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Malignant breast tumors Flashcards

1
Q

Malignant breast tumors - epidemiology

A
  1. commonly non-menopausal

2. african american

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2
Q

Malignant breast tumors - usually arises from

A

terminal duct lobular unit

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3
Q

Malignant breast tumors - genetics

A

overexpression of estrogen/progesterone receptors or c-erbB12 (HER-2, an EGF receptor) is common

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4
Q

Malignant breast tumors - is more aggressive if

A

triple negative (ER-, PR-, Her2/Neu-)

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5
Q

Malignant breast tumors - type affect

A

therapy and prognosis

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6
Q

Axillary lymph node involvement indicates

A

metastasis –> the most important prognostic factor in early stage disease

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7
Q

the most important prognostic factor in early stage disease

A

Axillary lymph node involvement

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8
Q

Malignant breast tumors - most often located … (grossly)

A

upper-outer quadrant of breast

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9
Q

Malignant breast tumors - risk factors

A
  1. High estrogen exposure
  2. increased total number of menstrual cycles
  3. older age at 1st live birth
  4. obesity M
  5. BRCA1/2 mutation
  6. African American (TRIPLE -)
  7. Peutz-Jeghers syndrome
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10
Q

malignant breast tumors - obesity is a risk factor - mechanism

A

high estrogen exposure as adipose tissue converts androstenedione to estrone

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11
Q

Malignant breast tumors - are divided to

A

noninvasive and invasive

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12
Q

Malignant breast tumors - noninvasive - types

A
  1. Ductal carcinoma in situ (DCIS)
  2. Comedocarcinoma (subtype of DCIS)
  3. Paget disease (subtype of DCIS)
  4. Lobular carcinoma in situ (LCIS)
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13
Q

Ductal carcinoma in situ of breast - histology

A
  • neoplastic cells fillls ductal lumen

- engorged blood vessels

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14
Q

Ductal carcinoma in situ of breast - arises from

A

ductal atypia

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15
Q

Ductal carcinoma in situ of breast - presentation

A
  • often seen early as MICROCALCIFICATIONS in mammography

- usually does not produce mass

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16
Q

breast comedocarcinoma

A

Ductal, central necrosis and dystrophic calcification (Subtype of DCIS)

17
Q

breast - Paget disease results from

A

Results from underlining DCIS or invasive breast cancer

18
Q

breast - Paget disease presentation

A

Eczematous patches on nipple

19
Q

breast - Paget disease - paget cells?

A

intraepithelial adenocarcinma cells

20
Q

Malignant breast tumors - invasive - types (and MC)

A
  1. invasive ductal carcinoma (MC - 75% of all breast ca)
  2. Invasive lobular carcinoma
  3. Medullary carcinoma
  4. Inflammatory breast cancer
21
Q

breast - invasive ductal carcinoma - frequency

A

MC (75%) of all breast invasive cancers

22
Q

breast - invasive ductal carcinoma - presentation

A
  • firm, fibrous, rock hard mass with sharp margins (2cm or greater)
  • advance: dippling of the skin or retraction of nipple
23
Q

breast - invasive ductal carcinoma - histology

A

small, glandular, duct-like cells (duct like structures) –> stellate infiltration

24
Q

Invasive lobular carcinoma - histology

A

orderly row of cells (INDIAN FILE)

25
Q

invasive lobular carcinoma - SPECIAL characteristic

A

downregulation of E-cadherin expression –> orderly row of cells (INDIAN FILE)

26
Q

Invasive lobular carcinoma - presentation

A

often bilateral with multiple lesions in the same location

27
Q

breast - Medullary carcinoma - histology

A

fleshy, cellular, lymphocytic infiltrate

28
Q

breast - Medullary carcinoma - gross appearance

A

well circumscribed mass mimicking fibroadenoma in mammography

29
Q

breast - Inflammatory breast cancer

A

Dermal lymphatic invasion by breast carcinoma –> they block lymphatic drainage

30
Q

breast - Inflammatory breast cancer presentation

A

Peau d’orange: breast skin resembles orange peel

31
Q

breast - Inflammatory breast cancer - often mistaken with

A

mastitis or Paget disease

32
Q

breast - Inflammatory breast cancer vs medullary according to prognosis

A

medullary –> good

Inflammatory breast cancer –> poor (50% surv at 5 yrs)

33
Q

Lobular carcinoma in situ?

A
  • malignant proliferation of lobular cells without invasion
  • no mass or calcification
  • low e-cadherin
  • often multifocal or bilateral
34
Q

situations with calcification in mammography

A
  1. Ductal in situ and invasive
  2. sclerosing adenosis
  3. fat necrosis

Reproductive (20 decks)

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