L3: Breast Cancer - Pt 1 Flashcards
1
Q
Incidence of Breast Cancer
A
2
Q
Incidence of Breast Cancer
- Most Common
A
- MC cancer in ♀ (All women are at risk with one from eight developing the disease within their lifetime)
- 2nd MC cause of death after lung cancer
3
Q
Incidence of Breast Cancer
- age
A
40 -50 yrs (no age is immune after Puberty)
4
Q
Incidence of Breast Cancer
- Gender
A
♀:♂ = 99 : 1
5
Q
Incidence of Breast Cancer
- Side
A
- Left > Right
- Synchronous 1% - Metachronous 5%
6
Q
Incidence of Breast Cancer
- Site
A
7
Q
RF for Breast Cancer
A
8
Q
RF for Breast Cancer
- Sporadic Breast Cancer (SBC)
A
9
Q
RF for Breast Cancer
- Familial Breast Cancer (FBC
A
10
Q
RF for Breast Cancer
- Hereditary Breast Cancer (HBC)
A
11
Q
Most Common Genes Implicated in Breast Carcinoma
A
12
Q
Most Common Genes Implicated in Breast Carcinoma
- BRCA 1
A
13
Q
Most Common Genes Implicated in Breast Carcinoma
- BRCA 2
A
14
Q
Most Common Genes Implicated in Breast Carcinoma
- P53
A
15
Q
Most Common Genes Implicated in Breast Carcinoma
- PTEN
A
16
Q
Most Common Genes Implicated in Breast Carcinoma
- MMR
A
17
Q
Most Common Genes Implicated in Breast Carcinoma
- STK11
A
18
Q
Most Common Genes Implicated in Breast Carcinoma
- CDH1 / E-Cadherin-1
A
19
Q
Most Common Genes Implicated in Breast Carcinoma
- High & Moderate Penetrance Genes?
A
20
Q
RF for Breast Cancer
- Geographical
A
- More common in Western Europe & USA
- Uncommon in Asia & Japan
- May be due to genetic or dietary factors
21
Q
RF for Breast Cancer
- Endocrinal
A
⎚ Non-lactating female
⎚ Not married or Nullipara - Elderly primigravida
⎚ Early menarche or late menopause due to prolonged exposure to estrogen
22
Q
RF for Breast Cancer
- Radiation
A
- Nuclear war - Medical purposes (Diagnostic or Therapeutic)
23
Q
RF for Breast Cancer
- Drugs
A
- Prolonged use of contraceptive pills > 10 years “uncertain”
- Postmenopausal hormone replacement therapy (estrogen & progesterone)
24
Q
RF for Breast Cancer
- Diet
A
- Diet rich in saturated fatty acids predisposes to cancers
- Obese patients because fat is an important source of estrogen production
- Alcohol & smoking
25
RF for **Breast Cancer**
- Diseases
- Previous cancer breast “6 times” “Most common”
- Previous breast irradiation or operation
26
Precancerous Lesions for **Breast Cancer**
27
Precancerous Lesions for **Breast Cancer**
- No Increased Risk
- Mild hyperplasia
- Adenosis
- Microcysts
- Simple Fibroadenoma
- Duct Ectasia
28
Precancerous Lesions for **Breast Cancer**
- Slight Increased Risk (*2)
- Moderate & florid hyperplasia
- Sclerosing adenosis
- Macrocysts
- complex fibroadenoma
- Duct papilloma
29
Precancerous Lesions for **Breast Cancer**
- Moderately Increased Risk (*4-5)
- Atypical ductal hyperplasia
- Atypical lobular hyperplasia
- LCIS
30
Precancerous Lesions for **Breast Cancer**
- Ductal
- Atypical ductal hyperplasia
- Duct Papilloma
31
Precancerous Lesions for **Breast Cancer**
- Atypical Ductal Hyperplasia
- Atypia present & criteria for ductal carcinoma in situ are absent
- Atypical ductal hyperplasia has some not all of these features.
- Floride ductal hyperplasia has 1.5 fold increased risk for cancer
32
Precancerous Lesions for **Breast Cancer**
- Lobules
1) Sclerosing adenosis
2) Radial scar
3) Macrocysts “rarely”
4) Complex fibroadenoma “rarely”
33
Family History of **Breast Cancer** & Subsequent Incraesed Risk
- Mother
- Sister
- Personal History
34
Risk of **Breast Cancer** in the following Conditions
- Papilloma, sclerosing adenosis, macrocyst, complex fibroad
- Atypical ductal hyperplasia - Atypical lobular hyperplasia
- Lobular carcinoma in situ (LCIS)
35
Pathological Types of **Breast Cancer**
36
Non infiltrating carcinoma
- Carcinoma in which malignant cells arising from epithelium lining TDLU and do not invade basement membrane
37
Types of **DCIS**
38
Van Nuys classification (most useful) of **DCIS**
39
If DCIS is Impalbable, It is Biopsied by .......
40
Characters of **LCIS**
- High risk factor
- 35% become invasive
- Lacks E-Cadherin
- Indian files pattern
41
Tavassoli Classification of **LCIS**
42
In **LCIS**, Chemo is indicated For ......
43
ME of **DCIS**
44
Types of **DCIS**
45
Types of **DCIS**
- Comedo
46
Types of **DCIS**
- Non-Comedo
a. Solid
b. Micropapillary
c. Cribriform
d. Papillary
47
Types of **DCIS**
- Another Classification
Anther classification based on
- nuclear grade and necrosis
into high, intermediate and low grade types
48
Risk in **LCIS**
49
ME of **LCIS**
50
**LCIS**
- Pattern Of Cells
- Monomorphic population of small rounded loosely cohesive cells fills/expands acini of lobule
51
**LCIS**
- Lobular Architecture
- Underlying lobular architecture can still be recognized
52
**LCIS**
- Mass & Ca+2
Cells never form mass & calcification is uncommon
53
**LCIS**
- Shape of Cells
- Signet ring cells containing mucin are commonly present.
54
**LCIS**
- Receptors on Cells
- LCIS almost always express ER & PR while overexpression of HER 2 /neu is not
55
**LCIS**
- NB
- Abnormal cells of atypical lobular hyperplasia,
LCIS, and invasive lobular CA are identical & consist
of small cells that have oval or round nuclei with
small nucleoli
56
Compare Between **DCIS** & **LCIS** in Terms of
- Age
- Incidence
- CP
- Mammography
- Multicentricity
- Bilaterallity
- Axillary Mets
- Synchronous Invasive Cx
- Subsequent Cx
