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Reproduction Week 7 2018/19 > 3: Breast Pathology II > Flashcards

3: Breast Pathology II Flashcards

1
Q

Tumours of which organs commonly spread to the breast?

A

Lungs

Ovaries

Kidneys

Skin (melanoma)

Smooth muscle (commonly uterus)

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2
Q

Which malignant skin tumour can spread to the breast?

A

Malignant melanoma

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3
Q

Breast cancer commonly spreads to which structures?

A

Ovaries

Peritoneum

Bones

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4
Q

Which cells are neoplastic in breast carcinomas?

A

Epithelial cells

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5
Q

In which specific part of the breast are most carcinomas found?

A

Lobules

functional units

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6
Q

Apart from the lobules, where else can breast carcinomas arise?

A

Ducts

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7
Q

What is meant by an in situ carcinoma?

A

Hasn’t breached basement membrane

So not invasive (yet)

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8
Q

What are the two specific types of lobular neoplasia?

A

Atypical lobular hyperplasia (<50% of lobule involved)

Lobular carcinoma in situ (>50% involved)

Invasive carcinoma after that

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9
Q

Lobular neoplasms tend to have oestrogen receptors.

What does this mean?

A

They grow in response to oestrogen

e.g menstrual cycle, OCP, HRT

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10
Q

20% of lobular neoplasms removed by core biopsy are hiding a more ___ lesion.

A

advanced

so the recurrence rate is really high

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11
Q

How are lobular neoplasms managed?

A

Excision

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12
Q

What happens to the centre of high grade ductal neoplasms (DCIS)?

A

Comedo necrosis

because growth outpaces blood supply

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13
Q

High grade ductal carcinomas can spread to involve what breast structures?

A

Lobules

Nipple

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14
Q

What is a cancer of the nipple which is highly associated with DCIS?

A

Paget’s disease of breast

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15
Q

What does Paget’s disease of breast look like?

A

Indrawn nipple

Painful swelling

Eczema around affected area

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16
Q

Which breast cancer is Paget’s disease most associated with?

A

DCIS

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17
Q

Is Paget’s disease invasive?

A

No

Still a carcinoma in-situ, bound by the basement membrane, but is likely to invade if not cut out

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18
Q

How is DCIS managed?

A

Surgical excision +/- radiotherapy, chemo, hormones, Herceptin

depends on the makeup of the tumour

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19
Q

Which proteins are commonly found in epithelial tumours and can be stained?

A

Cytokeratins

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20
Q

Both lobular and ductal neoplasms have the potential to become which tumours?

A

Invasive carcinomas

21
Q

Which structure is breached in invasive carcinomas?

A

Basement membrane

22
Q

What is the most common cancer affecting females?

A

Breast cancer

23
Q

What is the most common cancer affecting males?

A

Prostate cancer

24
Q

The incidence of breast cancer (increases / decreases) with age.

A

increases with age

thus screening

25
Q

(Increased / Decreased) age is a risk factor for breast cancer.

A

Increased age is a risk factor for breast cancer

26
Q

Genetic mutations in which genes are risk factors for breast cancer?

A

BRCA1 / 2

TP53 (Li Fraumeni syndrome)

27
Q

When menstrual abnormalities predispose you to breast cancer?

A

Early menarche

Late menopause

28
Q

Multiparity is a risk factor for breast cancer - true or false?

A

False

29
Q

Nullparity is a risk factor for breast cancer - true or false?

A

True

30
Q

Which lifestyle factors increase a person’s risk of developing breast cancer?

A

Obesity

Alcohol consumption

31
Q

Which genetic mutations are best known for causing breast cancer?

A

BRCA1 / BRCA2

32
Q

Which local structures can breast cancer spread to?

A

Breast stroma

Skin

Anterior chest wall muscles

33
Q

Which lymph nodes does breast cancer commonly spread to?

A

Axillary nodes (numbered 1 -3 inferior to superior) laterally

Internal mammary (thoracic) nodes medially

Both of these drain to the supraclavicular nodes (which is why you check here in a breast exam)

34
Q

What are sentinel nodes?

A

The first lymph nodes which would drain a suspected tumour

35
Q

What is a sentinel node biopsy?

A

Excision of the first nodes would drain a tumour to see if they’re positive for cancer

36
Q

Which type of carcinoma in situ most commonly gives rise to invasive breast cancer?

A

DCIS

37
Q

What is the difference between the

a) stage
b) grade

of a tumour?

A

a) Stage = spread

b) Grade = degree of differentiation

38
Q

The more differentiated a tumour is, the (better / worse) its prognosis.

A

worse

because the tumour cells highly metaplastic - not like their parent cells

39
Q

The more ___ receptors an invasive carcinoma has, the better its prognosis.

A

hormone receptors

because it can be targeted by drugs

40
Q

Malignant breast tumours possessing oestrogen receptors are susceptible to which treatments?

A

Oophorectomy

Tamoxifen

41
Q

Malignant breast tumours possessing progesterone receptors are vulnerable to which treatments?

A

Oophorectomy

Tamoxifen

I think it’s just the same as oestrogen receptors

42
Q

Apart from oestrogen and progesterone, what is another type of hormone receptor which is found in breast cancer?

A

HER2

43
Q

Which monoclonal antibody is derived from mice and can be used to target HER2 receptors in breast cancers?

A

Trastuzamab / Herceptin

which can’t be given to pregnant women

44
Q

Malignant breast tumours possessing HER2 receptors are vulnerable to which treatment?

A

Trastuzamab / Herceptin

45
Q

What is meant by the term triple negative when referring to breast cancer?

A

Tumour cells don’t have oestrogen, progesterone or HER2 receptors

Rendering it harder to treat

46
Q

Which gene mutations tend to cause triple negative breast cancers?

A

BRCA1 / 2

47
Q

Which organs are a common site of breast cancer metastasis because they produce oestogen?

A

Ovaries

48
Q

What are the treatment options for invasive carcinomas?

A

Surgery

Hormone therapy

Radiotherapy

Chemotherapy inc. trastuzamab

Reproduction Week 7 2018/19 (9 decks)

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