Malignant Breast Conditions Flashcards
What is the definition of breast carcinoma?
A malignant tumour of breast epithelial cells
Where does breast carcinoma arise from?
The terminal duct lobular unit
What type of cancer in breast carcinoma?
Adenocarcinoma
Where exactly is the hyperplasia in DCIS?
Epithelium
What is meant by an in situ carcinoma?
A carcinoma that is within the basement membrane consisting of acini and ducts
What is the difference between atypical lobular hyperplasia and lobular carcinoma in situ?
In ALH less than 50% of the lobule is involved; in LCIS more than 50% of the lobule is involved
What gene is there a deletiona dn mutation of in lobular in situ neoplasia?
CDH1 gene on chromosome 16
What protein marker is lost in lobular in situ neoplasia?
E Cadherin negative
Are lobular in situ neplasia’s ER negative or Er positive?
ER positive
Does the incidence of lobular in situ neoplasia increase or decrease after menopause?
Decreases
What is the management for a lobular in situ neoplasia found on core biopsy?
Excision or vacuum biopsy to exclude higher grade biopsy
What are the 4 types of ductal proliferations?
Epithelial hyperplasia of usual type
Columnar cell change
Atypical ductal hyperplasia
Ductal Carcinoma in situ
Is LCIS or DCIS more likely to be multifocal?
LCIS
Is LCIS or DCIS more likely to be from a single duct system?
DCIS
What is the definition of an invasive carcinoma?
Malignant epithelial cells have breached the basement membrane and infiltrated normal tissues.
List some of the risk factors for breast carcinoma
- Age
- Early menarche, nulliparity, no breastfeeding, late menopause (Due to unopposed oestrogen)
- OCP, HRT
- Obesity
- Alcohol
- Smoking
- Genetics
Which is the most common type of invasive breast cancer?
Ductal
What is meant by tumour grade?
How well differentiated the tumour is
What three things are assessed when calculating the histological grade of a breast tumour?
- Tubular differentiation (scored from 1 - 3)
- Nuclear pleomorphism (scored from 1 - 3)
- Mitotic activity (scored from 1 - 3)
What hormonal treatment in given to pre menopausal women with ER+ breast cancer?
Tamoxifen
What hormonal treatment in given to post menopausal women with ER+ breast cancer?
Aromatase inhibitors such as letrozole
What does HER2 stand for?
Human Epidermal Growth Factor 2
What drug is given to HER2+ tumours?
Trastuzamab (Herceptin)
What three things does the nottingham prognostic indicator take into consideration?
Tumour size
Tumour Grade
Lymph node status
Which type of breast cancer, in term of hormone receptors, has the worst prognosis?
Triple negative
Who should get an US scan instead of a mammogram in triple assessment?
Women under 40
What do patients who have a wide local excision for breast cancer always need?
Adjuvant radiotherapy
Where do both ductal and lobular breast cancers arise from?
The terminal duct lobular unit
