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TBL-MSK > TBL 1.2 > Flashcards

TBL 1.2 Flashcards

1
Q

What is the most common type of invasive breast cancer?


A

Ductal adenocarcinoma

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2
Q

How do invasive breast cancers typically present in the absence of mammographic screening?


A

As a mass of at least 2 to 3 cm in size

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3
Q

What factors influence the mammographic and gross appearance of invasive breast cancers?


A

The stromal reaction to the tumor

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4
Q

What is the typical appearance of invasive breast cancers on mammography?


A

A hard, irregular radiodense mass

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5
Q

What sound do tumors typically produce when cut or scraped?

A

A characteristic grating sound

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6
Q

What causes the characteristic grating sound in tumors?


A

Small, central pinpoint foci or streaks of chalky-white desmoplastic stroma and occasional foci of calcification

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7
Q

What can special tumors of breast cancer be organized into based on expression?


A

Molecular groups based on expression of ER and HER2

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8
Q

How do special histologic types of breast cancer differ from ductal carcinomas of no special type and break the established rules?


A

They often harbor unique genetic aberrations and distinct gene signatures and associations with clinical prognosis.

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9
Q

What is the subtype of breast cancer with the clearest association of phenotype and genotype?


A

Lobular carcinoma

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10
Q

What genetic alteration is commonly seen in lobular carcinoma?


A

Biallelic loss of expression of CDH1

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11
Q

How do lobular carcinomas typically infiltrate tissue?


A

As single cells

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12
Q

What is a characteristic feature of lobular carcinoma regarding desmoplastic response?


A

They sometimes fail to produce a desmoplastic response

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13
Q

What are the common sites of metastatic spread for lobular carcinoma?


A

Peritoneum, retroperitoneum, leptomeninges (carcinomatous meningitis) , gastrointestinal tract, ovaries, and uterus

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14
Q

What causes increased risk of lobular carcinoma in males and females?


A

Heterozygous germline mutations in CDH1

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15
Q

What is the association between lobular carcinoma and signet ring carcinoma of the stomach?


A

Individuals with CDH1 mutations have a greatly increased risk for signet ring carcinoma of the stomach

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16
Q

Why are carcinomas with a medullary pattern of interest?


A

Over half of BRCA1-associated carcinomas have this appearance

17
Q

How does the prognosis of tumors with a medullary pattern compare to other poorly differentiated carcinomas?

A

Tumor with medullary tumor has a better prognosis

18
Q

What unique feature related to T lymphocytes is noted in tumors with a medullary pattern?


A

They have an unusually large number of infiltrating T lymphocytes

19
Q

What types of breast cancer almost always fall within the luminal group?

A

Luminal groups are ER-positive/HER2-negative cancers
Specific special histologic types

20
Q

What are some of the special histologic types?


A

Lobular, mucinous, tubular and lobular carcinoma.

21
Q

How can tumors present in the breast?


A

As well-circumscribed masses or almost imperceptible infiltrations

22
Q

What is indicated by the presence of scant stromal reaction in tumor masses?


A

It suggests a well-circumscribed tumor

23
Q

What can larger carcinomas invade?


A

The pectoralis muscle and the dermis

24
Q

What physical change may occur in the skin due to tumor invasion of pectoralis and dermis?

A

Retraction or dimpling of the skin

25
Q

What happens when the tumor involves the central portion of the breast?


A

Retraction of the nipple may develop

26
Q

How can breast cancer rarely present before detection in the breast?


A

As metastasis to an axillary lymph node or a distant site

27
Q

Why might a primary carcinoma be small and obscured?

A

Due to dense breast tissue or lack of desmoplastic response

28
Q

How can “occult” primary tumors be detected?


A

By imaging studies using ultrasound or MRI

29
Q

What scoring system is used for grading invasive carcinoma?


A

The Nottingham Histologic Score

30
Q

What three factors are scored in the Nottingham Histologic Score?


A

Tubule formation, nuclear pleomorphism, and mitotic rate

31
Q

What characterizes Grade I (well differentiated) carcinomas?


A

They grow in a tubular or cribriform pattern with small uniform nuclei

32
Q

How do Grade 2 (moderately differentiated) carcinomas differ from Grade 1 carcinomas?

A

They have solid clusters or single infiltrating cells and greater nuclear pleomorphism and high number of mitotic figures

TBL-MSK (2 decks)

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