Pathology - Malignant Breast Flashcards
Malignant breast cancer usually arises from where and affects who?
terminal duct lobular unit.
post-menopausal women
HER-2 is what kind of receptor?
an EGF receptor
what does triple negative breast cancer mean?
triple negative (ER ⊝, PR ⊝, and Her2/Neu ⊝) more aggressive
Most important prognostic factor in early-stage disease?
Axillary Lymph Node involvement indicating metastasis
Where is breast cancer usually located?
Most often located in upper-outer quadrant of breast.
Why does obesity increase risk of breast cancer?
estrogen exposure as adipose tissue converts androstenedione to estrone
What obstetric and gynecologic risk factors are there for breast cancer? (3)
estrogen exposure, total number of menstrual cycles, older age at 1st live birth
What gene mutations increase risk of breast cancer?
BRCA1 and BRCA2 gene mutations
What group is at increased risk for triple negative breast cancer?
African Americans
What does Ductal Carcinoma in Situ arise from?
Arises from ductal atypia.
How does DIS present on mammography?
Often seen early as microcalcifications on mammography.
What is a subtype of DCIS that has Ductal, central necrosis
Comedocarcinoma
Paget disease of the breast results from what?
Results from underlying DCIS or invasive breast cancer.
What does Paget disease of the breast look like?
Eczematous patches on nipple
What are Paget Cells?
Paget cells = intraepithelial adenocarcinoma cells.
What presents as a firm, fibrous, “rock-hard” mass with sharp margins and small, glandular, duct-like cells
Invasive ductal carcinoma
What is seen grossly in Invasive Ductal Carcinoma?
Grossly, see classic “stellate” infiltration.
Most common breast cancer?
Invasive Ductal Carcinoma
What has orderly row of cells “indian File”
Invasive lobular carcinoma
What causes orderly row of cells in Invasive Lobular Carcinoma?
due to E-cadherin expression.
How does Invasive Lobular Carcinoma present?
Often bilateral with multiple lesions in the same location.
What breast cancer is fleshy, cellular, and has lymphocytic infiltrate?
Medullary carcinoma
Prognosis for Medullary Carcinoma?
good prognosis
What is Inflammatory breast cancer?
Dermal lymphatic invasion by breast carcinoma.
What presents with Peau d’orange?
Inflammatory Breast Cancer
How are lymphatics involved in inflammatory breast cancer?
neoplastic cells block lymphatic drainage.
Prognosis of inflammatory breast cancer?
Poor prognosis (50% survival at 5 years)
Don’t mistake Inflammatory breast cancer with what?
Often mistaken for Mastitis or Paget disease
