Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Bloc I - Reproduction > Sept12 M1,2-Breast Cancer > Flashcards

Sept12 M1,2-Breast Cancer Flashcards

1
Q

RFs for breast ca

A
  • > 50
  • FHx breast or ovarian ca
  • PHx BRCA1 or 2 mut or bx with breast lesion
  • estrogen: early menarche, late menopause, late age at first term pregnancy, nulliparity, HRT
  • lifestyle (weight, sedentary life, alcohol consumption)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

3 screening methods

A
  • mammography (every 2 years for 50-75)
  • self breast exam
  • clinical PE
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

most common breast ca presentation + others

A
  • mammogram
  • painless mass
  • skin changes
  • nipple abnormalities
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

(IMP) most common site of dev for breast cancer

A

upper outer quadrant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

(IMP) where beast cancer arises

A

terminal duct lobular unit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

possible breast pathologies

A
  • fibrocystic changes (non atypical OR atypica hyperplasia either ductal, lobular of flat epithelial)
  • in-situ CA (ductal and lobular)
  • invasive CA
  • fibroepithelial lesions (fibroadenoma and phyllodes tumor)
  • papilloma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

(IMP) tx of non atypical fibrocystic disease

A

no tx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

tx of atypical fibrocystic disease (hyperplasia) like ADH (atypical ductal hyperplasia) or ALH (atypical lobular hyperplasia)

A

consider surgical excision

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

fibrocystic changes on histo

A
  • cells of cystic spaces have apocrine metaplasia
  • sweat gland like
  • eosinophilic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

3 types of in situ CAs of the breast

A
  • DCIS (ductal carcinoma in situ): precursor to invasive CA. HAS CADHERIN.
  • LCIS (lobular): precusor lesion + marker of increased risk for invasive CA. NO CADHERIN
  • Paget disease (DCIS extendign in skin by travelling in duct)
  • NOT invasive
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

two main subtypes of LCIS

A
  • classic

- pleiomorphic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

classical LCIS tx

A

follow up

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

DCIS and pleiomorphic LCIS tx

A

excise

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

DCIS vs invasive CA

A

DCIS didn’t invade the stroma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

DCIS most common detection

A

CALCIFICATIONS on mammography

-DCIS doesn’t form a mass

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

DCIS subtypes

A
  • low grade (less likely ca)

- high grade (higher risk of invasive ca)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

high grade DCIS on histo

A
  • atypia
  • mitosis
  • necrosis
  • calcifications
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Paget disease symptoms

A
  • eczematous (red) nipple

- red bc inflammatory reaction to cancer cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

LCIS vs DCIS on histo

A
  • LCIS more detached cells bc no cadherin

* cadherin positive = DCIS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

3 types of classification of invasive CA

A
  • histological classif (ductal, lobular, mucinous, medullary, tubular)
  • based on R expression (ER+ or ER-, HER2+ or HER2-, triple negative)
  • molecular classif (luminal A, luminal B, HER2 enriched, basal type)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

link between molecular classif and R classif

A
  • luminal A and B = ER+, HER2-

- basal type = triple negative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

most common type of breast ca

A

ductal CA NOS (histo classif) NOS = not otherwise specified. that’s the name and that’s it

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

(IMP) lobular CA: what Rs and markers

A
  • ER+
  • PR+
  • HER2-
  • cadherin negative (like LCIS counterpart)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

(IMP) medullary CA charact, Rs, etc.

A
  • triple negative (ER-, PR-, HER2-).
  • circumscribed
  • differs from all other breast cas in that it is circumscribed
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

(IMP) tubular CA markers

A
  • ER+
  • PR+
  • HER2-
  • like lobular and tubular*
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

(IMP) ductal CA markers

A

can be postive or negative for all, it’s variable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

mucinous CA markers

A
  • ER+
  • PR+
  • HER-
  • like lobular and tubular*
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

3 breast cancers that are ER+, PR+, HER2-

A
  • tubular
  • lobular
  • mucinous
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

breast invasive CA with good prognosis

A
  • medullary CA (best prognosis)
  • ductal
  • tubular
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

receptor/molecular classification of breast invasive CA

A
  1. ER+, HER2-
  2. HER2+ (ER+ or ER-)
  3. triple negative (ER-, PR-, HER2-)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

how to remember if a cancer responds well to chemo

A

higher grade = responds well to chemo. not low grade bc chemo kills cells dividing very fast

32
Q

ER+ HER2- invasive CA: grade, complete response to chemo, relapse time

A
  • grade 1 or 2
  • weak resp to chemo (bc low grade)
  • time to relapse >10 yrs (so never considered cured)
33
Q

HER2+ (ER+ or ER-) invasive CA: grade, complete resp to chemo, time to relapse

A
  • grade 2 or 3. more aggressive
  • ER- = good resp to chemo. ER+ = weak resp to chemo
  • <10 years to relapse
34
Q

triple negative invasive CA: grade, complete resp to chemo, time to relapse

A
  • grade 3
  • 30% resp to chemo
  • <8 years relapse
35
Q

drug for HER+ tumors

A

herceptin (given on side of the chemo)

36
Q

herceptin MOA

A
  • paralyzes the HER2 Rs so its prolif function stops

- cells don’t prolif but don’t die so it’s not chemo

37
Q

trick to remember what’s a good prognosis for breast invasive CA

A

more negatives = worse prognosis. EXCEPT MEDULLARY.

