Invasive breast carcinoma - IARC

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World Health Organization Classification of Tumours Series Editors Paul Kleihues, M.D. Leslie H. Sobin, M.D. Pathology and Genetics of Tumours of the Breast and Female Genital Organs Editors Coordinating Editors Editorial Assistants Layout Illustrations Printed by Publisher Fattaneh A. Tavassoli, M.D. Peter Devilee, Ph.D. Lawrence M. Roth, M.D. Rosemary Millis, M.D. Isabelle Forcier Christine Zorian Lauren A. Hunter Sibylle Söring Pascale Dia Georges Mollon Lauren A. Hunter Druckhaus Tecklenborg 48565 Steinfurt, Germany <strong>IARC</strong>Press International Agency for Research on Cancer (<strong>IARC</strong>) 69008 Lyon, France
This volume was produced in collaboration with the International Academy of Pathology (IAP) The WHO Classification of Tumours of the Breast and Female Genital Organs presented in this book reflects the views of Working Groups that convened for Editorial and Consensus Conferences in Lyon, France, January 12-16 and March 16-20, 2002. Members of the Working Groups are indicated in the List of Contributors on page 365 The Working Group on Gynaecological Tumours greatly appreciates the participation of, and guidance by Dr. Robert E. Scully, Harvard Medical School
Page 2: Previous volumes in this series Kle
Page 8 and 9: Published by IARC Press, Internatio
Page 10 and 11: CHAPTER 1 Tumours of the Breast Can
Page 12 and 13: TNM classification of carcinomas of
Page 14 and 15: Invasive breast carcinoma I.O. Elli
Page 16 and 17: Rapid growth and greater adult heig
Page 18 and 19: tives, administrative and clerical
Page 20 and 21: Grade 1 - well differentiated: 3-5
Page 22 and 23: ent and this is occasionally extens
Page 24 and 25: Most melanotic tumours of the breas
Page 26 and 27: A Fig. 1.22 A Classic invasive lobu
Page 28 and 29: yet others at 90% {97,2147}. For pr
Page 30 and 31: Fig. 1.27 Medullary carcinoma. The
Page 32 and 33: myoepithelial cells in fibro a d e
Page 34 and 35: A Fig. 1.33 Neuroendocrine carcinom
Page 36 and 37: Macroscopy Fisher et al. reported t
Page 38 and 39: Fig. 1.39 Apocrine carcinoma. Note
Page 40 and 41: cells contain intracytoplasmic lume
Page 42 and 43: A Fig. 1.50 Carcinosarcoma. A Two a
Page 44 and 45: A B C Fig. 1.75 Lobular neoplasia.
Page 46 and 47: Intraductal proliferative lesions F
Page 48 and 49: A B absence of either microcalcific
Page 50 and 51: Fig. 1.83 Atypical ductal hyperplas
Page 52 and 53: A B Fig. 1.88 Large excision biopsy
Page 54 and 55: unusual variants as well. Using thi
Page 56 and 57:
esemble those identified in invasiv
Page 58 and 59:
A B Fig. 1.97 Microinvasive carcino
Page 60 and 61:
A Papilloma may be subject to morph
Page 62 and 63:
A B C Fig. 1.103 Papillary intraduc
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colour measuring from 0.5 to 12 cm.
Page 66 and 67:
Immunoprofile The cases studied by
Page 68 and 69:
Glycogen-rich, clear cell carcinoma
Page 70 and 71:
Differential diagnosis There may be
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quality metaphase spreads from an i
Page 74 and 75:
Fig. 1.67 Lobular carcinoma of brea
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detectable distant metastasis displ
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detected at a late stage as small t
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Extent of ductal carcinoma in situ
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Benign epithelial proliferations G.
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Fig. 1.112 Microglandular adenosis.
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A Apocrine adenoma ICD-O code 8401/
Page 88 and 89:
A B Fig. 1.128 Adenomyoepithelioma,
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Mesenchymal tumours M. Drijkoningen
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1113,1275}. There is a complex patt
Page 94 and 95:
A B Fig. 1.137 A Lipoma. Intraparen
Page 96 and 97:
Fig. 1.141 Angiosarcoma after breas
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A Fig. 1.144 Mammary osteosarcoma.
Page 100 and 101:
Fibroepithelial tumours J.P. Belloc
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aged women (average age of presenta
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lished data suggests a 21% rate of
Page 106 and 107:
A Fig. 1.157 Syringomatous adenoma
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Malignant lymphoma and metastatic t
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used. Inflammatory conditions in th
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male population both in the USA and
Page 114 and 115:
CHAPTER 2 Tumours of the Ovary and
Page 116 and 117:
Polyembryoma 9072/3 Non-gestational
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Surface epithelial-stromal tumours
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A Fig. 2.04 A Serous borderline tum
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A Fig. 2.06 Serous borderline tumou
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A Fig. 2.10 Invasive peritoneal imp
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Fig. 2.15 Mucinous carcinoma with i
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Fig. 2.20 Mucinous endocervical-lik
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A Fig. 2.28 Mucinous cystic tumour
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early secretory endometrium {2605}.
