Breast Cancer Overview and Types

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Questions and Answers

What percentage of breast cancers are classified as infiltrating ductal carcinoma (IDC)?

70-80%

10-20%

40-50%

80-90% (correct)

Which subtype of breast cancer accounts for approximately 6-8% of all cases?

Inflammatory breast cancer

Invasive lobular carcinoma (ILC) (correct)

Ductal carcinoma in situ (DCIS)

Paget’s disease of the nipple

What is the most aggressive form of breast cancer?

Inflammatory carcinoma (correct)

Paget’s disease of the nipple

Ductal carcinoma

Lobular carcinoma

Breast cancer arises primarily from which type of cells?

Epithelial lining cells of milk ducts Signup and view all the answers

What is Paget’s disease of the nipple characterized by?

Presence of intraepidermal tumor cells Signup and view all the answers

Which presenting symptoms are most commonly associated with Paget’s disease of the nipple?

Eczema or ulceration of the nipple Signup and view all the answers

What is a common misdiagnosis for inflammatory breast cancer?

Breast infection (Mastitis) Signup and view all the answers

Breast cancer is not merely a single disease but consists of various subtypes that vary in:

Behavior and prognosis Signup and view all the answers

Which gene mutations are primarily associated with inherited forms of breast cancer?

BRCA1 and BRCA2 Signup and view all the answers

What is the lifetime risk of developing breast cancer for New Mexican American Indians?

1 in 40 Signup and view all the answers

Which factor is NOT associated with an increased risk of developing breast cancer?

Current or former use of oral contraceptives Signup and view all the answers

What percentage of all breast cancer cases is attributed to mutations in breast cancer susceptibility genes?

5-10% Signup and view all the answers

Exposure to secondhand smoke is linked to breast cancer risk in which group of women?

Premenopausal women Signup and view all the answers

How does breast cancer primarily lead to complications and death?

Metastasis to distant body sites Signup and view all the answers

What change in breast tissue is associated with a lower risk of breast cancer?

Timing of first child birth Signup and view all the answers

What trend regarding breast cancer incidence has been observed over the past 50 years?

Increase in diagnosed cases each year Signup and view all the answers

Which type of breast cancer (BC) is defined by a lack of family history?

Sporadic BC Signup and view all the answers

Which diagnostic procedure is least invasive when evaluating for breast cancer?

Mammography Signup and view all the answers

What characterizes inherited cancer gene syndromes regarding their genetic transmission?

Passed on through autosomal dominant transmission Signup and view all the answers

In the evaluation of breast cancer, what is the main purpose of employing progressively invasive procedures?

To provide a more thorough investigation before reaching a diagnosis Signup and view all the answers

Which symptom is NOT commonly associated with breast cancer diagnosis?

Increased breast size Signup and view all the answers

What characteristic indicates advanced disease when examining axillary nodes?

Non-mobile and swollen nodes Signup and view all the answers

Which statement about polygenic breast cancer is true?

Gene interactions with the environment are poorly understood. Signup and view all the answers

Which of the following procedures offers the highest level of invasiveness?

Computerized stereotactic guided core needle biopsy Signup and view all the answers

Which of the following factors does not increase the risk of breast cancer?

Being diagnosed with a genetic syndrome that lowers breast cancer risk Signup and view all the answers

What does a Birad assessment of 3 indicate about the findings?

Probably benign with high probability (>98%) Signup and view all the answers

If a tumor is classified as T4, what does it indicate?

Tumor of any size with extension into the chest wall or skin Signup and view all the answers

Under what circumstances is MRI screening recommended in addition to mammograms?

For women who have a BRCA1 or BRCA2 mutation Signup and view all the answers

Which node classification indicates there is no regional lymph node metastasis?

N0 Signup and view all the answers

Which Birad assessment category suggests the need for a biopsy?

Category 4 Signup and view all the answers

What defines the M1 classification in breast cancer staging?

Distant metastasis present Signup and view all the answers

What is the primary reason MRI is not recommended for women with average risk for breast cancer?

It can lead to unnecessary anxiety and biopsies Signup and view all the answers

Which of the following statements about breast cancer risk factors is true?

