cancer does it carry a risk for?

A

Chromosome 13

–> Male breast cancer

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14
Q

What is the normal job of BRCA1 and 2?

A

Produce tumor suppressor proteins to help repair damaged double stranded DNA through homologous recombination

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15
Q

In what specific population are single gene mutations in BRCA1 or BRCA2 common? Thus, what measures are taken with them?

A

Ashkenazi Jews

–> Increased surveillance, prophylactic mastectomies/salpingo-oophorectomy

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16
Q

Which BRCA gene has the highest risk of causing breast cancer by age 70?

A

BRCA1

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17
Q

BRCA gene mutations also cause an increased risk for what other 2 cancers?

A

Pancreatic

Prostate

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18
Q

A majority of BRCA1 breast cancers are what type?

A

TNBC

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19
Q

A majority of BRCA2 breast cancers are what type?

A

Luminal – ER(+)

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20
Q

What are 3 other germline mutations that can cause familial breast cancer and their correlating syndromes?

A

TP53 - Li Fraumeni
PTEN - Cowden
SJK11 - Peutz-Jeghers

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21
Q

What is the most common type of sporadic breast cancer?

A

Luminal

22
Q

Describe how Luminal breast cancer arises

A
  • 1q gain and/or 16q loss
  • Flat epithelial atypia
  • PIK3CA mutations
  • Atypical Ductal Hyperplasia
  • DCIS
    = Lumiinal
23
Q

Describe how Luminal breast cancer arises

A
  • 1q gain and/or 16q loss
  • Flat epithelial atypia
  • PIK3CA mutations
  • Atypical ductal hyperplasia
  • DCIS
    = Luminal
24
Q

Recurrence rates for Luminal breast cancer?

A

Lowest rates or recurrence but continue at a steady rate

25
Q

Luminal breast cancer has what molecular features?

A

ER (+)

26
Q

HER2 breast cancer has what molecular features?

A

HER2 amplification (+)

27
Q

Describe how HER2 breast cancer arises

A
  • HER2 amplification
  • DCIS
    = HER2 cancer
28
Q

Is there a precursor lesion for HER2 breast cancer?

A

NO

- DCIS –> HER2 cancer

29
Q

Recurrence rates for HER2 breast cancer?

A

Early and late peaked recurrences

30
Q

Triple Negative breast cancer (TNBC) has what molecular features?

A

ER (-)

HER2 (-)

31
Q

Describe how TNBC arises

A
  • TP53 mutations
  • BRCA1 inactivation
  • DCIS
    = TNBC
32
Q

Describe how TNBC arises

A
  • TP53 mutations
  • BRCA1 inactivation
  • DCIS
    = TNBC
33
Q

Recurrence rates for TNBC?

A

Almost ALL recurrences occur within 8 years of initial diagnosis

34
Q

What are the 2 types of Luminal breast cancers and their proliferation rates?

A

Luminal A = Low proliferation

Luminal B = High proliferation

35
Q

Luminal A breast cancer occurs in what patients usually?

A

Older women and men

- PIK3CA mutations common

36
Q

Luminal B breast cancer occurs in what patients usually?

A

BRCA2 mutation carriers

– equal PIK3CA and TP53 gene mutations

37
Q

What stain is highly picked up by Luminal B breast cancer?

A

Ki67

38
Q

Where do Luminal breast cancers commonly metastasize?

A

BONE

39
Q

In Luminal cancers (ER+), what else is usually highly expressed?

A

PR+

40
Q

If a Luminal breast cancer is ER AND PR (+), what is the prognosis for that?

A

HIGHEST SURVIVAL

– well differentiated and slow growing

41
Q

What is the major risk factor for developing Luminal breast cancer?

A

Estrogen exposure

42
Q

Estrogen exposure causes what 2 things to occur in the breast that can be correlated with cancer development?

A
  • Increases growth factors

- (+) proliferation of epithelial cells during menstrual cycle

43
Q

With HER2 breast cancer, what is the most common gene mutation and usual patient?

A

Young women

– TP53 mutations

44
Q

What is HER2 and what does it do?

A

Receptor tyrosine kinase

  • -> (+) RAS and P13K-AKT
  • -> (+) proliferation and (-) apoptosiis
45
Q

HER2 breast cancers usually metastasize to what 3 locations?

A

Bone
Viscera
Brain

46
Q

What is one agent that can potentially work on some of the HER2 cancers?

A

Herceptin (mAb) against HER2

47
Q

What patients does TNBC usually affect and common gene mutation?

A

Young black women, BRCA1 carriers

- TP53 mutations common

48
Q

Which type of breast cancer is more likely to present as a palpable mass due to its rapid growth?

A

TNBC

49
Q

TNBC metastasizes to what 3 locations?

A

Bone
Viscera
Brain

50
Q

Almost ALL breast carcinomas are what?

A

Adenocarcinomas

ENRP (45 decks)

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