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breast > Robbins > Flashcards

Robbins Flashcards

1
Q

Discharge associated with malignancy is most commonly due to

A

ductal carcinoma in situ (DCIS)

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2
Q

most common benign masses in the breasts

A

fibroadenomas and cysts

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3
Q

Approximately 50% of breast carcinomas are located in what quadrant of the breast?

A

upper outer

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4
Q

Squamous metaplasia of lactiferous ducts is alsso known as (3)

A

recurrent subareolar abscess, periductal mastitis, and Zuska disease

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5
Q

key feature of squamous metaplasia of lactiferouducts

A

keratinizing squamous metaplasia

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6
Q

lesion most common in women with type 1 (insulin-dependent) diabetes or autoimmune thyroid disease and is hypothesized to have an autoimmune basis

A

lymphocytic mastopathy

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7
Q

three principal nonproliferative morphologic changes in the breast

A

cystic change, fibrosis, and adenosis

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8
Q

Microscopically, there is an increase in dense collagenous connective tissue associated with epithelial hyperplasia of the duct lining. Lobule formation is almost never observed.

A

gynecomastia

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9
Q

Gynecomastia also rarely occurs as a part of this syndrome

A

Klinefelter syndrome (XXY karyotype)

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10
Q

T/F Lesions characterized by proliferation of epithelial cells, without atypia, are associated with a small increase in the risk of subsequent carcinoma in either breast

A

True

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11
Q

is a clonal proliferation having some, but not all, of the histologic features of carcinoma in situ

A

Atypical hyperplasia

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12
Q

give the relative risk:
Non proliferative breast changes

A

1

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13
Q

give the relative risk:
Proliferative disease without atypia

A

1.5 - 2

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14
Q

give the relative risk:
Proliferative disease with atypia

A

4 -5

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15
Q

give the relative risk:
Carcinoma in situ

A

8 - 10

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16
Q

is the most common and deadly malignancy of women globally

A

breast carcinoma

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17
Q

are defined as being positive for ER and negative for HER2

A

luminal cancers

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18
Q

are defined as cancers overexpressing HER2 and can be either ER-positive or ER-negative

A

HER2 cancers

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19
Q

are cancers that are negative for ER and HER2. These cancers are termed as such because they also fail to express progesterone receptor (PR), which is under the control of ER

A

tripple negative cancers

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20
Q

> 4 relative risk factors for developing breast cancer (6)

A

-female gender
-increasing age
-strong family hx (>1 relative, young multiple CA)
-personal hx of breast cancer
-high breast density
-germline mutation with high penetration

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21
Q

2.1 - 4 relative risk factors for developing breast cancer (3)

A

-germline mutation of moderate penetrance
-high dose radiation to chest at young age
-family history (1 1st degree relative)

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22
Q

Based on gene expression profiling:
luminal

A

ER+ HER2-

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23
Q

Based on gene expression profiling:
HER2-enriched

A

HER2+

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24
Q

Based on gene expression profiling:
basal-like

A

ER- HER2-

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25
Q

most common gene mutation associated with hereditary susceptibility to breast cancer

A

BRCA1

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26
Q

mutation that confers a smaller risk for ovarian carcinoma (10% to 20%) but is associated more frequently with male breast cancer

A

BRCA2

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27
Q

process in which a normal sister chromatid is used as a template for repairing the DNA break

A

homologous recombination

28
Q

dominant pathway of breast cancer development, constituting 50% to 65% of cases

A

ER positive pathway

29
Q

luminal subgroup with low growth fractions

A

Luminal A

30
Q

luminal subgroup with high levels of expression of genes associated with proliferation

A

luminal B

31
Q

luminal subgroup that does not respond well to cytotoxic chemotherapy

A

luminal A

32
Q

most common subtype of breast cancer in patients with germline TP53 mutations (Li-Fraumeni syndrome)

A

HER-2 positive breast cancers

33
Q

is a receptor tyrosine kinase that promotes cell proliferation and opposes apoptosis by stimulating the RAS- and PI3K-AKT signaling pathways.