Having a first-degree relative with a BRCA1 or BRCA2 mutation increases risk Signup and view all the answers

What does a Birad assessment of 0 signify?

Incomplete information requiring further imaging Signup and view all the answers

Which tumor size corresponds to T2 classification?

Tumor between 2–5 cm Signup and view all the answers

Which Birad assessment suggests that routine screening is recommended without immediate concern?

Category 2 Signup and view all the answers

What is indicated by the N3 classification in breast cancer staging?

Metastasis in fixed ipsilateral axillary lymph nodes Signup and view all the answers

At what percentage likelihood is a lesion deemed highly suspicious for malignancy in a Birad assessment?

At least 95% Signup and view all the answers

Which statement best describes the implications of a lifetime breast cancer risk of 20% or greater?

It indicates a significant concern for developing breast cancer Signup and view all the answers

What is the recommended follow-up for a Birad assessment of 3?

Six-month follow-up Signup and view all the answers

Study Notes

Disease Summary

Breast cancer (BC) is a prevalent and aggressive malignancy arising from breast cells.
It can invade surrounding tissues, metastasize to distant organs, and result in severe organ damage or death.
Numerous subtypes of breast cancer exist, each with varying behavior and prognosis.
Most cases arise from the epithelial lining of milk ducts (ductal carcinomas), with invasive ductal carcinoma (IDC) being the most common, constituting 80-90% of cases.
Invasive lobular carcinoma (ILC) accounts for 6-8% of breast cancers, while Paget’s disease of the nipple is rare and presents with eczema or ulceration.
Inflammatory breast cancer, a highly aggressive form, comprises 3% of cases and may resemble breast infections.
Higher incidence rates of BC in African American women ages 40-50 compared to Caucasian women.
Lifetime BC risk estimates are 1 in 21 for New Mexican Hispanics and 1 in 40 for New Mexican American Indians.
In the U.S., BC diagnoses have steadily increased over the past 50 years, with an overall frequency of 11 cases per 10,000 women as of 2001.
Genetic mutations in susceptibility genes account for 5-10% of cases, with BRCA1 and BRCA2 mutations being the most significant inherited risk factors.
Other notable genetic mutations linked to breast cancer include PTEN, STKII/LKB1, ATM, MSH2/MLH2, and CHEK2.
Exposure to secondhand smoke increases BC risk in premenopausal women; oral contraceptives show no significant risk increase based on extensive studies.
Ionizing radiation exposure before age 30 markedly increases BC incidence, while daily alcohol consumption and high breast tissue density are additional risk factors.

Pathophysiology

Breast cancer develops through a stepwise accumulation of genetic errors due to disruptions in cell growth regulation.
Uncontrolled cell division leads to tumor formation, depriving healthy cells of nutrients and oxygen.
Cancer cells can metastasize to lymph nodes or other organs, with common sites including the lungs, liver, and bones.
Metastatic spread is associated with poor outcomes, distinguishing sporadic, inherited, and polygenic forms of breast cancer.
A woman’s age at first childbirth influences her risk for BC; younger age correlates with lower risk due to completed breast differentiation post-pregnancy.

Diagnosis: Clinical Manifestations and Laboratory Tests

Evaluation for breast cancer includes patient history, physical examination, imaging, and biopsy.
Diagnostic techniques: mammography, ultrasonography, fine-needle aspiration, guided core needle biopsy, excisional biopsy.
Physical signs of BC include abnormal breast size, contour changes, nipple retraction, and swelling.
Palpation identifies enlarged axillary and supraclavicular nodes, indicating potential metastasis.
BI-RADS assessment categorizes findings from incomplete information (0) to known malignancy (6), guiding further investigation or treatment.
Guidelines recommend mammography every 1-2 years for women over 40, while MRI is suggested for high-risk patients, including those with BRCA mutations or previous chest radiation.
Tumor staging includes classifications for primary tumor size (T0-T4), regional lymph node involvement (N0-N3), and distant metastasis (M0, M1).

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Description

This quiz covers essential information about breast cancer, including its prevalence, types, and characteristics. You'll learn about the most common forms, such as invasive ductal carcinoma and inflammatory breast cancer, as well as the demographics affected by this disease. Gain insight into the differences between subtypes and their prognostic implications.