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IV, 6% {2233}. Patients with grade
Page 136 and 137:
A Fig. 2.37 A This polypoid intracy
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Fig. 2.40 Endometrioid cyst with at
Page 140 and 141:
1 tumours are extremely rare. Almos
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Fig. 2.50 Borderline Brenner tumour
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express thrombomodulin and have bee
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serous and transitional cell carcin
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is yellow to tan with a variable ad
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Genetic susceptibility JGCTs may pr
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Clinical features F i b romas may b
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distinguishes this tumour from the
Page 156 and 157:
A Fig. 2.77 A Retiform Sertoli-Leyd
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Mean ages of 21 and 38 years and me
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Tumours unassociated with PJS form
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mal origin without crystals of Rein
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Germ cell tumours F. Nogales A. Tal
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cases, anisokaryosis has no prognos
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ation may coexist in the same neopl
Page 170 and 171:
Table 2.06 Grading of ovarian immat
Page 172 and 173:
A B Fig. 2.102 A Mature cystic tera
Page 174 and 175:
Diagnostic procedures Elevated urin
Page 176 and 177:
associated with mature teratomas sh
Page 178 and 179:
atives intimately admixed. The germ
Page 180 and 181:
Fig. 2.113 Mixed germ cell-sex cord
Page 182 and 183:
A Fig. 2.116 A Adenomatous hyperpla
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Fig. 2.117 Small cell carcinoma, hy
Page 186 and 187:
Clinical features Adenoid cystic-li
Page 188 and 189:
Histopathology This epithelial tumo
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sis. Corpus luteum of pregnancy has
Page 192 and 193:
Lymphomas and leukaemias L.M. Roth
Page 194 and 195:
Secondary tumours of the ovary J. P
Page 196 and 197:
Occasionally, the colonic adenocarc
Page 198 and 199:
Peritoneal tumours S.C. Mok J.O. Sc
Page 200 and 201:
A B Fig. 2.140 Cystic adenomatoid m
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whelmingly poor {1038,1547,2310}. H
Page 204 and 205:
CHAPTER 3 Tumours of the Fallopian
Page 206 and 207:
TNM and FIGO classification of carc
Page 208 and 209:
Endometrioid adenocarcinoma Endomet
Page 210 and 211:
Two examples of adenofibroma of bor
Page 212 and 213:
A Fig. 3.11 Adenomatoid tumour. A T
Page 214 and 215:
Clinical features Patients range in
Page 216 and 217:
Fig. 3.16 Uterus-like mass. The cys
Page 218 and 219:
CHAPTER 4 Tumours of the Uterine Co
Page 220 and 221:
TNM and FIGO classification of non-
Page 222 and 223:
Epithelial tumours and related lesi
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endometrioid adenocarcinoma fro m a
Page 226 and 227:
fers from the prototypical type I e
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the ovary and bladder. Unlike prima
Page 230 and 231:
schema {1535,2602}. Although this c
Page 232 and 233:
Table 4.03 Altered gene function in
Page 234 and 235:
Mesenchymal tumours and related les
Page 236 and 237:
areas are limited to less than 30%
Page 238 and 239:
A B C Fig. 4.30 Leiomyosarcoma. A T
Page 240 and 241:
e used sparingly and is reserved fo
Page 242 and 243:
A B Fig. 4.38 Leiomyoma with perino
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cytological atypia, tumour cell nec
Page 246 and 247:
Mixed epithelial and mesenchymal tu
Page 248 and 249:
Prognosis and predictive factors Th
Page 250 and 251:
tumours may superficially invade th
Page 252 and 253:
A Fig. 4.46 A Gestational choriocar
Page 254 and 255:
A Fig. 4.49 A Classic complete hyda
Page 256 and 257:
Sex cord-like, neuroectodermal and
Page 258 and 259:
Secondary tumours of the uterine co
Page 260 and 261:
WHO histological classification of
Page 262 and 263:
Epithelial tumours M. Wells J.M. Ne
Page 264 and 265:
Fig. 5.04 Mechanisms of human papil
Page 266 and 267:
Fig. 5.08 Keratinizing squamous cel
Page 268 and 269:
in their Asian population {2957}. I
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have a strong association with high
Page 272 and 273:
e red by squamous epithelium {380}.
Page 274 and 275:
endometrioid adenocarcinoma of the
Page 276 and 277:
metrial epithelium. In some cases t
Page 278 and 279:
with distinct cell borders and a gr
Page 280 and 281:
Mesenchymal tumours M.L. Carcangiu
Page 282 and 283:
{781}, liposarcoma {2840,3016}, ost
Page 284 and 285:
Mixed epithelial and mesenchymal tu
Page 286 and 287:
Fig. 5.44 Wilms tumour. The tumour
Page 288 and 289:
A Fig. 5.47 Implant of endometrial
Page 290 and 291:
CHAPTER 6 Tumours of the Vagina Alt
Page 292 and 293:
Epithelial tumours E.S. Andersen A.
