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Patho II > The Breast > Flashcards

The Breast Flashcards

(48 cards)

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1
Q

What are the two major structures of the breast?

A

Ducts

Lobules

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2
Q

What are the two types of epithelial cells of the breast?

A

Luminal

Myoepithelial

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3
Q

What are the two types of stroma of the breast?

A

Interlobular

Intralobular

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4
Q

What structural changes occur in the breast during the 1st half of the menstrual cycle?

A

Lobules are relatively quiescent

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5
Q

What happens to the structure of the breast after ovulation?

A

Cell proliferation and the number of acini per lobule increases

INtralobular stroma becomes edematous

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6
Q

What happens to the structure of the breast during menstruation?

A

Regression of the lobules and the disappearance of edema

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7
Q

What happens to the breast pre-puberty?

A

Lactiferous ducts are formed at birth but lobules remain underdeveloped until puberty

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8
Q

What happens to breast during puberty?

A

Ovarian ESTROGEN and PROGESTERONE induces branching of the ductal system and development of lobules

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9
Q

What happens to the breast during pregnancy?

A

Progesterone and prolactin induce complete maturation of the breast at the time of the first full-term pregnancy

Permanent increase in number and size of lobules

Oxytocin induces myoepithelial proliferation and differentiation

Following lactation, total breast size decreases due to apoptosis of epithelium and lobule atrophy

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10
Q

What happens to the breast during aging and menopause?

A

Lobular and ductal atrophy occurs

Interlobular stroma decreases in fibrous connective tissue and increase in adipose tissue content

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11
Q

What are the three classifications of benign breast lesions?

A

Non-proliferative

Proliferation without atypia

Atypical hyperplasia

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12
Q

What is non-proliferation benign breast lesions associated with?

A

Simple breast cysts

NOT associated with an increased risk of breast cancer

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13
Q

What is a simple breast cyst?

A

Fluid-filled masses derived from teh terminal duct lobular unit

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14
Q

What is proliferation without atypia benign breast lesions associated with?

A

Fibroadenoma

Small increased risk of developing breast cancer

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15
Q

What is atypical hyperplasia benign breast lesions associated with?

A

Substantial increased risk of developing breast cancer

Multifocal lesions

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16
Q

What is a simple fibroadenoma?

A

Benign solid tumors containing glandular as well as fibrous tissue

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17
Q

What is the etiology of simple fibroadenoma?

A

Not known but likely a hormonal relationship

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18
Q

What is the classification of simple fibroadenomas?

A

Proliferation without atypia

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19
Q

What is a complex fibroadenoma?

A

Associated with a slightly increased risk of cancer when multicentric proliferative changes are present

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20
Q

What causes fibroadenomas?

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A

Estrogen, progesterone, and lactation during pregnancy

Some have receptors on their surface and respond to human epidermal factor (EGH) and growth hormone

21
Q

What is the cause of calcified fibroadenomas seen in older patients?

Study These Flashcards
A

Increased stromal growth

Necrosis

22
Q

What is the most common type of breast carcinoma?

Study These Flashcards
A

Adenocarcinoma

23
Q

What are the two types of in situ breast carcinomas?

Study These Flashcards
A

Ductal (DCIS) (aka introduction carcninoma)

Lobular

24
Q

What are the two types of invasive breast carcinomas?

Study These Flashcards
A

Infiltrating ductal

Invasive lobular

25
What is the human epidermal growth factor receptor 2 (HER2) oncogene?
Encodes for the HER2 receptors which belongs to the epidermal growth factor receptor (EGFR) family
26
What does the HER2 receptor do?
Controls epithelial cell growth and differentiation Maybe angiogenesis
27
What percentage of human breast cancers have amplification/overexpression of HER2?
18-20%
28
What are the three major genetic pathways of carcinogenesis?
ER +, HER2 - HER2 + ER -, HER2 -
29
What major genetic pathway of carcinogenesis is the most common?
ER +, HER2 -
30
What pathway is associated with HER2 + breast carcinogenesis?
Cancers arise through a pathway that is strongly associated with amplifications of the HER2 gene
31
What pathway is associated with ER -, HER2 - genetic pathways of carcinogenesis?
Cancers arise through a distinct pathway that is independent of ER-mediated changes in gene expression and HER2 gene amplifications
32
What are triple negative breast cancer cells negative for?
Progesterone ER HER2
33
What are the dominant drivers of cell proliferation and survival in the majority of human breast cancers?
ER and/or HER2 signaling pathways
34
What are the clinical implications of HER2-ER crosstalk?
Resistance can occur to broth endocrine and HER2 therapies
35
What is Carcinoma in Situ/Ductal Carcinoma in Situ?
Malignant clonal proliferation of epithelial cells limited to ducts and lobules by the basement membrane
36
What are the three main categories of CIS/DCIS?
HIgh grade Low grade Intermediate grade
37
What is High grade CIS/DCIS?
Lesions lack estrogen and progesterone receptors High proliferative rate Overexpression of the HER2 oncogene P53 mutations Angiogenesis
38
What is low grade CIS/DCIS?
Lesions are estrogen and progesterone receptor positive Low proliferative rate Rarely (if ever) show abnormalities of the HER2/new or p53
39
What are intermediate grade CIS/DCIS?
Somewhere between low and high grade
40
What are the three invasive (infiltrating) breast carcinomas?
ER positive, HER2 negative - low proliferation ER positive, HER2 negative - high proliferation HER2 positive ER negative, HER2 negative
41
What is ER positive, HER2 negative, low proliferation invasive breast carcinomas?
Respond well to hormonal treatment and long survival with metastatic disease is possible, despite the fact that incomplete responses to chemotherapy are the rule
42
What is ER positive, HER2 negative, high proliferation invasive breast carcinomas?
10% of these carcinomas show a complete response to chemotherapy
43
What is HER2 positive invasive breast carcinomas?
Second most common molecular subtype
44
What is ER negative, HER2 negative invasive breast carcinomas?
Basal-like triple negative carcinoma Third major molecular structure
45
What mutations represent 80-90% of familial breast cancers?
BRCA1 and BRCA2
46
What are BRCA1 and BRCA2 genes?
Genes that produce tumor suppressor proteins which help to repair damaged DNA
47
What are the major risk factors for sporadic breast cancer?
Hormone Exposure! ``` Gender Age at menarche and menopause Reproductive history Breastfeeding Exogenous estrogens Radiation exposure Exposure to chemicals with estrogen like effects ```
48
How does hormonal exposure cause sporadic breast cancer?
By stimulating breast growth during puberty, menstrual cycles, and pregnancy thereby increasing the number of cells that can potentially give rise to a cancer

Patho II (16 decks)

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