A

HER2

34
Q

all breast carcinomas arise from cells in the

A

terminal duct lobular unit

35
Q

T/F many of the molecular changes found in invasive breast carcinomas also are found in breast carcinoma in situ

A

True

36
Q

dcis morphology that may occasionally produce a vague nodularity, but more often is detected as clustered or linear and branching areas of calcification

A

comedo

37
Q

major risk factors for recurrence in dcis are (3)

A

high nuclear grade and necrosis
extent of disease
positive surgical margins

38
Q

The observed loss of cellular adhesion in LCIS is usually due to dysfunction of this protein

A

E-cadherin

39
Q

Gene for e-cadherin

A

CDH1

40
Q

DCIS is usually ER __ HER2__

A

ER- HER2+

41
Q

LCIS is usually ER____ HER2____

A

ER+ Her2-

42
Q

Paget disease does not occur in this in-situ lesion

A

LCIS

43
Q

breast carcinoma subtype with biallelic loss of expression of CDH1

A

Lobular carcinoma

44
Q

over half of BRCA1-associated carcinomas have this subtype appearance

A

carcinomas with medullary pattern

45
Q

hyper/hypo methylation of BRCA1 promoter leads to downregulation of BRCA1 expression

A

hyper

46
Q

Some special histologic types of cancer almost always fall within the luminal (ER-positive/HER2-negative) group namely (4)

A

lobular, mucinous, tubular, papillary

47
Q

Two special histologic types frequently overexpress HER2 namely (2)

A

apocrine and micropapillary

48
Q

TNBC (ER-negative, HER2-negative) often corresponds to one of several special histologic types (2)

A

carcinoma with medullary features and metaplastic carcinoma

49
Q

prognostic/predictive/both?

Factors related to tumor biology are usually

A

both prognostic and predictive

50
Q

prognostic/predictive/both?

factors related to tumor extent are

A

prognostic

51
Q

most important prognostic factor for invasive carcinoma in the absence of distant metastases

A

Lymphnode metastases

52
Q

breast cancer complication of infiltration of the skin and ulceration

A

carcinoma en cuirasse

53
Q

Breast CAP T staging:
pT1mi
PT1a
pT1b
pT1c
pT2
pT3
pT4a
pT4b
pT4c

A

pT1mi </=0.1 cm
PT1a >0.1 </=0.5
pT1b >0.5 </= 1cm
pT1c >1 </=2 cm
pT2 >2 </=5
pT3 >5cm
pT4a invasion of chest wall
pT4b ulceration/edema of skin
pT4c both a and b

54
Q

T/F invasion of pectoralis muscle is staged in CAP as pT4a

A

false, pT4a is invasion of chest wall (intercostal muscles or deeper) which is rarely included in mastectomy specimens

55
Q

The most important familial factor conferring an increased risk for male breast cancer is germline mutation of the

A

BRCA2 tumor suppressor gene

56
Q

More than 90% of breast cancers in males are of what molecular subtype?

A

luminal ER+ HER2-

57
Q

T/F prognosis in male breast cancer is similar to that of women when matched for stage.

A

T

58
Q

two types of stroma in the breast

A

intralobular and interlobular

59
Q

two breast specific tumors that arise from cells of the intralobular stroma

A

fibroadenoma and phyllodes tumor

60
Q

Both fibroadenoma and phyllodes tumor are driven by somatic mutations in

A

MED12

61
Q

most common benign tumor of the female breast

A

Fibroadenoma

62
Q

half of women receiving this after renal transplantation developed multiple, bilateral fibroadenomas that regress after cessation of treatment

A

cyclosporin A

63
Q

features of complex fibroadenoma (4)

A

cysts larger than 0.3 cm, sclerosing adenosis, epithelial calcifications, or papillary apocrine change

64
Q

phyllodes tumors that display malignant behavior are more likely to have mutations in additional genes, such as

A

TERT

65
Q

Features of malignant phyllodes (5)

A

-Stromal overgrowth (4x field without epithelium)
-Increased mitoses (≥10 per 10 HPFs)
-Increased stromal cellularity (Often diffuse)
-Infiltrative borders
-Malignant heterologous elements (except well-differentiated liposarcoma,
as it has a low metastatic risk)

66
Q

Malignant Tumor of Interlobular Stroma that arises as a complication of therapy

A

angiosarcoma

67
Q

Young women with this type of lymphoma may present with massive bilateral breast involvement, often while pregnant or lactating

A

Burkitt

breast (1 decks)

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