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Flashcards in 01b: Breast Cancer Deck (70)
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1

By far the most common tumor of the breast arises from which tissues?

Ductal (predominantly) and lobular epithelium (adenocarcinomas)

2

Very common cause of "breast lumps" that fall under non-proliferative breast disease. Does this increase risk of malignancy?

Fibrocystic change

No (not unless associated with atypical hyperplasia)

3

List the tissue changes in fibrocystic disease of breast.

1. metaplasia
2. stromal fibrosis and calcification
3. cyst formation

4

Proliferative breast disease without atypia usually causes (palpable/non-palpable) masses with (X) relative risk of developing breast cancer.

Non-palpable (detected by mammogram);
X = 1.5-2x

5

T/F: Proliferative breast disease with atypia fulfill criteria for carcinoma.

False - almost, but fall short

6

List the two types of proliferative breast disease with atypia.

1. ADH (atypical ductal hyperplasia)
2. ALH (atypical lobular hyperplasia)

7

Proliferative breast disease with atypia associated with (X) relative risk of developing breast cancer.

X = 4-5

8

Most common benign tumor found in breast. Which tissue components are found in this lesion?

Fibroadenoma;

Epithelial (ductal) and mesenchymal

9

Fibroadenomas occur primarily in (older/younger) women, are hormonally (responsive/unresponsive), and (increase/decrease) in size with menopause.

Younger (under 30);
Responsive
Decrease/regress

10

T/F: Fibroadenomas generally confer no increased risk for cancer.

True (unless accompanied by more complex epithelial proliferation)

11

Carcinomas of breast are divided into which two main types? Star the most common.

Carcinomas arising from:
1. ductal epithelium* (75%)
2. lobular epithelium

12

Intraductal carcinoma is (invasive/non-invasive) and associated with (good/bad) prognosis.

Non-invasive (Carcinoma-in-situ)

Good (if adequately excised)

13

Intraductal carcinoma now accounts for a (lower/higher) % of breast carcinoma cases, since the use of mammogram screening.

Higher (up to 30% as opposed to 5% in the past); this is good - detecting before invasion

14

(By far) the most common breast carcinoma, arising from (ductal/lobular) epithelium:

Ductal;
Invasive ductal carcinoma NST (no special type)

15

Describe the texture of the typical masses found in Invasive ductal carcinoma (NST). What gives them this texture?

Firm, gritty;

Prominent background fibrosis and calcification

16

Invasive ductal carcinoma (NST): by the time the carcinoma is palpable, (X)% of patients will have metastasis to axillary lymph nodes.

X = 50

17

Well-differentiated breast carcinomas tend to be estrogen R (pos/neg) and progesterone R (pos/neg) and HER2 (pos/neg).

Pos, Pos, neg

18

Medullary carcinoma is a (ductal/lobular) disease of the breast that's more commonly seen with (X) mutation. What's the general prognosis?

Ductal
X = BRCA1 (13% of carcinomas in these patients; only 1% of breast carcinomas overall)

Better prognosis than typical ductal NST

19

(X) subtype of ductal breast carcinomas tends to occur in older women. It's characterized by excessive (Y) production, forming (soft/hard) masses.

X = Colloid (mucinous) carcinoma

Y = mucin
Soft (gelatinous)

20

T/F: Colloid (mucinous) carcinoma has worst prognosis than typical ductal carcinoma NST.

False - better

21

Paget's disease of the nipple is seen in (X)% of breast cancers. (Benign/malignant) cells extend from underlying (X) to nipple epidermis.

X = 1-2
Malignant

X = ducts

22

T/F: Presence of Paget's worsens prognosis of underlying carcinoma because cells must cross BM to reach nipple epithelium.

False - don't cross BM; doesnt alter prognosis

23

Breast cancer from lobular epithelium: cells are (larger/smaller), (more/less) likely to be palpable. Tendency to be (uni/multi)-centric and (X)% are bilateral.

Smaller; less

Multi;
X = 5-10

24

Lobular carcinoma in situ: (X)% of patients develop invasive carcinoma that's (lobular/ductal) in (same/contralat) breast over period of 20 y.

X = 30
Etiher/both;
Either same or contralateral breast

25

Invasive lobular carcinoma: why are as many as (X)% of cases easily missed?

X = 25

Negligible stromal reaction

26

(X) breast carcinomas have different metastasis pattern compared to others. They metastasize to (lungs/GI/ovaries) as opposed to (lungs/GI/ovaries).

X = Invasive lobular

GI, ovaries/uterus (peritoneum, retroperit, meninges);

Lungs/pleura

27

Ductal carcinoma of breast: which subtype(s) rarely metastasize?

Medullary, colloid, tubular

28

T/F: EGFR is a poor prognostic factor in breast cancer.

True

29

Scarff-Bloom-Richardson Grading System: which 3 characteristics taken into account in breast cancer grading?

1. Tubular formation
2. Nuclear pleomorphism
3. Mitosis

30

T/F: Many ovarian neoplasms cannot be detected early.

True - so they're responsible for almost half of the deaths from cancer of the female genital tract