Class: Breast Neoplasias

Question 1

MC type of breast cancer

Answer 1

Infiltrating ductal cancer is the MC by far

Question 2

what is the most important prognostic factor in cancer?

Answer 2

Nodal or extranodal is

Question 3

A 52yo lady presents for routine examination, you obtain a screening mammography which shows a cluster of small calcifications in the left breast. Your send her for a stereotactic-guided core biopsy and get these tissue results. What is the most likely diagnosis?
Ductal carcinoma in situ
Invasive ductal carcinoma
Usual Ductal Hyperplasia
Atypical ductal hyperplasia

Answer 3

Atypical ductal hyperplasia

Question 4

what cancer shows necrotic calciications in ducts

Answer 4

Ductal carcinoma in situ DCIS (comedo type)

Question 5

How to tell the difference betwen Ductal Carinoma in Situ (DCIS) and Atypical Ductal hyperplasia

Answer 5

Neoplastic cells do not completely fill the duct space in ADH

Question 6

E-cadherin negative stain means what dx? calcifications present?

Answer 6

LCIS (lobular carcinoma in situ)

no calcifications

Question 7

Desmoplastic stroma- is part of what cancer

Answer 7

Infiltrating Ductal Carcinoma

Question 8

describe the tumor of a Infiltrating Ductal Carcinoma

Answer 8

Hard, chalky white, gritty, (“crab-like”)

Question 9

which cancer has cells that lavk E-cadherin

Answer 9

invading lobular carcinoma (also lobular carcinoma in-situ)

Question 10

Which underlying carcinoma is pagets disease of the nipple assc with

Answer 10

DCIS

ductal carcinoma in situ

Question 11

What does inflammatory disease of the nipple present with

Answer 11

peau d’ orange gross morphology

Question 12

2 risk factors for male BC

Answer 12

BRCA 2, Klinefleters

Question 13

ER/PR+ respond to what drug

Answer 13

tamoxifen

Question 14

What action does tamoxifen have at breast, uterus, bone

Answer 14

antagonizes Estrogen/progesterone at breast

aginist at bone, uterus

Question 15

Her2+ leads to treatment with what?

Answer 15

Herceptin

Question 16

Mobile lump is what dx in :
young
old

Answer 16

young: fibroadenoma

old = phylloides

Question 17

cyclical pain leads to what dx

Answer 17

fibrocystic change

Question 18

Clear pus from nipple–> what dx

Answer 18

duct ectasia

Question 19

bloody discharge –> dx? (2)

Answer 19

duct papilloma, DCIS

Question 20

nipple eczema–> what dx?

Answer 20

pagets disease of breast

Question 21

MC mass in:
young women
women >50 (generally)

Answer 21

young wmoen = fibrocystic breast disease

> 50 = breast cancer

Question 22

Single most prognostic factor in breast cancer is?

Answer 22

lymph node or extranodal involvement

Question 23

DCIS shows what on mammo

Answer 23

microcalcifications on mammo

Question 24

DCIS show s what HISTO?

Answer 24

filling the ducts on histo (comedocarcinoma)

Question 25

3 cancers with poor px

Answer 25

triple negatove
inflammatory
male

Question 26

Consider BRCA testing for patients with breast cancer in these pops (3)

Answer 26

< 50y triple negative tumor
invasive ovarian/fallopian tube, peritoneal cancer
more than 2 family members with history of breast cancer

Question 27

why no mammo in younger pts

Answer 27

High false-positive mammogram in younger patients

Question 28

What is Breast cancer screening 40-50y?

Answer 28

talk to your patient to determine plan