Page 1 of 1: surg. poorer prognosis of breast carcinoma

pratik · Credits: 11374 My Scrapbook

a 50 year old woman notes a lump in her left breast. she goes to her physician assistant who palpates a 2 cm firm mass in her left breast. a fine needle aspiration biopsy is performed and on microscopic examination a ductal cacinoma is seen. a poorer prognosis for patient is most closely with which of the following findings

a aneuloploidy by flow cytometry
b positive immunohistochemical staining for estrogen receptor
c a well differntiated histologic apperance
d intraductal growth pattern
e stage of t1n0m0

friendy · Credits: 736 My Scrapbook

well differentiated histological appearance

drpsg · Credits: 6208 My Scrapbook

[b]THE PROGNOSTIC FACTORS ASSOCIATED WITH THE BREAST CARCINOMA

1) MOST IMPOTANT IS THE TU,OR STAGING THE SIZE OF TUMOR AND THE LYMPH NODE STATUS PROVIDES RESONABLY GOOD PREDICTOR OF THE PROGNOSIS OF THE DISEASE
SO T1 N0 MO IS STAGE ONE AND HAS A 5 YR SURVIVAL RATE OF 92%

2) ESTROGEN AND PROGESTERONE RECEPTORS : IF BOTH OR EITHER OF THE TWO ARE LACKING IT IS A POOR PROGNOSIS AS MORE CHANCE OF RECURRENCE

3) THE LATEST TESCH IS MEASUREMENT OF THE TUMOR GROWTH RATE
S PHASE ANALYSIS USING THE FLOW CYTOMETRY IS THE MOST ACCURATE MEASURE
INDIRECT S PHASE ASSESSMENT USING THE ANTIGENS ASSOCIATED WITH THE CELL CYCLE SUCH AS PCNA ( KI 67)
TUMORS WITH HIGH PROPORTION OF CELLS IN THE S PHASE POSE A GREATER RISK OF RELAPSE AND CHEMO RX OFFERS THE GREATEST SURVIVAL BENEFIT FOR THESE PATIENTS

4) ASSESSMENT OF THE DNA CONTENT IS OF ODEST VALUSE AND NON DIPLOID TUMORS HAVE SOMWHAT WORSE PROGNOSIS

5) REGARDING THE HISTOLOGY TUMORS WITH POOR NUCLEAR GRADE ie POOR DIFFERENTIATED HAVE A HIGHER RISK OF RECURRENCE THAN WITH A TUMOR OF GOOD NUCLEAR GRADE

6) TUMORS WITH OVEREXPRESSED erb2 ( HER-2/ neu) OR HAVE A MUTATED p53 GENE HAVE A WORSE PROGNOSIS

OTHER VARIABLES WHICH ARE UNDER STUDY AS POTENTIAL PROGNOSTIC MARKERS ARE

1) TYPE 4 COLLAGENASE

2) CATHEPSIN D

3) PLASMINOGEN ACTIVATOR

4) PLASMINOGEN ACTIVATOR RECEPTOR

5) METASTASIS SUPPRESSOR GENE nm23

ANEUPLOIDY HAS GOT INCEREASED RECURRENCE SO IS A POOR PROGNOSTIC FACTOR

HISTOLOLOGIC SUBTYPES OF BREAST CA ( EG MEDULLARY , LOBULAR , COLLOID ETC) SEEMS TO HAVE A LITTLE SIGNIFICANCE IN PROGNOSIS ONCE THE TUMOR IS TRULY INVASIVE

REGARDING THE INTRAUCTAL CA : DUCTAL CA WHICH HAS NOT INVADED THE EXTRADUCTAL TISSUE IS INTRAL DUCTAL OR INSITU DUCTAL SO IT WILL HAVE A GOOD PROGNOSIS

THIS IS INFO GATHERED FRO HARRI 16 AND CMDT 04

SO READING THIS I THINK THE ANS SHOULD BE a) aneuloploidy by flow cytometry
READ THE TABLE 16-4 CMDT 2004 PROGNOSTIC FACTORS IN NODE NEGATIVE BREAST CANCER[/b]

pratik · Credits: 11374 My Scrapbook

thanks for this fantastic effort

friendy · Credits: 736 My Scrapbook

YEA! AGreed to drpsg.

it is flow cytometry that wud detect' 'aneupoloidy' .

poor progosis is there with presence of aneupoloidy.
'aneupoloidy is the amount ofabnormal DNA present in the malignant cells .

in benign n normal cells this amount of DNA is in normal amount n its termed as' eupoloidy'

drpsg · Credits: 6208 My Scrapbook

THAT WAS A GOOD Q FROM WHERE IS IT PRATIK

kumar123 · Credits: 6017 My Scrapbook

Agree its aneuploidy

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