Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

MCC > Wk 7 Breast Cancer > Flashcards

Wk 7 Breast Cancer Flashcards

(55 cards)

Start Studying
1
Q

3 endocrine risk factors for breast cancer

A
  1. later age at first pregnancy
  2. early menarche & late menopause
  3. HRT
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Breast cancer genetics

A

BRCA1 and BRCA2
-there are other less penetrant inherited genes
-all acount for less than 10%

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

Breast cancer genetics

A

BRCA1 and BRCA2
-there are other less penetrant inherited genes
-all acount for less than 10%

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

General breast cancer risk factors

A
  1. older age
  2. endocrine factors
  3. obesity
  4. diet,EtOH use, sedentary lifestyle
  5. genetics BRCA1, BRCA2
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the UofU mammography recommendation?

A

40, yearly

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

What info do we want from pathology?

A
  1. histologic type
  2. tumor size
  3. grade
  4. margin status
  5. hormone receptor status
  6. HER2 status
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is breast tissue analogy and parts?

A

Like a specialized sweat gland w/ ducts and secretory glands (lobules)
-like a bunch of grapes w/ lobules = grapes, ducts = stems

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

Breast tissue histology at various ages

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

Categories of breast pathology

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Breast Pathology Categories

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Classification of breast lesions according to risk of invasive cancer

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

What meds are used for breast cancer?

A

For localized:
tamoxifen
anastrozole

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

How are estrogen and progesterone markers measured?

A
  1. immunohistochemistry
  2. gene expression
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is HER2 gene?

A

Encodes a transmembrae protein tyrosine kinase
-related to EGFR
-tumor expression may predict poor px

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

Ab med to know for HER2

A

Trastuzumab
Pertuzumab (don’t need to know)
-there are others too!

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

How is HER2 measured?

A

IHC (measures the membrane protein)
FISH (looking for extra copies of the gene)

-expressed in 15-20% of invasive breast cancers

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

IHC testing for HER2 expression

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Adjuvent therapies, might be NED but high prevalence of recurrence

A
  1. radiation - local
  2. systemic therapies:
    -chemo
    -hormonal (ER/PR+): tamoxifen, aromatase inhibitors (only post-menopausal)
    -trastuzumab (HER2+)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Adjuvent therapies, might be NED but high prevalence of recurrence

A
  1. radiation - local
  2. systemic therapies:
    -chemo
    -hormonal (ER/PR+): tamoxifen, aromatase inhibitors (only post-menopausal)
    -trastuzumab (HER2+)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Research results from adjuvant radiation therapy

A

No change in overall deaths
but dramatic decrease in recurrences

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Research effects of chemotherapy

A

30% reduction in recurrence
25% reduction in death

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

What type of breast cancer is tamoxifen used for?

A

ER+

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

What is the chemotx regimen for metastatic breast cancer?

Study These Flashcards
A

Hormone receptor +: tamoxifen or aromatase inhibitors

Hormone receptor negative, HER2 negative = “triple negative breast cancer” - chemotherapy, many agents

