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MCC > MCC final > Flashcards

MCC final Flashcards

1
Q

What is the functional unit of the breast?

A

the terminal duct-lobular unit (TDLU)

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2
Q

What is galactorrhea?

A

breast milk production outside of lactation

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3
Q

What are three primary causes of galactorrhea?

A

Nipple stimulation
prolactinoma of AP
drugs

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4
Q

What is the name for the most common breast changes in premenopausal women?

A

fibrocystic changes

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5
Q

What are two notable features of fibrocystic changes on a gross exam?

A

-Vague irregularity of breast tissue “lumpy bumpy”

-“blue dome” cyst presentation

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6
Q

What characterizes sclerosing adenosis? What is the associated increase risk of carcinoma?

A

too many glands in lobule, with accompanying fibrosis notable for calicification; 2x normal risk

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7
Q

What characterizes an intraductal papilloma?

A

a papillary lesion within the duct which often leads to bloody nipple discharge

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8
Q

How is intraductal papilloma best distinuished from papillary carcinoma?

A

Benign proliferations of epithelium with posess BOTH layers (luminal and myoepithelial)

Carcinomas will only have ONE layer of epithelium (myoepithelial absent in PC)

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9
Q

What is the most common benign tumor of the breast?

A

Fibroadenoma

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10
Q

What is the most common tumor in a premenopausal female?

A

Fibroadenoma

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11
Q

What type of pathology is indicated here?

A

Fibroadenoma

Note sharp demarcation from normal tissue, and extra glands and fibrous tissue

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12
Q

What three things are most noteworthy about a fibroadenoma?

A

Well-circumscribed marble-like mass

Estrogen sensitive

No increasd risk for carcinoma

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13
Q

How is a phyllodes tumor different from a fibroadenoma?

A

A phyllodes tumor involves an overgrowth of the FIBROUS component

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14
Q

Out of a fibroadenoma and a phyllodes tumor, which have potential for malignancy?

A

Phyllodes tumor

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15
Q

What type of pathology is indicated here?

A

Phyllodes tumor

Note the “leaf like” projections

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16
Q

What type of pathology is indicated here?

A

Intraductal papilloma

Note the growth of the papilloma into the milk duct

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17
Q

What pathology is indicated here?

A

fibrocystic changes

Note the bluish hue to the conglomerates in the cyst

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18
Q

What pathology is indicated here?

A

Atypical ductal hyperplasia

Note the clonal proliferations that partially fill involved ducts

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19
Q

What is the relative risk for carcinoma in a discovery of atypical ductal hyperplasia?

A

5x

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20
Q

What differentiates usual from atypical ductal hyperplasia?

A

atypical presents with clonal cells of similar size and shape

21
Q

What pathology is indicated here?

A

Proliferative disease without atypia (usual ductal hyperplasia)

Note the variance in cell size

22
Q

What pathology is indicated here?

A

Atypical lobular hyperplasia

23
Q

What are the three general types of DCIS?

A

Comedo DCIS
Noncomedo DCIS
Paget disease

24
Q

What is the typical treatment for DCIS?

A

Localized excision and radiation therapy (breast conserving therapy)

25
Q

What pathology is indicated here?

A

Comedo DCIS

Note the poor differentiation of cells inside the ducts

26
Q

What pathology is indicated here?

A

Papillary carinoma (papillary DCIS)

Note how there is only one layer of epithelial cells for the duct (two would indicate intraductal papilloma)

27
Q

What pathology is indicated here?

A

Lobular carcinoma in situ (LCIS)

28
Q

What significant phenotype/genotype is the same for atypical lobular hyperplasia, invasive lobular carcinoma and LCIS?

A

estrogen receptor +
E-cadherin -

29
Q

What is the usual treatment for LCIS?

A

Usually tamoxifen
usually not surgery

30
Q

What are the relative risks of invasive carcinoma with DCIS or LCIS?

A

8-10x

31
Q

What are the four most significant risks for breast cancer?

A

female gender
increasing age
personal history
family history
(there are many more)

32
Q

What are the defining characteristics of a luminal breast cancer?

A

ER+
Her2-

33
Q

What are the defining characteristics of a HER2 cancer?

A

Her2+
ER+/-

34
Q

What is the defining characteristic of a triple negative breast cancer?

A

ER-
PR-
HER2-

35
Q

Male breast cancer is more likely related to a BRCA1 or BRCA2 mutation?

A

BRCA2

36
Q

Ovarian and female breast cancer is more likely related to a BRCA1 or BRCA 2 mutation?

A

BRCA1

37
Q

Using the Notingham scoring system, what grade of invasive breast carcinoma is indicated here?

A

Grade 1

Note hyperplasia of small, clonal cells with some stroma present

38
Q

Using the Notingham scoring system, what grade of invasive breast carcinoma is indicated here?

A

Grade 2

Note the vast hyperplasia of small, clonal cells with very little fibrous tissue

39
Q

Using the Notingham scoring system, what grade of invasive breast carcinoma is indicated here?

A

Grade 3

Note the extreme hyperplasia of small, clonal cells with almost no fibrous tissue visible, as well as high mitotic activity of cells

40
Q

What are the four general subtypes of invasive ductal carcinoma?

A

Tubular carcinoma
Medullary carcinoma
Mucinous carcinoma
Inflammatory carcinoma

41
Q

What pathology is indicated here?

A

Mucinous carcinoma

Note malignant cells floating in mucus pools

42
Q

Which two subtypes of invasive ductal carcinoma have a good prognosis? Which has the worst prognosis?

A

Tubular and mucinous carcinoma

Inflammatry carcinoma

43
Q

What pathology is indicated here?

A

Tubular carcinoma

Note the desmoplastic stroma (blue-gray color), loss of two epithelial cell types

44
Q

What pathology is indicated here?

A

medullary carcinoma

Note the high grade malignant tumor cells with many inflammatory cells in background

*increased liklihood in BRCA1 mutations

45
Q

What is a prognostic factor?

A

A factor providing information on clinical outcome at the time of dx independent of therapy

46
Q

What is a predictive factor?

A

A factor providing information on the likelihood of a response to a given treatment

47
Q

What are major prognostic factors for breast cancer?

A

Distant metastases (M)
Regional lymph nodes (N)
Tumor extent (T)
Tumor grade
ER, PR and HER2 expression
special histologic types

48
Q

What are major predictive factors of breast cancer?

A

ER, PR and HER2 expression
proliferation markers

49
Q

What is meant by the ABCD warning signs of melanoma?

A

A- asymmetry
B- border (irregular)
C- color (multiple)
D- diameter (>6mm)

MCC (10 decks)

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