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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?

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
Luminal breast cancer has what molecular features?
ER (+)
26
HER2 breast cancer has what molecular features?
HER2 amplification (+)
27
Describe how HER2 breast cancer arises
- HER2 amplification - DCIS = HER2 cancer
28
Is there a precursor lesion for HER2 breast cancer?
NO | - DCIS --> HER2 cancer
29
Recurrence rates for HER2 breast cancer?
Early and late peaked recurrences
30
Triple Negative breast cancer (TNBC) has what molecular features?
ER (-) | HER2 (-)
31
Describe how TNBC arises
- TP53 mutations - BRCA1 inactivation - DCIS = TNBC
32
Describe how TNBC arises
- TP53 mutations - BRCA1 inactivation - DCIS = TNBC
33
Recurrence rates for TNBC?
Almost ALL recurrences occur within 8 years of initial diagnosis
34
What are the 2 types of Luminal breast cancers and their proliferation rates?
Luminal A = Low proliferation | Luminal B = High proliferation
35
Luminal A breast cancer occurs in what patients usually?
Older women and men | - PIK3CA mutations common
36
Luminal B breast cancer occurs in what patients usually?
BRCA2 mutation carriers | -- equal PIK3CA and TP53 gene mutations
37
What stain is highly picked up by Luminal B breast cancer?
Ki67
38
Where do Luminal breast cancers commonly metastasize?
BONE
39
In Luminal cancers (ER+), what else is usually highly expressed?
PR+
40
If a Luminal breast cancer is ER AND PR (+), what is the prognosis for that?
HIGHEST SURVIVAL | -- well differentiated and slow growing
41
What is the major risk factor for developing Luminal breast cancer?
Estrogen exposure
42
Estrogen exposure causes what 2 things to occur in the breast that can be correlated with cancer development?
- Increases growth factors | - (+) proliferation of epithelial cells during menstrual cycle
43
With HER2 breast cancer, what is the most common gene mutation and usual patient?
Young women | -- TP53 mutations
44
What is HER2 and what does it do?
Receptor tyrosine kinase - -> (+) RAS and P13K-AKT - -> (+) proliferation and (-) apoptosiis
45
HER2 breast cancers usually metastasize to what 3 locations?
Bone Viscera Brain
46
What is one agent that can potentially work on some of the HER2 cancers?
Herceptin (mAb) against HER2
47
What patients does TNBC usually affect and common gene mutation?
Young black women, BRCA1 carriers | - TP53 mutations common
48
Which type of breast cancer is more likely to present as a palpable mass due to its rapid growth?
TNBC
49
TNBC metastasizes to what 3 locations?
Bone Viscera Brain
50
Almost ALL breast carcinomas are what?
Adenocarcinomas

ENRP (45 decks)

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