HER2 + - trastuzumab or newer anti-HER2 agents

24
Q

Breast cancer tx flow chart

25
Where does breast cancer often spread?
Bone
26
Mucinous Carcinoma
excellent px -tumor cells stuck in mucous, can't go anywhere -usually in elderly women
27
What is DCIS?
Ductal carcinoma in situ =malignant prolif of cells in ducts w/ no invasion of basement membrane -detected as calcification on mammography that is dystophic calcification on top of necrotic cells in center -more likely ipsilateral *calcifications are not always malignant (ex fat necrosis and sclerosing adenosis) -TX: surgery and tamoxifen for ER+
28
What is the functional unit of the breast?
Terminal duct lobular unit -lobule has glands (produce milk) w/ cancer, can get malignant prolif of cells in the duct (DCIS) bound by basement membrane
29
What are 4 main subtypes of breast cancer?
1. DCIS (ductal carcinoma in situ) - Paget's disease of the nipple (a type of DCIS that walked it's way up to the nipple) 2. IDC (invasive ductal carcinoma) - cells invade basement membrane 3. LCIS (lobular carcinoma in situ) 4. ILC (invasive lobular carcinoma)
30
What is Comedo type DCIS?
High-grade cells w/ necrosis and dystrophic calcification in center of ducts
31
What is Paget's Disease of the breast?
DCIS that extends up ducts to nipple skin -presents as nipple ulceration and erythema -almost always associated w/ an underlying carcinoma
32
Invasive Ductal Carcinoma
-forms duct-like structures in desmoplastic stroma (CT grows w/ tumor as structural support) -most common type of invasice carcinoma -presents as mass (PE or mammo) -advanced can -> dimpling skin or retraction of nipple
33
What are 4 subtypes of invasive ductal carcinoma?
1. tubular carcinoma 2. mucinous carcinoma 3. medullary carcinoma 4. inflammatory carcinoma
34
Tubular carcinoma
-malignant -desmoplastic stroma -2nd cell type is absent (should be epithelial cell and myoepithelial cell) -good px
35
What makes up the breast stroma?
adipose tissue, fibrous tissue, BVs, lymphatic channels
36
What makes up the TDLU?
=terminal duct lobular unit 1. 2 cell layers: -luminal cell, myoepithelial cell 2. intralobular duct 3. intralobular specialized stroma
37
What age range does this breast tissue represent?
pre-menarche
38
Age range w/ associated breast tissue?
premenopausal
39
Age range w/ associated breast tissue?
premenopausal
40
Age range/functional status associated w/ breast tissue?
lactation
41
Fxnal status of breast tissue?
Postmenopausal
42
Apocrine metaplasia and cysts
=fibrocystic changes myoepithelial cells are present -no atypia -no risk of malignancy
43
Proliferative disease w/o atypia
44
Proliferative disease w/ atypia
-atypical lobular hyperplasia (ALH) is E-caderin negative -4-5x relative lifeteim risk for developing cancer
45
What are 3 types of biphasic lesions?
1. fibroadenoma 2. phyllodes tumor 3. gynecomastia
46
What is a fibroadenoma?
-most common benign breast tumor -20's-30's -often multiple and bilateral -hormonally responsive -well-circumscribed mass w/ prolif of epithelial and stromal componenets
47
What is gynecomastia?
-benign condition in males -uni- or bilateral -due to increased circulating estrogens -endogenous causes: cirrhosis, decreased testosterone, Klinefelter syndrome or fxning testicular tumors -exogenous: EtOH, drugs -expansion of stroma w/ mild epithelial hyperplasia
48
What is Phyllodes tumor?
-affects older women -rapid growth of stromal component w/ leaf-like architecture -benign, borderline and malignant forms
49
What are the 2 categories of malignant breast neoplasms?
1. in situ carcinoma (usually doesn't present as a mass) 2. invasive carcinoma
50
What are 3 pathways of sporadic breast cancer?
1. ER+, HER2-: germline BRCA2 -> PIK3CA mutations ->atypical hyperplasia -> DCIS (50-65% of cancers) 2. ER-, HER2-: germline BRCA1 mutations -> TP53 mutations -> BRCA inactivation -> DCIS (15% of cancers) 3. HER2+: germline TP53 mutations -> HER2 amplification->DCIS (20% of cancers)
51
Lobular carcinoma in situ
LCIS (ER+, e-cadherin-) -diffuse multicentric and bilateral -LCIS treated as a disease marker b/c associated risk of invasive cancer similar in both breasts -more likely both breasts -TX: surveillance, tamoxifen
52
Major histological marker of invasive breast carcinoma
loss of myoepithelial cells
53
Grading Invasive Carcinomas
54
Carcinoma histology
55
Histology of ER positive slide

MCC (44 decks)

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