Malignant Breast Disease

Question 1

_____ pts are at significantly increased risk for development of invasive carcinoma in both breasts.

Answer 1

LCIS

Question 2

Dx? Found on mammo: Clonal proliferation of epithelial cells within the ducts leaving the myoepithelial layer with basement membrane intact

Answer 2

DCIS

Question 3

_____ is associated with a significant risk of developing invasive carcinoma in the ipsilateral breast.

Answer 3

DCIS

Question 4

What does Her2/neu normally do?

Answer 4

promotes cell growth

Question 5

Breast cancer in males most often clinically presents as _____.

Answer 5

a subareolar palpable mass

Question 6

DCIS is associated with a significant risk of developing ______.

Answer 6

invasive carcinoma in the ipsilateral breast

Question 7

When tumors occur in the _____ quadrant they preferentially spread to the internal mammary lymph nodes.

Answer 7

inner

Question 8

_____ pattern DCIS contains central necrosis and is always high grade.

Answer 8

Comedo

Question 9

Breast tumors that express estrogen and progesterone receptors have a _____ prognosis.

Answer 9

better

Question 10

BRCA1 or BRCA2: slightly increased risk for ovarian cancer increased risk for male breast CA

Answer 10

BRCA2

Question 11

What general cancer type is the most common primary breast CA?

Answer 11

carcinoma

Question 12

Where does a metastasis found in the breast usually come from?

Answer 12

hematologic malignancies (but also melanoma, lung, ovarian, kidney, prostate, and stomach)

Question 13

Dx?: composed of stromal and epithelial components and both arise from the stroma immediately surrounding the breast lobules (intralobular stroma) stromal growths covered by epithelium often forming a leaf-like appearance

Answer 13

Phylloides tumor - a type of Mixed (Biphasic) breast CA

Question 14

Chronic edema of the limb is associated with which breast CA?

Answer 14

angiosarcoma

Question 15

Pts presenting with Paget’s disease of the nipple often have an underlying _____.

Answer 15

invasive carcinoma

Question 16

BRCA1 or BRCA2: increased risk for ovarian cancer breast carcinomas have a distinct histologic appearance typically ER, PR and Her2/neu negative

Answer 16

BRCA1

Question 17

Dx? incidental finding of mulitcentric, bilateral, small, uniform cells with round nuclei filling the lobules and poorly adhering to adjacent cells

Answer 17

LCIS

Question 18

What genetic syndrome increases the risk of male breast CA?

Answer 18

Klinefelter’s

Question 19

What is the defect in Cowden syndrome?

Answer 19

mutation in PTEN

Question 20

How does Paget’s disease of the nipple present?

Answer 20

a scaly rash on the nipple with pruritus

Question 21

What is the curative tx for DCIS?

Answer 21

surgery

Question 22

LCIS pts are at significantly increased risk for development of ______.

Answer 22

invasive carcinoma in both breasts

Question 23

What is the defect in Li-Fraumeni Syndrome?

Answer 23

p53 mutation

Question 24

What is the most important prognostic factor in breast CA?

Answer 24

lymph node spread

Question 25

When tumors occur in the inner quadrant they preferentially spread to the ______ lymph nodes.

Answer 25

internal mammary

Question 26

Dx? Neoplastic DCIS cells grow from the ducts onto the adjacent skin without invading through the basement membrane of the ducts or skin

Answer 26

Paget's disease of the nipple

Question 27

Comedo pattern DCIS contains central necrosis and is always _____ grade.

Answer 27

high

Question 28

Comedo pattern DCIS contains _____ and is always high grade.

Answer 28

central necrosis

Question 29

What does CHEK2 normally do?

Answer 29

tumor suppression

Question 30

Lobular carcinoma uniquely will have ____ on histology due to loss of e-cadherin.

Answer 30

single file lines of cells

Question 31

What mutation increases the risk of male breast CA?

Answer 31

BRCA2

Question 32

What is the normal function of the BRCA genes?

Answer 32

tumor suppression (DNA damage repair)

Question 33

Dx?: well-circumscribed mass solid sheets of enlarged cells with high-grade nuclei and frequent mitoses; marked associated inflammation a pushing, rounded boarder triple negative BRCA1 +

Answer 33

Medullary carcinoma

Question 34

Dx?: presents in 5th decade Very well differentiated tumor composed of well-formed tubules and relatively bland appearing cells with low nuclear grade Hormone receptors w/o Her2/neu Excellent prognosis

Answer 34

tubular carcinoma

Question 35

Her2/neu overexpression is assoc. with a _____ prognosis.

Answer 35

poor

Question 36

Dx?: well-circumscribed mass in older age groups small islands of tumor cells floating in pale-blue lakes of mucin expresses hormone receptors most freq in BRCA1 mutation pts

Answer 36

Mucinous (colloid) carcinoma

Question 37

What does high grade DCIS often overexpress? Low grade?

Answer 37

high grade = Her2/neu low grade = hormonal receptors

Question 38

What is the defect in Peutz-Jeghers syndrome?

Answer 38

Mutation in STK11/LKB1

Question 39

What is the tx for Her2/neu + breast CA?

Answer 39

trastuzumab, Herceptin