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64 Cards in this Set
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- Back
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What is the relative risk of cancer in breasts with usual ductal hyperplasia?
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1.5-2x
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What is the relative risk of cancer in sclerosing adenosis, radial scar, peripheral papillomas, complex sclerosing lesions?
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1.5-2x
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What is the relative risk of cancer in atypical ductal hyperplasia?
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4-5X
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If ADH is seen on core biopsy, what percentage has DCIS on excision?
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15%
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If FEA is seen on core biopsy, what percentage has a worse lesion on excision?
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15-30%
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What % of women get breast cancer?
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1/8 = 12.5%
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What is the most common type of cancer in women?
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Breast
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What is the leading cause of cancer death in women age 35-54?
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Breast cancer
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What chromosomes are BRCA1 and BRCA2 on?
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BRCA1 = 17
BRCA2 = 13 |
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What % of breast cancers are hereditary?
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5-10%
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What is the risk (% and relative risk) of developing breast cancer in the ipsilateral breast with DCIS?
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95%, 8-10 fold increased relative risk
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Where does the E-cadherin gene map?
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16q22
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What is the risk (% and relative risk) of developing cancer in the setting of LCIS in either breast?
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20-25%, 8-10X
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In the setting of invasive lobular carcinoma, what is the risk (%) of contralateral carcinoma?
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10-15%
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What percentage of invasive lobular carcinoma is associated with LCIS?
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40-60%
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In staging breast cancer, what is:
- pNo (ITC) - pN1mi - pN1 |
- pNo (ITC): <0.2 mm
- pN1mi: 0.2-2mm - pN1: >2mm |
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Compared to female breast cancer, what is the incidence of male breast cancer?
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Male breast cancer is 1% of female breast cancer
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Elston grading:
- Tubule formation cut-offs - Nuclear pleomorphism - Mitoses * Based on 10 hpf (field diameter 0.44 mm) * based on 10 hpf (field diameter 0.59 mm) |
- Tubule formation cut-offs
* 1 point = >75% * 2 points = 10-75% * 3 points = <10% - Nuclear pleomorphism * 1 point = minimal nuclear variation in size and shape * 2 points = moderate variation in size and shape * 3 points = marked pleomorphism - Mitoses * 10 hpf (field diameter 0.44 mm) -- 1 point = 0-5 -- 2 points = 6-10 -- 3 points = >10 * 10 hpf (field diameter 0.59) -- 1 point = 0-9 -- 2 points = 10-19 -- 3 points = >20 |
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In Elston grading what are the number of points for:
- Grade 1 - Grade 2 - Grade 3 |
- Grade 1: 3-5
- Grade 2: 6-7 - Grade 8-9 |
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In embryogenesis in what week does the milk line (a.k.a. mammary ridge) form?
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5th week of gestation
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Peripheral papilloma is characterized by what relative risk for developing cancer?
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1.5-2x
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Fibrocystic change is associated with what relative risk for cancer?
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1. Same as general population
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What is Stewart-Treves syndrome?
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post-mastectomy lymphangiosarcoma of the arm
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What is the incidence of post-radiation angiosarcoma?
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0.2-1%
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What is the relative risk of developing cancer in the setting of solitary intraductal papilloma arising from large ducts?
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The relative risk is 1. Same as general population.
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What is the relative risk of developing cancer in the setting of multiple intraductal papillomas/peripheral papillomas arising in terminal duct lobular units?
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1.5-2X
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What is the relative risk of developing contralateral breast cancer in the setting of ADH?
What about ADH arising from a papilloma? |
ADH: Relative risk of 4-5 in contralateral breast
ADH arising from papilloma: No increased risk of contralateral breast cancer |
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With regard to risk for cancer, how is ADH more like LCIS than DCIS?
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DCIS confers ipsilateral risk while ADH and LCIS confer bilateral risk.