Page 294 and 295:
Aetiology The fact that both VAIN a
Page 296 and 297:
Fig. 6.10 Fibroepithelial polyp.A m
Page 298 and 299:
er of mitoses varies but is usually
Page 300 and 301:
ICD-O codes Adenosquamous carcinoma
Page 302 and 303:
A C Fig. 6.17 Sarcoma botryoides. A
Page 304 and 305:
1-11 cm. They may arise anywhere in
Page 306 and 307:
elsewhere in the female genital tra
Page 308 and 309:
A Fig. 6.24 Yolk sac tumour. A The
Page 310 and 311:
g rowing in sheets. Some may have s
Page 312 and 313:
WHO histological classification of
Page 314 and 315:
Epithelial tumours E.J. Wilkinson M
Page 316 and 317:
even with additional sectioning, it
Page 318 and 319:
type) is a highly diff e rentiated
Page 320 and 321:
Clinical features Bartholin gland c
Page 322 and 323:
glandular elements surrounded by fi
Page 324 and 325:
Mesenchymal tumours R.L. Kempson M.
Page 326 and 327:
Table 7.03 Differential diagnosis o
Page 328 and 329:
Prognosis and predictive factors A
Page 330 and 331:
Table 7.04 Clark levels of cutaneou
Page 332 and 333:
A Fig. 7.23 Vulvar peripheral primi
Page 334 and 335:
Familial aggregation of cancers of
Page 336 and 337:
BRCA1 syndrome Definition Inherited
Page 338 and 339:
dispose individuals to the developm
Page 340 and 341:
Fig. 8.05 To assess whether wild-ty
Page 342 and 343:
Fig. 8.07 Factors that modify risk
Page 344 and 345:
BRCA2 syndrome R. Eeles S. Piver S.
Page 346 and 347:
tubal or ovarian carcinomas. Howeve
Page 348 and 349:
in typical nuclear foci that may re
Page 350 and 351:
Breast tumours Frequency Breast can
Page 352 and 353:
Fig. 8.14 Codon distribution of som
Page 354 and 355:
Breast tumours Age distribution and
Page 356 and 357:
Hereditary non-polyposis colon canc
Page 358 and 359:
essary in the evaluation of the pat
Page 360 and 361:
Age distribution and penetrance Mos
Page 362 and 363:
Contributors Dr Vera M. ABELER** De
Page 364 and 365:
Dr Carlo LA VECCHIA Laboratory of E
Page 366 and 367:
Dr Manuel TEIXEIRA Department of Ge
Page 368 and 369:
02.100 Dr. A. Ostor 02.101 Dr. F.A.
Page 370 and 371:
52. Akhtar M, Robinson C, Ashraf Al
Page 372 and 373:
180. Bapat K, Brustein S (1989). Ut
Page 374 and 375:
307. Bolis GB, Maccio T (2000). Cle
Page 376 and 377:
436. Chang J, Sharpe JC, A'Hern RP,
Page 378 and 379:
562. Costa MJ, Ames PF, Walls J, Ro
Page 380 and 381:
689. Di Domenico A, Stangl F, Benni
Page 382 and 383:
820. Falck J, Petrini JH, Williams
Page 384 and 385:
943. Gad A, Azzopardi JG (1975). Lo
Page 386 and 387:
1067. Grimes MM (1992). Cystosarcom
Page 388 and 389:
1197. Herod JJ, Shafi MI, Rollason
Page 390 and 391:
1323. Jacques SM, Qureshi F, Ramire
Page 392 and 393:
1449. Khalifa MA, Mannel RS, Harawa
Page 394 and 395:
1564. Lagios MD (1977). Multicentri
Page 396 and 397:
1687. Loman N, Johannsson O, Kristo
Page 398 and 399:
1807. McCluggage G, McBride H, Maxw
Page 400 and 401:
1937. Mukai M, Torikata C, Iri H (1
Page 402 and 403:
2056. Norris HJ, Taylor HB (1967).
Page 404 and 405:
2180. Park JS, Jones RW, McLean MR,
Page 406 and 407:
2304. Puls LE, Hamous J, Morrow MS,
Page 408 and 409:
2 4 3 4 . Rosen PP, Groshen S, Saig
Page 410 and 411:
2559. Schlesinger C, Silverberg SG
Page 412 and 413:
2686. Silverberg SG (1999). Protoco
Page 414 and 415:
2806. Stutz JA, Evans AJ, Pinder S,
Page 416 and 417:
2942. Tornos C, Silva EG, Ordonez N
Page 418 and 419:
3061. Wargotz ES, Norris HJ (1990).
Page 420 and 421:
3189. Yoshioka T, Tanaka T (2000).
Page 422 and 423:
References 425
Page 424 and 425:
Biphasic teratomas, 168 BLM, 341, 3
Page 426 and 427:
G GADD45, 343, 353 GCDFP-15, 25, 33
Page 428 and 429:
MPNST, see Malignant peripheral ner
Page 430:
Small cell / oat cell carcinoma, 32
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