Top 4 Cancers (Patho) - Block 4 Flashcards
RF of breast cancer?
- Age
- Gender
- Family hx
- BRCA1 or BRCA2 gene mutation
- Menarche before age 12
- Menopause after age 55
- Previous `breast issues
- Obesity
- Smoking
- Alcohol abuse
- Radiation
What are the classifications of breast cancer?
HR:
* Estrogen receptor postive
* Progesterone receptor positive
HER2
What are the subtypes of breast cancer?
HR+/HER2-
HR-/HER2-
HR+/HER2+
HR-/HER+
What is the tumor suppressor gene for breast cancer?
BRCA1 and 2 are normally expressed in the cells of breast and other tissue -> inherited mutation in on or both of these genes
What is the difference between BRCA1 and 2?
1: increase the risk of breast, ovarian, pancreatic, cervical, uterine, and colon cancer
2: increase the risk of breast, ovarian, pancreatic, gallbadder, bile duct, and melanoma cancers
Are BRCA mutations exclusive to females?
No, men can also be affected
Outcomes of HER2 overexpression?
Cells grow too quickly
What is the most common breast malignancy of women in the US?
Carcinoma
What are the histologic types of breast cancer?
- Insitu ductal or lobular carcinoma
- Infltrating ductal or lobular carcinoma
- Inflammatory carcinoma
What occurs during to early stages of breast cancer?
- Asymptomatic
- Changes in size or shape of breast
- Skin changes
- Inverted nipple
- Red, scaly, rash
What are concerning sx of breast cancer?
- Blood tinged discarge
- Red scaly nipples
- Ulceration
- Mass (hard, fixed, nonmobile on palpation)
What is the leading cause of cancer death in males and females? Primary RF of developmen?
Lung cancer; cigarette smoking
What is the survival rate of lung cancer?
5 years
RF of lun cancer?
- Smoking
- Secondhand smoking
- Occupational exposure
- Genetic susceptibility
- Benign chronic lung conditions
- Viral infection
- Gender
- Dietary factors
Virus that can cause lung cancer?
HPV
How can dietary facotors cause lung cancer?
Low serum levels of antioxidants (Vitamin A and E)
Are males or females more susceptible to developing lung cancer?
Women
What is the primary cause of lung cancer?
Cigrette smoking: linear relationship between intesity of smoking and progressive epithelial changes
What are the types of lung cancer?
Small cell
Non-small cell
* Adenocarcinoma
* Squamous cell carcinoma
* Large cell carcinoma
What are the characteristics of SCLC?
Oat cell cancer:
* Aggressive, rapid growth and metastasis
* Develops in regional lymph nodes
* Linear relationship with smoking
Complication associated with SCLC?
Superior vena cava syndrome: enlarging cancer in mediastinal lymph nodes can gradually impede blood return to te superor vena cava
How are adenocarcinoma and squamous cell carcinoma classified?
Well-differentiated: dividing cancer cells retain more of the normal features bu is unregulated and fast
Poorly differntiated: cells retain enough histologic characteristics to be identified as adenocarcinoma or squamous cell carcinoma but have fewer normal cell features
What is the most common form of NSCLC?
Adenocarcinoma:
* gladular epithelial cancers
* bronchioloalveolar cancers: grow along preexisting alveolar walls without metastasizing or destroying alveolar structure
What are the characteristics of squamous cell carcinoma?
Exclusively occurs in cigarette smokers:
* Epidermoid carcinomas: orginates in bronchial epitheial mucosa and move along the bronchial wall
* Majority originate medially in chest at points of bronchial bifurcation
* Slow growth and metastasis
* Obstructs bronchi due to central location
What are the characteristics of large cell carcinoma?
- Undifferntiated tumors
- Least common NSCLC
- Poorly differntiated epithelial cell cancer
- Metastisis is easy and wide
Breast cancer stages are characterized by?
- Size of tumor
- Number of nodes involved
- Metastasis to other parts of the body
Descrube the staging of lung cancer?
What are the clinical presentations of lung cancer?
- Persistant cough
- Hemoptysis (blood in sputum)
- Obstructive pneumonia with atelectasis
- Dyspnea
- Chest pain
- Hoarseness
- Paraneoplastic syndrome
What is paraneoplastic syndrome?
Sx within normal tissue that occur somewhere distant from the tumor (ectopic)
Who should get an annual digital rectal exam (DRE)?
- Beginning at age 50 for most men
- Beginning at age 45 for AA or men with first-degree relatives with prostate cancer
- Beginning at age 40 for men with more than one first-degree relative with prostate cancer.
What are the causes of increased PSA other than cancer?
- UTI
- Prostate stimulation
- Vigourous exercise
- Certain medications
What are the zones of the prostate? Which is the most susceptible to cancer?
- Central
- Transition
3. Peripheral
What is the classification system used to distinguish well diffentiated cells from poorly diffentiated?
Gleason’s Pattern
What are the localized sx of prostate cancer?
- Frequnet urination
- Weak urine flow
- Blood in urineand semen
- ED
- Dysuria
- Discomfort when sitting
Systemic sx of prostate cancer?
Pain in bones
Edema in legs
Weight loss
Fatigue
Changes in bowel habits
What is the difference between colon and rectal cancer?
Colon: malignant growth and division of abnormal cells in the ascending, trasverse, or decending colon
Rectal: malignant growth or tumor occurring up to 15 cm from the anal opening
What are adenomas of the colon?
Benign polyps formed from gladular structures in the intestinal mucosal epithelium
What are the types of colon polyps?
Rased adenoma: flat or sessile
Pedunculated adenoma: have a stalk
What are the pathways that develop conventional adenomas and sessile serrated polyps? What are the drivers of both?
- Chromosomal instability pathway
- Microsatellite instabiltiy pathways
Mutated tumor suppressor genes and oncogenes
What are the stages of colon/rectal cancer?
What are the RF of colon/recal cancer?
- Large polyps
- Old
- Smoking
- Family hx of cancer
- Nonuse of NSAIDs
Clinical presentations of early CRC?
- Hematochezia
- Change in bowel habits
- Faitgue
- Weight loss
- Generalized or localized ab pain
- Sx of anemia
What are the characteristics of right side cancer?
Ascending colon:
1. Silent
2. Pain with mass in RLQ
3. Tumors stay to one side of colon wall
4. No obstruction
5. Blood in stool is dark red
What are the characteristics of left side cancer?
Descending colon:
1. Grow circumferentially around the colon
2. Intestinal obstruction
3. Stools are pencil like and bloodis bright red
What do physicians look for in a physical exam that can suggest CRC?
- Distended abdomen
- Enlarged lymph nodes
- Palpable ab mass
- Mass may be palpable with digital exam (rectal)
