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Block I: Reproduction & Sexuality > Pathology: Breast Cancer > Flashcards

Pathology: Breast Cancer Flashcards

1
Q

2 family history risk factors for breast cancer

A
  • Breast cancer
  • Ovarian cancer
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2
Q

5 personal history risk factors for breast cancer

A
  • BRCA 1/2 mutations
  • Bx with ADH
  • LCIS or DCIS
  • Dense breast tissue (mammogram)
  • Radiation
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3
Q

5 reproductive history risk factors for breast cancer

A
  • Early menarche (<12)
  • Late menopause
  • Late age at first term pregnancy
  • Nulliparity
  • HRT
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4
Q

3 lifestyle risk factors for development of breast cancer

A
  • Weight
  • Sedentary life
  • Alcohol consumption
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5
Q

3 precursors to breast cancer

A
  • Ductal epithelial hyperplasia
  • Atypical ductal hyperplasia
  • Ductal carcinoma in situ - invasive carcinoma
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6
Q

3 minor lesions of the breast

A
  • Supernumerary nipple
  • Congenital inversion of the nipple
  • Galactocele
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7
Q

Findings of nonproliferative fibrocytic changes on histology

A
  • Cysts (blue dome)
  • Fibrosis
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8
Q

4 moderate risk (1.5x) findings of proliferative fibrocytic changes in histology

A
  • Hyperplasia
  • Sclerosing adenosis (mimicking carcinoma)
  • Florid hyperplasia
  • Sclerosing adenosis
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9
Q

2 high risk (5x) findings of proliferative fibrocytic changes

A

Atypical hyperplasia

Ductal/lobular

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10
Q

3 types of in-situ carcinomas of the breast

A
  • Ductal carcinoma in-situ (DCIS)
  • Lobular carcinoma in-situ (LCIS)
  • Mammary Paget Disease
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11
Q

7 types of invasive carcinomas

A
  • Ductal
  • Lobular
  • Medullary
  • Tubular
  • Mucinous
  • Micropapillary
  • Metaplastic Breast Cancer
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12
Q

Most common invasive breast carcinoma

A

Ductal NOS

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13
Q

Profile of lobular invasive carcinoma (5)

A
  • E-cadherin negative
  • ER+
  • PR+
  • Her2 -
  • May not feel as mass
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14
Q

Profile of medullary invasive carcinoma

A
  • Good prognosis
  • Triple negative
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15
Q

Profile of tubular invasive carcinoma (4)

A
  • Very good prognosis
  • ER+
  • PR-
  • Her2-
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16
Q

Profile of mucinous invasive carcinoma (5)

A
  • Good prognosis
  • Older patients
  • ER+
  • PR+
  • Her2-
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17
Q

Type of invasive carcinoma that has frequent lymph node metastasis

A

Micropapillary

18
Q

Profile of metaplastic breast cancer (2)

A
  • Heterogenous group
  • Usually triple negative
19
Q

Modified Scharff-Bloon-Richardson Grading System

A
  • Well-differentiated / low grade (I/III)
  • Intermediate grade (II/III)
  • Poorly differentiated / high grade (III/III)
20
Q

If e-cadherin positive, what is the type of breast cancer?

A

Ductal

21
Q

If e-cadherin is negative, what is the type of breast cancer?

A

Lobular

22
Q

Profile of breast cancer that tends to metastasize to brain

A
  • Triple negative
  • Her2+
23
Q

3 other common breast lesions aside from carcinomas

A
  • Fibroepithelial lesions
    • Fibroadenoma
    • Phyllodes tumor
  • Papilloma
24
Q

Most common breast tumor in young women

A

Fibroadenoma

NOTE: Usually appears before 30 and can regress after menopause

25
Q

Gross appearance of fibroadenoma

A
  • Round
  • Rubbery (can compress it)
  • Well-circumscribed
26
Q

Risk of cancerous progression of fibroadenoma

A

None

27
Q

Histological profile of fibroadenoma

A

Biphasic (stromal and epithelial)

NOTE: Carcinoma = epithelial only

28
Q

Histological profile of phyllodes tumor

A

More pronounced stroma; very cellular (can make a sarcoma)

29
Q

7 prognostic factors of breast cancer

A
  • Axillary lymph node status
  • Tumor size
  • Vascular invasion
  • Grade
  • Tumor subtype
  • ER/PR expression
  • Her2
  • Overexpression/amplification
30
Q

3 predictive factors of breast cancer

A
  • ER/PR
  • HER2
  • Oncotype DX (RT-PCR – 21 GENES, RECURRENCE SCORE)
    • Predict benefit from chemotherapy and hormonal therapy
31
Q

5 treatments for breast cancer

A
  • Surgery
  • Radiation therapy
  • Hormonal therapy
  • Chemotherapy
  • Targeted therapy: herceptin, lapatinib
32
Q

4 intrinsic subtypes of breast cancer

A
  • Luminal A (ER+ and/or PR+, HER2-)
  • Luminal B (ER+ and/or PR+, HER2+)
  • HER2 (ER-)
  • Basal-Like (Triple negative, cytokeratin 5/6+ and or/ EGFR+)
33
Q

Most common subtype of breast cancer

A

Luminal A

34
Q

Prognosis of Luminal A breast cancer subtype

A
  • Less aggressive
  • Lower histological grade
  • Good prognosis
  • Hormone responsive
35
Q

Risk factor for Luminal A breast cancer

A

Associated with increasing age

36
Q

Which Luminal subtype has a worse outcome?

A

Luminal B

37
Q

Prognosis of HER2+ (ER-) breast cancer subtype

A
  • Highly aggressive
  • High grade histology
  • Outcome improved with HER2
38
Q

2 risk factors for HER2+ (ER-) breast cancer subtype

A

Risk as young age greater than luminal subtypes

African American ethnicity may be factor

39
Q

Prognosis of basal-like breast cancer

A

Aggressive

High-grade histology

High mitotic rate

40
Q

Risk factors for basal-like breast cancer

A

Younger age (<40)

More likely premenopausal African American women

Block I: Reproduction & Sexuality (23 decks)

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