Pathology - Malignant Breast Flashcards

1
Q

Malignant breast cancer usually arises from where and affects who?

A

terminal duct lobular unit.

post-menopausal women

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2
Q

HER-2 is what kind of receptor?

A

an EGF receptor

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3
Q

what does triple negative breast cancer mean?

A

triple negative (ER ⊝, PR ⊝, and Her2/Neu ⊝) more aggressive

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4
Q

Most important prognostic factor in early-stage disease?

A

Axillary Lymph Node involvement indicating metastasis

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5
Q

Where is breast cancer usually located?

A

Most often located in upper-outer quadrant of breast.

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6
Q

Why does obesity increase risk of breast cancer?

A

estrogen exposure as adipose tissue converts androstenedione to estrone

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7
Q

What obstetric and gynecologic risk factors are there for breast cancer? (3)

A

estrogen exposure, total number of menstrual cycles, older age at 1st live birth

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8
Q

What gene mutations increase risk of breast cancer?

A

BRCA1 and BRCA2 gene mutations

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9
Q

What group is at increased risk for triple negative breast cancer?

A

African Americans

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10
Q

What does Ductal Carcinoma in Situ arise from?

A

Arises from ductal atypia.

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11
Q

How does DIS present on mammography?

A

Often seen early as microcalcifications on mammography.

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12
Q

What is a subtype of DCIS that has Ductal, central necrosis

A

Comedocarcinoma

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13
Q

Paget disease of the breast results from what?

A

Results from underlying DCIS or invasive breast cancer.

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14
Q

What does Paget disease of the breast look like?

A

Eczematous patches on nipple

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15
Q

What are Paget Cells?

A

Paget cells = intraepithelial adenocarcinoma cells.

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16
Q

What presents as a firm, fibrous, “rock-hard” mass with sharp margins and small, glandular, duct-like cells

A

Invasive ductal carcinoma

17
Q

What is seen grossly in Invasive Ductal Carcinoma?

A

Grossly, see classic “stellate” infiltration.

18
Q

Most common breast cancer?

A

Invasive Ductal Carcinoma

19
Q

What has orderly row of cells “indian File”

A

Invasive lobular carcinoma

20
Q

What causes orderly row of cells in Invasive Lobular Carcinoma?

A

due to E-cadherin expression.

21
Q

How does Invasive Lobular Carcinoma present?

A

Often bilateral with multiple lesions in the same location.

22
Q

What breast cancer is fleshy, cellular, and has lymphocytic infiltrate?

A

Medullary carcinoma

23
Q

Prognosis for Medullary Carcinoma?

A

good prognosis

24
Q

What is Inflammatory breast cancer?

A

Dermal lymphatic invasion by breast carcinoma.

25
Q

What presents with Peau d’orange?

A

Inflammatory Breast Cancer

26
Q

How are lymphatics involved in inflammatory breast cancer?

A

neoplastic cells block lymphatic drainage.

27
Q

Prognosis of inflammatory breast cancer?

A

Poor prognosis (50% survival at 5 years)

28
Q

Don’t mistake Inflammatory breast cancer with what?

A

Often mistaken for Mastitis or Paget disease