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Unit 5: Path - The Breast > Carcinoma of the Breast > Flashcards

Carcinoma of the Breast Flashcards

1
Q

What population is considered a high risk for breast cancer? Moderate risk?

A

Patients with BRCA mutation or have a Hx of chest radiation; FHx of breast cancer or multiple RFs

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2
Q

What are the majority of breast cancers stimulated by?

A

Estrogen

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3
Q

What is the strongest association with increased risk for breast cancer?

A

FHx in first degree relatives

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4
Q

What two genes are major contributors to breast cancer pathogenesis

A

BRCA1 and BRCA2 tumor-suppressor genes

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5
Q

What mutations are typically found in typical breast cancer?

A

Majority of cancers are ER, progesterone receptor, and human epidermal growth factor 2 (HER2) NEGATIVE

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6
Q

What is carcinoma in situ a precursor to?

A

Invasive Carcinoma

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7
Q

Ductal Carcinoma in situ. What are characteristics that are typically found uscopically?

A

Comedo necrosis, calcification

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8
Q

Ductal carcinoma in situ noncomedo type. What grade is this?

A

Low-grade DCIS

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9
Q

In what setting does uinvasive carcinoma occur?

A

Typically in the setting of high-grade DCIS

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10
Q

How is DCIS distinguished from epithelial hyperplasia?

A

IHC: DCIS lacks high-molecular-weight cytokeratin staining

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11
Q

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?

A

Encapsulated Papillary Carcinoma

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12
Q

What is Paget Disease of the nipple?

A

Presence of malignant glandular epithelial cells within the epidermis of the nipple and areola.

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13
Q

Paget Disease of the nipple. What are characteristic uscopic findings?

A

Ductal-type carcinoma cells that are larger and have more abundant pale cytoplasm than surrounding keratinocytes

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14
Q

What genetic overexpression is normally seen in Paget disease of the nipple?

A

HER2 overexpression

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15
Q

Mutation of what gene is associated in lobular carcinoma in situ pathogenesis? What protein does it encode?

A

CDH1 encoding E-cadherin

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16
Q

Lumina of the terminal duct lobular units are distended by tumor cells, which exhibit round nuclei and small nucleoli. What is the Dx?

A

Lobular carcinoma in situ

17
Q

A dyshesive population of markedly atypical epithelial cells with central comedo necrosis fills and distends the ducts. Dx?

A

Pleomorphic Lobular Carcinoma in situ

18
Q

How is lobular carcinoma in situ differentaited from ductal carcinoma in situ?

A

Lobular neoplastic cells show a loss of E-cadherin staining

19
Q

From what is invasive breast carcinoma derived?

A

Terminal Ductal Lobular Unit

20
Q

Typically, what do most invasive ductal carcinomas express?

A

ER positive

21
Q

Cells from single strands that invade betwixt collagen fibers in a single pattern. What is the Dx?

A

Invasive lobular carcinoma

22
Q

Invasive Lobular Carcinoma is shown. What is this characteristic morphology shown?

A

Targetoid arrangement

23
Q

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?

A

Tubular carcinoma

24
Q

What is the ER and HER2 status of tubular carcinoma?

A

ER positive and HER2 negative

25
Q

Low-grade malignant epithelial cells form acini, nests or trabeculae, which appear to float in pools of extracellular mucin. Dx?

A

Mucinous Carcinoma

26
Q

What is the ER and HER2 status of mucinous carcinoma?

A

ER positive HER2 negative

27
Q

A moderate to marked lymphoplasmacytic infiltrate and no tubule formation is seen. What is the Dx?

A

Medullary Carcinoma

28
Q

What is the typical ER, PR, HER2 status of medullary carcinomas?

A

ER, PR, HER2 negative (“triple negative”)

29
Q

Malignant epithelial nests or acini are surrounded by a clear space. What is the Dx?

A

Micropapillary Carcinoma

30
Q

Cartilagenous and osseus matrix in a tumor with hereologous elements. Elsewhere foci of poorly differentiated adenocarcinoma were seen. Dx?

A

Metaplastic Carcinoma

31
Q

Typical ER and HER2 profile of metaplastic carcinoma?

A

ER and HER2 negative

32
Q

What classification system is used for breast cancer?

A

Tumor, regional lymph nodes, and distant metastases (TMN)

33
Q

What determines tumor grade?

A

Histological analysis

34
Q

How does HER2 positivity affect Px?

A

HER2 positivity is an adverse prognostic factor irrespective of lymph node status

35
Q

How can HER2, ER, and PR status be determined?

A

Using IHC

Unit 5: Path - The Breast (6 decks)

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