Carcinoma of the Breast Flashcards
What population is considered a high risk for breast cancer? Moderate risk?
Patients with BRCA mutation or have a Hx of chest radiation; FHx of breast cancer or multiple RFs
What are the majority of breast cancers stimulated by?
Estrogen
What is the strongest association with increased risk for breast cancer?
FHx in first degree relatives
What two genes are major contributors to breast cancer pathogenesis
BRCA1 and BRCA2 tumor-suppressor genes
What mutations are typically found in typical breast cancer?
Majority of cancers are ER, progesterone receptor, and human epidermal growth factor 2 (HER2) NEGATIVE
What is carcinoma in situ a precursor to?
Invasive Carcinoma
Ductal Carcinoma in situ. What are characteristics that are typically found uscopically?
Comedo necrosis, calcification
Ductal carcinoma in situ noncomedo type. What grade is this?
Low-grade DCIS
In what setting does uinvasive carcinoma occur?
Typically in the setting of high-grade DCIS
How is DCIS distinguished from epithelial hyperplasia?
IHC: DCIS lacks high-molecular-weight cytokeratin staining
A fibrovascular core lined by malignant epithelial cells, w/o intervening myoepithelial cell layer, fills the intraductal space. There edge of the tumor has a pushing front, w/o evidence of stromal invasion. Dx?
Encapsulated Papillary Carcinoma
What is Paget Disease of the nipple?
Presence of malignant glandular epithelial cells within the epidermis of the nipple and areola.
Paget Disease of the nipple. What are characteristic uscopic findings?
Ductal-type carcinoma cells that are larger and have more abundant pale cytoplasm than surrounding keratinocytes
What genetic overexpression is normally seen in Paget disease of the nipple?
HER2 overexpression
Mutation of what gene is associated in lobular carcinoma in situ pathogenesis? What protein does it encode?
CDH1 encoding E-cadherin
Lumina of the terminal duct lobular units are distended by tumor cells, which exhibit round nuclei and small nucleoli. What is the Dx?
Lobular carcinoma in situ
A dyshesive population of markedly atypical epithelial cells with central comedo necrosis fills and distends the ducts. Dx?
Pleomorphic Lobular Carcinoma in situ
How is lobular carcinoma in situ differentaited from ductal carcinoma in situ?
Lobular neoplastic cells show a loss of E-cadherin staining
From what is invasive breast carcinoma derived?
Terminal Ductal Lobular Unit
Typically, what do most invasive ductal carcinomas express?
ER positive
Cells from single strands that invade betwixt collagen fibers in a single pattern. What is the Dx?
Invasive lobular carcinoma
Invasive Lobular Carcinoma is shown. What is this characteristic morphology shown?
Targetoid arrangement
The tumor is composed of almost entirely open and angulated tubules lined by a single layer of mildly pleomorphic epithelial cells with prominent apical snouts. What is the Dx?
Tubular carcinoma
What is the ER and HER2 status of tubular carcinoma?
ER positive and HER2 negative
