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Pathology 2 Block 2 > Malignant Breast Cancer > Flashcards

Malignant Breast Cancer Flashcards

1
Q

in what lobe of the breast does breast cancer occur?

A

upper outer quadrant

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2
Q

risk factors of breast cancer are mostly due to what factor?

A

estrogen related…others are obesity, genetical, post-menopause, atypical hyperplasia

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3
Q

what are the clinical findings of breast cancer?

A
  • painless mass
  • nipple retraction
  • skin dimpling
  • fixation
  • painless axillary lymphadenopathy
  • hepatomegaly or bone pain
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4
Q

what tool can be used as a screening test to identify breast cancer?
what does it detect?

A

mammography

  • detects non-palpable masses
  • detects microcalcifications that happen with ductal carcinoma in situ or sclerosing adenosis
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5
Q

what can a mammography not distinguish?

A

cannot distinguish between malignant or benign breast masses

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6
Q

what is the 1st spreading mechanism used by breast cancer?

A

lymph

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7
Q

Outer quadrant tumors spread where?

A

axillary lymph nodes

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8
Q

Inner quadrant tumors spread where?

A

internal mammary nodes

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9
Q

what is the 2nd mechanism used by breast cancer to spread?

A

blood stream

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10
Q

what are the common places of spread of breast cancer via blood?

A

lungs, bones, liver, brain and ovaries

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11
Q

breast cancer that spreads via blood to the bones is identifiable how?

A

osteolytic bone lesions with pain being relieved by local radiation

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12
Q

what is more important extra-nodal spread or nodal spread?

A

Extranodal spread has greater significance than nodal metastasis.

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13
Q

what is Sentinel node biopsy?

A
  • Sampling of the initial node that drains the cancer.
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14
Q

what does a sentinel node biopsy that is negative tell you?

A

If negative for metastasis then the other nodes in that group are usually negative.

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15
Q

what does a sentinel node biopsy that is positive tell you?

A

If positive for metastasis then there is one third chance that other nodes in that group have metastasis.

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16
Q

Estrogen and progesterone receptor assay can be good for what?

A

it allows to identify if a cancer can be treated with tamoxifen (anti-estrogen)

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17
Q

what test can be done in order to determine if poor prognosis can be given?

A

erb 2 (HER-neu) amplification must be present

18
Q

most breast cancer are what type?

A

adenocarcinomas

19
Q

adenocarcinomas are derived from what cell?

A

glandular epithelium

20
Q

what are the 2 categories of breast cancer? and what are they’re limitations?

A

1) non-invasive or in situ cancer - limited to ducts and lobules and don’t metastasize
2) invasive cancer - metastasize by penetrating basement membrane

21
Q

what are the non-invasive cancers?

A

Ductal carcinoma in situ (DCIS)

Lobular carcinoma in situ

22
Q

what are the Invasive cancers?

A 
Infiltrating ductal carcinoma
Paget’s disease of breast (nipple)
Medullary carcinoma
Inflammatory carcinoma
Invasive lobular carcinoma
Tubular carcinoma
Colloid (mucinous) carcinoma
23
Q

what is a ductal carcinoma in situ?

A

malignant cells filling the ductal lumen that haven’t crossed the basement membrane

24
Q

what patterns are found in carcinoma in situ?

A

cribriform (sieve-like)

comedo (necrotic center that can undergo calcification)

25
Q

what is lobular carcinoma?

A

non-palpable mass with malignant cells appearing as solid clusters that pack and distend the lobules

26
Q

how is lobular carcinoma usually found? with lobular carcinoma there is an increased incidence of what?

A

its incidentally found on breast biopsy and there is increased incidence on the opposite breast

27
Q

what is an Infiltrating ductal carcinoma?

A

Invasion of the stroma by malignant cells causing desmoplasia (pronounced fibroblastic proliferation)

28
Q

what is another name for Infiltrating ductal carcinoma?

A

scirrhous carcinoma

29
Q

infiltrating ductal carcinoma is composed of what type of cell?

A

of malignat cells arranged in glandular pattern, solid nests and cords

30
Q

can infiltrating ductal carcinoma be felt?

A

yes i leads to masses that are hard and gritty that deform the breast

31
Q

what is paget’s disease of the nipple?

A

Is a variant of ductal carcinoma in situ or Invasive ductal carcinoma BUT involves the epidermis of the nipple or areola

32
Q

what is the clinical presentation of paget’s disease of the nipple?

A

Ulceration, oozing, fissuring and eczematous change (rash) in the skin of the nipple and areola.

33
Q

what is seen at micro level in pagets disease of the nipple?

A

large cells with clear cytoplasm

found singly or in groups within the epidermis

34
Q

what is a Medullary carcinoma? and how does it look?

A
  • lymphocytic infiltrate, associated with BRCA 1 mutation

- Has a soft fleshy consistency, tumor cells are large.

35
Q

what is a Inflammatory carcinoma?

A

Cancer cells block the lymphatics of the skin giving rise to orange peel appearance (peau d orange) (The skin appears reddish, swollen and hot – resembling an inflammatory process.)

36
Q

Invasive lobular carcinoma appears how?

A

tends to have cells arranged in linear fashion

37
Q

what should you know of Tubular carcinoma?

A

Develops in terminal ductules, increased incidence of cancer in opposite breast

38
Q

Colloid (mucinous) carcinoma occurs on who in the population? how does it look?

A

Usually occur in elderly women, neoplastic cells surronded by pools of extracellular mucin

39
Q

what is gynecomastia?

A

Refers to an enlargement of the adult male breast.

40
Q

why does gynecomastia happen?

A

Proliferation of glandular component in male breast

Caused by estrogen.

41
Q

what is the clinical presentation of gynecomastia?

A

bilateral Subareolar mass

42
Q

what can lead to gynecomastia?

A

Klinefelter’s
Cirrhosis - can’t metabolize estrogen
Spironolactone

Pathology 2 Block 2 (32 decks)

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