38
Q

PR- invasive CA charact

A
  • more aggressive
  • generally ER+
  • tend to give chemo
39
Q

why the medullary invasive CA is an exception and prognosis is good

A

is well contained by the associated inflammation and the lymphocytes that contain the tumor

40
Q

invasive ductal CA detected how

A

irregular mass on radiology

41
Q

what can also cause irregular mass on radiology (ddx of that)

A

radial scarrs (are benign)

42
Q

invasive ductal CA on macro

A
  • firm
  • irregular border
  • whitish
43
Q

normal ductal anatomy

A
  • myoepithelial cells on periphery
  • luminal cells inside producing milk in lobules and forming the ducts
  • fat and fibrous stroma around the whole thing
44
Q

DCIS charact (is NOT ductal invasive CA) on histo

A

tumor cells are still inside the duct and myoepithelial cells are present

45
Q

how to recognize that a carcinoma of the breast is still in situ

A

myoepithelial cells surround it (periphery) and the tumor cells didn’t reach the BM

46
Q

invasive ductal CA charact

A
  • no assoc myoepith cells

- monoclonal prolif

47
Q

inflammatory ductal CA sx and dx

A
  • sx: breast red and inflamed. (reason = lymphovascular invasion and the tumor cells block the lymphatics)
  • dx: bx
48
Q

ddx to inflammatory ductal CA (red inflamed breast)

A
  • nursing

- pregnant

49
Q

tx of inflammatory ductal CA

A
  • neoadjuvant chemo (meaning before surgery)

- total mastectomy 6 months later

50
Q

Nottingham grading for breast CA (ductal especially bc most common)

A
  • well diff, low grade = 1 (lot of grands, more tubules)
  • interm grade = 2
  • poorly diff = high grade = 3 (sheets of cells)
  • based on atypia, mitotic count and tubule formation*
51
Q

charact of invasive LOBULAR Ca

A
  • doesn’t form a mass
  • E cadherin neg
  • invades stroma
52
Q

E cadherin + vs -

A

+ is ductal

- is lobular

53
Q

mucinous CA charact

A
  • elderly
  • ER+ (better prognosis)
  • rarely metastasizes
54
Q

mucinous CA on histo

A

neoplastic cells floating in a lake of mucin

55
Q

possible region of metastasis for breast cancers

A
  • lung
  • bone
  • brain (usually ER+ (bc herceptin doesn’t cross the BBB) or triple negative)
56
Q

(imp?) most common mets for breast cancer

A

bone

57
Q

charact of ER and PR staining

A
  • are nuclear Rs so nuclear stain
  • nucleus round = positive
  • all white, blue = negative
58
Q

charact of HER2/Neu staining

A
  • cytoplasmic memb R

- honeycomb pattern = positive

59
Q

other test for HER2 Neu testing

A

FISH (fluorescent in situ hybridization)

  • red probe for her2 neu
  • green probe for chromosome 17
  • if over 2 red probes per cell (one cell has 2 green probes) = amplified = positive
60
Q

goal of HER 2 Neu testing

A

if positive, can tx with herceptin (lapatinib)

61
Q

how does tamoxifen work (for ER+ tumors)

A
  • partial agonist
  • in the breast, acts as an antagonist and suppresses breast ca dev
  • not cytotoxic
  • can cause uterine ca*
62
Q

aromatase inhibitors do what

A

inhibit conversion of estrogen in fatty tissue, only good to give in post menopausal women

63
Q

aromatase inhibitors vs tamoxifen for ER+ tumors: when to use

A
  • pre menopausal woman: tamoxifen

- post menopausal woman: can use both

64
Q

2 types of fibroepith lesions in the breast

A
  • fibroadenoma

- Phyllodes tumor

65
Q

(imp) most common tumor of the breast

A

fibroadenoma. can regress. can become huge in pregnancy

66
Q

charact of fibroadenomas

A
  • biphasic (2 components): stromal + epithelial components
  • before age 30
  • bigger in late menstrual cycle and pregnancy
  • regresses after menopause
67
Q

spectrum of lesions of fibroadenomas

A

like any tumor

  • benign
  • borderline
  • malignant
  • fibroepith has 2 benign kinds and 1 borderline kind
68
Q

phyllodes tumor charact

A
  • malignant
  • hematogenous spread (no lymph node dissection)
  • old tumor with a tumor increasing in size (can’t be fibroadenoma bc would be regressing)
  • benign (usually), borderline or malignant
69
Q

2 components of fibroadenomas

A
  • stroma
  • glandular (epith)
  • both benign*
70
Q

phyllodes tumor on macro

A
  • larger than fibroadenoma
  • leafy nodular
  • cystic spaces
71
Q

components of phyllodes tumor

A

also biphasic

  • epithelial comp benign
  • stromal comp more on the malignant, atypical side. stromal comp is exaggerated, more prominent. if becomes malignant = sarcoma. (sarcomas spread in blood first)
72
Q

ddx of nipple serous or bloody discharge

A 
#1 papilloma
#2 cancer
73
Q

2 types of papillomas

A
  • peripheral. small and multiple = papillomatosis. (more likely to be malignant. same risk as atypical hyperplasia)
  • central (big and single)
74
Q

intraductal papilloma charact

A
  • lactiferous duct for ex
  • papillary structures look like normal breast tissue
  • benign lesion
75
Q

how to stop bloody discharge in papillomas

A

take it out

Bloc I - Reproduction (57 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions