Malignant Breast Disease

Question 1

Both BRCA genes cary an increased risk for ovarian cancer. Which BRCA gene carries more of a risk?

Answer 1

BRCA1

Question 2

Which BRCA gene is associated with an increased risk in male breast cancer?

Answer 2

BRCA2

Question 3

What cancer syndrome, associated with breast cancer, is due to a mutation in P53?

Answer 3

Li-Fraumeni syndrome

Question 4

Aside from breast cancer, what other cancers are associated with Li-Fraumeni syndrome?

Answer 4

Sarcoma
(Breast)
Leukemia
Adrenal gland
(SBLA cancer syndrome)

Question 5

What is the p53 gene product?

Answer 5

p53 protein induces expression of p21

p21- TF that inhibits transition from G1 to S phase

Question 6

What chromosome is p53 on?

Answer 6

17

Question 7

What is the most important risk factor for a woman to develop breast cancer?

Answer 7

Age

Question 8

What is DCIS that involves the nipple?

Answer 8

Paget disease

Question 9

DCIS has 5 classic patterns. Describe the comedocarcinoma pattern.

Answer 9

Central area of necrosis

Question 10

Low grade DCIS often expresses what hormonal receptors?

Answer 10

Estrogen

Progesterone

Question 11

High grade DCIS often overexpress what receptor?

Answer 11

Her2/neu

Question 12

What is the standard of care for DCIS?

Answer 12

Surgery

Question 13

DCIS (especially the solid pattern) can be difficult to distinguish from LCIS. How can the molecular properties of LCIS be used to distinguish between the two?

Answer 13

LCIS has decreased expression of E-cadherin

E-cadherin is a cell to cell adhesion molecule

Question 14

Does LCIS or DCIS form calcifications?

Answer 14

DCIS

Question 15

Detail the increased risk for invasive carcinoma if a woman has DCIS vs LCIS.

Answer 15

DCIS- higher risk in ipsilateral breast

LCIS- higher risk in both breast

Question 16

Does LCIS increase risk for invasive ductal or lobular carcinoma?

Answer 16

Both

Question 17

What is the most common location of invasive carcinoma of the breast?

Answer 17

Upper outer quadrant

Question 18

What is the most common breast cancer?

Answer 18

Invasive ductal carcinoma

Question 19

Invasive carcinoma extends beyond the basement membrane into the stroma. What cells that are part of the normal TDLU architecture are lost in carcinoma?

Answer 19

Myoepithelial cells

Question 20

What breast tumor is well differentiated; always ER/PR positive, HER2 negative; and has a good prognosis?

Answer 20

Tubular carcinoma

Question 21

Typically breast tumors that are “triple negative” portend a poor prognosis. Given this fact, why is it important to identify a medullary carcinoma?

Answer 21

Triple negative tumor

Good prognosis

Question 22

An angiosarcoma of the breast is associated with what risk factors?

Answer 22

Radiation
Chronic edema (Stewart-Treves syndrome)

Question 23

What is the composition of a Phyllodes tumor?

Answer 23

Stroma
Epithelium
(leaf like appearance)

Question 24

What is the most important prognostic factor for breast cancer?

Answer 24

Lymph node involvement