Lecture 5 - Breast Cancer

Question 1

breast:,

lined by ____ layers of epithelium. what are these layers?

Answer 1

2;
luminal layer (inner);
myoepithelial (outer)

Question 2

breast cancer risk factors:
____ estrogen exposure, ___ total number menstrual cyles, ____ age at first live birth, increased age, ____ menarche, late menopause

Answer 2

increase, increased, older, early

Question 3

BRCA:
tumor suppressor or oncogene?
what does it normally do?

Answer 3

tumor suppressor;

DNA repair

Question 4

which BRCA has a larger increased risk of ovarian cancer? which increases risk of male breast cancer and prostate cancer?

Answer 4

BRCA1, BRCA2

Question 5

mammograms:
a _____ mammogram is used when there is no concerns. a _____ mammogram is used when there is concern for breast cancer or history of breast cancer.

Answer 5

screening;

diagnostic

Question 6

mammography suggestive findings:
soft tissue masses with ____ or architectural distortion;
____ ____

Answer 6

spiculation;

microcalcification clusters

Question 7

What kind of imaging is used often on women < 30 for initial evaluation?

what imaging is used after diagnosis but prior to treatment?

Answer 7

ultrasound, MRI

Question 8

MRI has a high ____ but relatively low ____ –> why its not used for screening typically, unless in patient groups with high _____

Answer 8

sensitivity, specificity;

incidence

Question 9

fibrocystic change:
present with _____ breast pain or lumps. often cysts, papillary _____ metaplasia, stromal fibrosis. risk of cancer is typically _____

Answer 9

premenstrual;
apocrine;
unchanged

Question 10

fat necrosis:
____ oil cyst on mammography;
___ necrotic fat and _____ cells on biopsy

Answer 10

calcified;

liquefactive, giant

Question 11

what part of the breast has the highest density/area breast cancer occurs?

Answer 11

upper outer quadrant

Question 12

fibroadenoma:
most common in ____ (younger or older) women;
size and tenderness increases with increased ______. encapsulated or free?

Answer 12

younger;
estrogen (ie pregnancy);
encapsulated

don’t increase risk of breast cancer typically

Question 13

sclerosing adenosis:

acini/stroma fibrosis, associated with _____. increased risk of cancer or no?

Answer 13

calcifications;

yes (slightly)

Question 14

papilllary carcinoma:
characterized by ______ discharge.
seen in ____ women.
lined by what?

Answer 14

blood nipple;
post menopausal;
epithelial cells without myoepithelial cells

Question 15

intraductal papilloma:
characterized by nipple discharge.
seen in ____ women;
lined by what?

Answer 15

pre-menopausal;
epithelial AND myoepithelial cells

increased risk cancer

Question 16

DCIS:
characterized by central _____ surrounded by _____ on histology;
early malignancy with or without basement membrane penetration

Answer 16

necrosis; dystrophic calcification

no basement membrane penetration

Question 17

which subset of DCIS is characterized by high grade cells and increased risk of progression?

Answer 17

comedocarcinoma

Question 18

lobular carcinoma in situ:
usually discovered _____;
____ cells due to loss of _____;
usually one focus or multifocus?

Answer 18

incidentally (ie no calcifications, masses);
dyscohesive, E-cadherin;
multifocal and often bilateral

Question 19

invasive ductal carcinoma:
most common type invasive cancer;
can cause dimpling of skin due to _______;

Answer 19

deformation of suspensory ligament

Question 20

inflammatory breast cancer:

due to ______ invasion. causes ______ (breast cancer resembles orange peel). often mistaken for ______

Answer 20

dermal lymphatic;
Peau d’orange;
mastitis (or Paget’s)

Question 21

phyllodes tumor:
pre or post-menopausal?
large mass of _____ and cysts with leaf-like lobulations.
progress to malignant or no?

Answer 21

post menopausal;
fibrous/connective tissue;

can be malignant

Question 22

invasive lobular carcinoma:
cells are ____ on histology due to decreased ____ expression.

often bilateral/multifocal

Answer 22

single file;

E-cadherin