Brainscape's Knowledge GenomeTM

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


See full index

MCC > Wk 7 Breast Cancer > Flashcards

Wk 7 Breast Cancer Flashcards

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?

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

A
25
Q

Where does breast cancer often spread?

A

Bone

26
Q

Mucinous Carcinoma

A

excellent px
-tumor cells stuck in mucous, can’t go anywhere
-usually in elderly women

27
Q

What is DCIS?

A

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
Q

What is the functional unit of the breast?

A

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
Q

What are 4 main subtypes of breast cancer?

A
  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
Q

What is Comedo type DCIS?

A

High-grade cells w/ necrosis and dystrophic calcification in center of ducts

31
Q

What is Paget’s Disease of the breast?

A

DCIS that extends up ducts to nipple skin
-presents as nipple ulceration and erythema
-almost always associated w/ an underlying carcinoma

32
Q

Invasive Ductal Carcinoma

A

-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
Q

What are 4 subtypes of invasive ductal carcinoma?

A
  1. tubular carcinoma
  2. mucinous carcinoma
  3. medullary carcinoma
  4. inflammatory carcinoma
34
Q

Tubular carcinoma

A

-malignant
-desmoplastic stroma
-2nd cell type is absent (should be epithelial cell and myoepithelial cell)
-good px

35
Q

What makes up the breast stroma?

A

adipose tissue, fibrous tissue, BVs, lymphatic channels

36
Q

What makes up the TDLU?

A

=terminal duct lobular unit
1. 2 cell layers:
-luminal cell, myoepithelial cell
2. intralobular duct
3. intralobular specialized stroma

37
Q

What age range does this breast tissue represent?

A

pre-menarche

38
Q

Age range w/ associated breast tissue?

A

premenopausal

39
Q

Age range w/ associated breast tissue?

A

premenopausal

40
Q

Age range/functional status associated w/ breast tissue?

A

lactation

41
Q

Fxnal status of breast tissue?

A

Postmenopausal

42
Q

Apocrine metaplasia and cysts

A

=fibrocystic changes
myoepithelial cells are present
-no atypia
-no risk of malignancy

43
Q

Proliferative disease w/o atypia

A
44
Q

Proliferative disease w/ atypia

A

-atypical lobular hyperplasia (ALH) is E-caderin negative
-4-5x relative lifeteim risk for developing cancer

45
Q

What are 3 types of biphasic lesions?

A
  1. fibroadenoma
  2. phyllodes tumor
  3. gynecomastia
46
Q

What is a fibroadenoma?

A

-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
Q

What is gynecomastia?

A

-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
Q

What is Phyllodes tumor?

A

-affects older women
-rapid growth of stromal component w/ leaf-like architecture
-benign, borderline and malignant forms

49
Q

What are the 2 categories of malignant breast neoplasms?

A
  1. in situ carcinoma (usually doesn’t present as a mass)
  2. invasive carcinoma
50
Q

What are 3 pathways of sporadic breast cancer?

A
  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
Q

Lobular carcinoma in situ

A

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
Q

Major histological marker of invasive breast carcinoma

A

loss of myoepithelial cells

53
Q

Grading Invasive Carcinomas

A
54
Q

Carcinoma histology

A
55
Q

Histology of ER positive slide

A

MCC (44 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions