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ENRP > Breast Pathology part 4 > Flashcards

Breast Pathology part 4 Flashcards

1
Q

Almost ALL breast carcinomas are what type?

A

Adenocarcinoma

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2
Q

What do Breast Adenocarcinomas arise from?

A

TDLU

- terminal ductal lobular unit

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3
Q

What is Carcinoma in Situ?

A

Cancer cells are confined within ducts/lobules by the basement membrane

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4
Q

With Carcinoma in Situ of the breast, where does it metastasize? What cells are preserved?

A

CANNOT METASTASIZE

- Myoepithelial cells are preserved

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5
Q

What are the 2 types of breast CIS?

A

Ductal (DCIS)

Lobular (LCIS)

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6
Q

DCIS is detected by? What is seen?

A

Mammography

– Calcifications are seen

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7
Q

Besides calcifications, how else can DCIS be detected?

A

Fibrosis that causes a mass or density

Nipple discharge

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8
Q

How does LCIS differ from DCIS?

A

Cells grow in a dyscohesive fashion

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9
Q

LCIS is detected by?

A

INCIDENTAL biopsy

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10
Q

What usually causes the cells to grow dyscohesively with LCIS?

A

Dysfunction of E-cadherin (CDH1 gene)

– loss of cell adhesion

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11
Q

What usually causes the cells to grow dyscohesively with LCIS?

A

Loss of cell adhesion due to dysfunction of E-Cadherin (CDH1 gene)

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12
Q

Which CIS type is more often bilateral?

A

LCIS

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13
Q

LCIS usually has what molecular changes besides E-cadherin?

A

ER and PR (+)

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14
Q

With Invasive breast carcinomas, 1/3 are classified as special types and the rest are considered?

A

Ductal/No Special Type

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15
Q

Lobular Carcinomas involve what genetic change?

A

Biallelic loss of CDH1 (e-cadherin)

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16
Q

Are Lobular Carcinomas easy to detect?

A

No – difficult to detect by palpation and imaging

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17
Q

What cells will be present with Lobular Carcinomas?

A

Mucinous Signet Ring Cells

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18
Q

What 5 locations do Lobular Carcinomas spread to?

A

Peritoneum
Leptomeninges
GI
Ovaries and Uterus

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19
Q

What 5 locations do Lobular Carcinomas often spread to?

A

Peritoneum
Leptomeninges
GI
Ovaries and Uterus

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20
Q

Carcinoma with Medullary Pattern has what genetic changes?

A

Hypermethylation of BRCA1 promoter

–> Decreased BRCA1 expression

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21
Q

What cells are often present with Carcinoma with Medullary Pattern?

A

T cells

22
Q

Carcinoma with Medullary Pattern has what type of prognosis?

A

BETTER prognosis than other invasive carcinomas

23
Q

How will Mucinous (colloid) Carcinomas look?

A

Gray-Blue gelatin appearance

24
Q

How will the cells look with Mucinous (colloid) Carcinoma?

A

Cells in clusters within large lakes of mucin

25
Q

What are the symptoms of Inflammatory carcinoma?

A

Breast erythema
Swelling
Skin thickening = orange peel

26
Q

What are the symptoms of Inflammatory carcinoma?

A

Breast erythema
Swelling
Skin thickening = orange peel

27
Q

How does Inflammatory carcinoma cause the symptoms and what is weird about it?

A

Cancer cells plug lymphovascular dermis spaces

** NO INFLAMMATION **

28
Q

Is there inflammation present with Inflammatory Carcinoma?

A

NO

29
Q

How is the prognosis with Inflammatory Carcinoma?

A

POOR

30
Q

Ductal Carcinomas are usually hard radiodense masses. When they are cut, what sound is heard?

A

Grating sound

31
Q

Paget’s disease often occurs with what molecular type of breast cancer?

A

HER2

32
Q

What is the symptom of Paget’s Disease?

A

Fluid seeping out of nipple and a mass felt

33
Q

What is the symptom of Paget’s Disease?

A

Fluid seeping out of nipple and mass usually felt too

34
Q

Describe how Paget’s Disease arises

A
  • Paget cells extend from DCIS to the nipple skin
  • Disrupt the epithelial barrier
    = Nipple discharge
35
Q

Do Paget cells cross the basement membrane with Paget’s Disease?

A

No

36
Q

What is the most important prognostic factor with breast cancer?

A

Metastasis beyond regional lymph nodes

37
Q

What specific lymph node status is important with breast cancers?

A

Axillary

38
Q

TNM staging with breast cancers goes from 0-4. Describe Stage 1 and 4

A

1: size is < 2 cm; no metastases
4: any size; +/- lymph node involvement; metastases present

39
Q

What will be seen histologically with Gynecomastia?

A

Collagenous CT

Ductal Hyperplasia

40
Q

What causes a button-like subareolar enlargement in men?

A
  • Estrogen increase/Testosterone decrease
  • Liver disease
  • Meds
  • 47XXY/neoplasm
41
Q

Male breast cancer is usually what type and what stage at presentation?

A

Luminal type

- HIGH stage at presentation

42
Q

Male breast cancer may present how?

A

Mass

Skin ulceration

43
Q

Intralobar stroma can give rise to what 2 benign tumors?

A

Fibroadenoma

Phyllodes tumor

44
Q

What is the most common benign tumor of the breast and where does it arise from?

A

Fibroadenoma

– intralobar stroma

45
Q

The 2 benign tumors that arise from intralobar stroma have what mutation?

A

MED12

46
Q

Which tumor from Intralobar stroma is likely multiple and bilateral and may be associated with Cyclosporin A use?

A

Fibroadenoma

47
Q

Which tumor from Intralobar stroma usually affects older women and has more cells/mitotic rate/pleomorphism?

A

Phyllodes tumor

48
Q

Intralobar stromal derived benign tumors have an extra?

A

Extra epithelial component – biphasic

49
Q

Tumors from where do NOT have an accompanying epithelial componant?

A

Interlobar stroma

50
Q

What germline mutation is common in male breast cancer?

A

BRCA2

ENRP (45 decks)

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