Cancer as disease -breast cancer part 2

Question 1

What is found between the tubules?

Answer 1

Fatty stromal cells

Question 2

What is special about the myoepithelial cells?

Answer 2

They have a contractile phenotype

Question 3

Describe the response to oestrogen in a normal breast.

Answer 3

The response to oestrogen is to stimulate growth The cell that express oestrogen receptors do NOT grow in response to oestrogen They act as a beacon and produce growth factors the stimulate the growth of nearby cells

Question 4

How is the response to oestrogen different in breast cancer?

Answer 4

The cells displaying oestrogen receptors directly respond to oestrogen as a growth factor and stimulate their own growth

Question 5

What is the difference between lobular and medullary carcinoma?

Answer 5

Lobular – the tumour has some resemblance of the architecture of the gland (there are tubules of some form) Medullary – the tumour cells don’t look anything like the epithelial cells from the mammary gland

Question 6

Where is the oestrogen receptor normally located in the cells

Answer 6

It is a cytosolic receptor It is found in the cytosol bound to a heatshock protein

Question 7

What is a SERM?

Answer 7

Selective oestrogen receptor modulator

Question 8

Why is tamoxifen considered a SERM?

Answer 8

It is anti-oestrogenic in the breast It is oestrogenic in bone and cardiovascular system.

Question 9

Which adrenal hormones are aromatised in post-menopausal women?

Answer 9

Androstenedione (and testosterone, to a lesser extent)

Question 10

How do suicide inhibitors work?

Answer 10

They initially compete with the natural substrate for the active site The enzyme then specifically acts on the inhibitor to yield reactivealkylating species, which form covalent bonds at or near the active site of the enzyme Through this mechanism the enzyme is irreversibly inactivated

Question 11

What can progestin therapy be used for?

Answer 11

Metastatic breast cancer

Question 12

What is a big problem with endocrine therapy?

Answer 12

Resistance develops

Question 13

What proportion of breast tumours are first spotted by the women themselves?

Answer 13

> 90%

Question 14

What sort of cancer are most breast tumours?

Answer 14

Carcinomas (arising from ductile tissue

Question 15

Recall 2 types of carcinoma that can arise from an in situ carcinoma of the breast

Answer 15

Lobular Medullary

Question 16

Recall 3 factors that influence lifetime oestrogen exposure

Answer 16

1. Menarche 2. Timing of first pregnancy 3. Contraceptive pill/ HRT

Question 17

What sort of drug is tamoxifen an what is the effect of tamoxifen on the cell?

Answer 17

SERM Halts cell at G1

Question 18

What is the first line treatment for PR+ breast cancers?

Answer 18

Progestins