Podcast
Questions and Answers
Which subtype of breast cancer is characterized by both ER and PR negative status along with Her2 positivity?
Which subtype of breast cancer is characterized by both ER and PR negative status along with Her2 positivity?
- Triple negative
- Luminal B
- Luminal A
- Her2 (correct)
What is the common feature of BCL2 across all breast cancer subtypes?
What is the common feature of BCL2 across all breast cancer subtypes?
- Indicator of aggressive disease
- Marker of good prognosis (correct)
- Marker of poor prognosis
- Specific to Her2 positive cases
Which therapy is indicated for PD-L1 positive breast cancer?
Which therapy is indicated for PD-L1 positive breast cancer?
- Hormonal therapy
- Neoadjuvant therapy
- Immunotherapy (correct)
- Her2 targeted therapy
Which subtype has a low score for both ER and PR, and is characterized as basal type?
Which subtype has a low score for both ER and PR, and is characterized as basal type?
What is the primary characteristic that subdivides Her2 low tumors?
What is the primary characteristic that subdivides Her2 low tumors?
What constitutes the triple assessment for breast cancer diagnosis?
What constitutes the triple assessment for breast cancer diagnosis?
Which immunohistochemistry markers are routinely tested for hormone receptor status in breast cancer?
Which immunohistochemistry markers are routinely tested for hormone receptor status in breast cancer?
What is Ductal Carcinoma In-Situ (DCIS) characterized by?
What is Ductal Carcinoma In-Situ (DCIS) characterized by?
What genetic alteration is associated with Secretory Carcinoma?
What genetic alteration is associated with Secretory Carcinoma?
Which characteristic is NOT associated with Tall Cell Carcinoma with Reversed Polarity (TCCRP)?
Which characteristic is NOT associated with Tall Cell Carcinoma with Reversed Polarity (TCCRP)?
Which option accurately describes the proliferation rate and risk factors of low nuclear grade breast neoplasia?
Which option accurately describes the proliferation rate and risk factors of low nuclear grade breast neoplasia?
What type of phenotype is most commonly associated with Tall Cell Carcinoma with Reversed Polarity?
What type of phenotype is most commonly associated with Tall Cell Carcinoma with Reversed Polarity?
Which of the following is a method for in situ hybridization used for HER2 testing?
Which of the following is a method for in situ hybridization used for HER2 testing?
Flashcards
Breast Cancer Symptoms
Breast Cancer Symptoms
Nipple discharge and lumps.
Triple Assessment
Triple Assessment
Evaluation involving clinical findings, imaging (mammo/US), and pathological exam (histology, IHC) for breast cancer.
Routine Breast Cancer Tests
Routine Breast Cancer Tests
ER, PR (hormonal therapy response), and HER2 (Trastuzumab therapy) receptor tests.
Immunohistochemistry (IHC) in Breast Cancer
Immunohistochemistry (IHC) in Breast Cancer
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In Situ Hybridisation in Breast Cancer
In Situ Hybridisation in Breast Cancer
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DCIS
DCIS
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Low-Nuclear Grade Breast Neoplasia
Low-Nuclear Grade Breast Neoplasia
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Secretory Carcinoma
Secretory Carcinoma
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Tall Cell Carcinoma with Reversed Polarity (TCCRP)
Tall Cell Carcinoma with Reversed Polarity (TCCRP)
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Luminal A breast cancer
Luminal A breast cancer
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Luminal B breast cancer
Luminal B breast cancer
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HER2+ breast cancer
HER2+ breast cancer
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Triple-negative breast cancer (TNBC)
Triple-negative breast cancer (TNBC)
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HER2 low breast cancer
HER2 low breast cancer
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Neoadjuvant therapy
Neoadjuvant therapy
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Immunotherapy for breast cancer
Immunotherapy for breast cancer
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PD-L1
PD-L1
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BCL2
BCL2
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Basal-like breast cancer
Basal-like breast cancer
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Ki67
Ki67
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FISH
FISH
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Enhertu
Enhertu
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Atezolizumab
Atezolizumab
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Study Notes
Breast Cancer
- Symptoms: Nipple discharge, lumps
- Triple Assessment: Clinical features, imaging (mammography, US), pathological examination (histology, IHC)
- Routine Tests: Estrogen receptor (ER), progesterone receptor (PR), HER2 (for Trastuzumab-based therapy)
- Immunohistochemistry (IHC) tests for ER, PR, HER2, Ki67, and others
- In situ hybridization (FISH, CISH, DDISH) for HER2
- Newer techniques include PCR, NGS, WGS
- Ductal Carcinoma In Situ (DCIS): 20-25% of screened cases
- Stage before cancer invades
- Low Nuclear Grade Breast Neoplasia: Family of precursor and invasive lesions
- Similar immunophenotype and molecular features: Loss of long arm of chromosome 16 and gain of 1q
- Similar nuclear features and low proliferation rate
- Different risk factors, better response to therapy, and a less aggressive course than high-risk lesions
- Types of Low Nuclear Grade Breast Neoplasia:
- Grade 1 ductal, tubular, lobular, mucinous carcinomas (histological types)
Secretory Carcinoma
- Pathognomonic Feature: ETV6-NTRK3 gene fusion
- Treatment: Small molecule inhibitors (larotrectinib and entrectinib) targeting NTRK3 and other NTRK family members
- Further Testing: Need for ETV6-NTRK3 tests
Tall Cell Carcinoma with Reversed Polarity (TCCRP)
- Characteristic Feature: Invasive breast carcinoma with cell nests arranged in a predominantly solid, papillary pattern; reversed polarity of nuclei; and lack of myoepithelial cells around nests.
- Molecular Characteristics: Expression of both low- and high-molecular-weight cytokeratins; triple-negative or weakly hormone receptor-positive phenotype
- Prevalence: Seen in 84% of cases; not commonly found in other invasive breast cancers
IHC Subtypes
- Luminal A: ER, PR+ HER2-, low Ki67
- Luminal B: ER, PR +/- HER2+/-, higher Ki67
- HER2+: ER, PR-, HER2+3 score, +2 FISH
- Triple-Negative: ER, PR-, HER2-
- HER2 Low: ER, PR-, HER2 +1/+2, FISH -
BCL2
- Marker of good prognosis across all subtypes
Therapy
- Neoadjuvant Therapy: Used in early breast cancer (BC)
- Immunotherapy: Indicated for PD-L1 positive metastatic TNBC
- HER2 Low: Considered negative; not suitable for anti-HER targeted therapy
- Targeted Therapies: Pembrolizumab, Atezolizumab, Enhertu
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Description
This quiz covers key aspects of breast cancer including symptoms, diagnostic assessments, routine tests like hormone receptor analysis, and specific types of neoplasms such as Ductal Carcinoma In Situ (DCIS). Explore the techniques used in pathology and the significance of low nuclear grade lesions. Test your knowledge on the latest methodologies and their implications for treatment.
