Flashcards in 01b: Breast Cancer Deck (70)
By far the most common tumor of the breast arises from which tissues?
Ductal (predominantly) and lobular epithelium (adenocarcinomas)
Very common cause of "breast lumps" that fall under non-proliferative breast disease. Does this increase risk of malignancy?
No (not unless associated with atypical hyperplasia)
List the tissue changes in fibrocystic disease of breast.
2. stromal fibrosis and calcification
3. cyst formation
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
T/F: Proliferative breast disease with atypia fulfill criteria for carcinoma.
False - almost, but fall short
List the two types of proliferative breast disease with atypia.
1. ADH (atypical ductal hyperplasia)
2. ALH (atypical lobular hyperplasia)
Proliferative breast disease with atypia associated with (X) relative risk of developing breast cancer.
X = 4-5
Most common benign tumor found in breast. Which tissue components are found in this lesion?
Epithelial (ductal) and mesenchymal
Fibroadenomas occur primarily in (older/younger) women, are hormonally (responsive/unresponsive), and (increase/decrease) in size with menopause.
Younger (under 30);
T/F: Fibroadenomas generally confer no increased risk for cancer.
True (unless accompanied by more complex epithelial proliferation)
Carcinomas of breast are divided into which two main types? Star the most common.
Carcinomas arising from:
1. ductal epithelium* (75%)
2. lobular epithelium
Intraductal carcinoma is (invasive/non-invasive) and associated with (good/bad) prognosis.
Good (if adequately excised)
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
(By far) the most common breast carcinoma, arising from (ductal/lobular) epithelium:
Invasive ductal carcinoma NST (no special type)
Describe the texture of the typical masses found in Invasive ductal carcinoma (NST). What gives them this texture?
Prominent background fibrosis and calcification
Invasive ductal carcinoma (NST): by the time the carcinoma is palpable, (X)% of patients will have metastasis to axillary lymph nodes.
X = 50
Well-differentiated breast carcinomas tend to be estrogen R (pos/neg) and progesterone R (pos/neg) and HER2 (pos/neg).
Pos, Pos, neg
Medullary carcinoma is a (ductal/lobular) disease of the breast that's more commonly seen with (X) mutation. What's the general prognosis?
X = BRCA1 (13% of carcinomas in these patients; only 1% of breast carcinomas overall)
Better prognosis than typical ductal NST
(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
T/F: Colloid (mucinous) carcinoma has worst prognosis than typical ductal carcinoma NST.
False - better
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
X = ducts
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
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.
X = 5-10
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
Either same or contralateral breast
Invasive lobular carcinoma: why are as many as (X)% of cases easily missed?
X = 25
Negligible stromal reaction
(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);
Ductal carcinoma of breast: which subtype(s) rarely metastasize?
Medullary, colloid, tubular
T/F: EGFR is a poor prognostic factor in breast cancer.
Scarff-Bloom-Richardson Grading System: which 3 characteristics taken into account in breast cancer grading?
1. Tubular formation
2. Nuclear pleomorphism