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What are the good prognosis breast cancers? (3)
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Tubular, mucinous, medullary
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This invasive breast carcinoma is well circumscribed, has greater than 75% syncytial growth pattern, and is associated with marked lymphoplasmacytic infiltrate.
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Medullary carcinoma
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What's the typical expression of medullary carcinoma:
ER PR Her2/Neu |
ER: negative
PR: negative Her2/Neu: negative |
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Is medullary carcinoma associated with BRCA1 or BRCA2?
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BRCA1
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What % of invasive lobular carcinoma is bilateral?
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10-20%
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What percent of invasive ductal carcinoma is bilateral?
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5%
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What IHC is specific for Paget's disease?
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Her2/Neu
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This lesion is a benign infiltrating neoplasm characterized by tubular structures with "comma-shaped" appearance which can recur if incompletely excised.
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Syringomatous adenoma
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This carcinoma has mucinous and neuroendocrine differentiation.
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Solid papillary carcinoma
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IHC pattern in microglandular adenosis:
p63 S100 AE1/3 ER PR Her2 p53 GCDFP |
p63: negative (lacks myoepithelial cells)
S100: positive AE1/3: positive ER: negative PR: negative Her2: negative p53: negative GCDFP: negative |
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The Van Nuys Prognostic index scores DCIS based on what 3 categories?
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1. Size:
- 1 pt = <15.0 mm - 2 pt = 16-40 mm - 3 pt = >40 mm 2. Nuclear grade - 1 pt = low grade - 2 pt = intermediate grade - 3 pt = high grade 3. Distance from margin - 1 pt = >10 mm - 2 pt = 1-9 mm - 3 pt = <1 mm Score: Low risk of recurrence = 3-4 Intermediate risk of recurrence = 5-6 High risk of recurrence = 7-9 |
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Phylloes tumor is more common in what ethnic groups?
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Asians and Latinos (especially from Central and South America)
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Increased or decreased risk of breast cancer:
old age |
increased
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Increased or decreased risk of breast cancer:
being from the USA or Western countries |
increased
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Increased or decreased risk of breast cancer:
early menarche (<12 yrs) |
increased
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Increased or decreased risk of breast cancer:
late menopause (after 54) |
increased
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Increased or decreased risk of breast cancer:
nulliparity |
increased
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Increased or decreased risk of breast cancer:
maternal age at first birth >30 |
increased
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Increased or decreased risk of breast cancer:
high breast density |
increased
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Increased or decreased risk of breast cancer:
hormone replacement therapy |
increased
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Increased or decreased risk of breast cancer:
OCP |
increased
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Increased or decreased risk of breast cancer:
obesity in post-menopausal women |
increased
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Increased or decreased risk of breast cancer:
alcohol consumption |
increased
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Increased or decreased risk of breast cancer:
geographic location in Africa or Asia |
decreased
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Increased or decreased risk of breast cancer:
early first pregnancy |
decreased
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Increased or decreased risk of breast cancer:
breast-feeding for prolonged duration |
decreased
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Increased or decreased risk of breast cancer:
obesity in pre-menopausal women |
decreased
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Increased or decreased risk of breast cancer:
increased physical activity |
decreased
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Increased or decreased risk of breast cancer:
tamoxifen |
decreased
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What mutations are associated with familial breast carcinoma? (6)
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BRCA1, BRCA2, PTEN, ATM, p53, STK11 (aka LKB1)
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Where does p53 map? What is the eponym for the familial p53 mutation?
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17q13.1; Li-Fraumeni syndrome
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Where does PTEN map and what is the eponym for the familial PTEN mutation?
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10q23.3; Cowden's syndrome
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Where does ATM map?
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11q22-23
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Where does STK11/LKB1 map and what is the name of the familial syndrome involving this gene?
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19q13.3; Peutz-Jeghers
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Is BRCA1 germ line mutation associated with male breast cancer?
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No. But BRCA2 is.
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Is BRCA2 germ line mutation associated with male breast cancer?
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Yes. But BRCA1 is not.
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