33 Special Types of Invasive Breast Carcinoma: Diagnostic Criteria ...

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Case 19 What is your best interpretation? 1. Invasive mucinous ca 2. Invasive mixed mucinous mucinous, lobular and ductal ca 3. Invasive ductal ca, with focal mucinous differentiation, NST 4. Invasive micropapillary ca 0% 0% 0% 0% 1 2 3 4 383 10/8/2011 128
Case 20 • 35 year old female with 4 cm breast mass • Needle core biopsy Case 20 What is your best interpretation 1. Invasive ductal ca, NST 2. Invasive micropapillary ca 3. Invasive papillary ca 4. Invasive mixed papillary and ductal ca 0% 0% 0% 0% 1 2 3 4 10/8/2011 129
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33 Special Types of Invasive Breast
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Special Types of Invasive Breast Ca
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INVASIVE BREAST CARCINOMAS CONSIDER
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ER Neg. PR Neg. HER2 Neg. CK 5/6 Po
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Triple-negative Breast Carcinomas
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E-cadherin E-cadherin EGFR ++ ER ne
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ER/PR Positive HER2 Negative INVASI
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Tubulolobular Signet-ring Histiocyt
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Illustrative Example: 61 y/o female
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E-Cadherin ER PR 10/8/2011 17
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LCIS vs DCIS • Patients with lobu
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Examples of E-cadherin staining in
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Classic Low-grade DCIS - E-cadherin
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E-cadherin IHC CASE D 10/8/2011 25
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E-cadherin IHC CASE E 10/8/2011 27
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Literature Summary: Correlation of
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10/8/2011 31
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CD10 SMA MIB-1 10/8/2011 33
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Carter et al. Cancer 1977 & 1983
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Differential Diagnosis: 1. Invasive
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10/8/2011 39
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SYNAPTOPHYSIN SMA 10/8/2011 41
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Nassar et al. (AJSP 2006;30:501-7.)
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Special Types of Invasive Breast Ca
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Tubular carcinoma • It has been d
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Tubular carcinoma Histopathology
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Flat Epithelial Atypia When should
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Microglandular adenosis + reticulin
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mitosis ductal ductal, NST tubular
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Treatment • Breast conservation t
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Cribriform carcinoma Histopathology
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Cribriform carcinoma Prognosis •
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Cribriform Carcinoma Pearls of Path
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Clinicopathological features Mucino
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Case 4 Mucinous carcinoma Mixed muc
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Treatment • Breast conservation a
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Incipient mucocele-like lesion Cyst
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10/8/2011 73
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10/8/2011 75
Page 79 and 80: SMA Dx: Spindle-cell Breast Carcino
Page 81 and 82: Dx: Pure Squamous Carcinoma 10/8/20
Page 83 and 84: Osseous Differentiation (Osteosarco
Page 85 and 86: Spindle-cell Carcinoma of the Breas
Page 87 and 88: Phyllodes y Tumors Phyllodes Tumor
Page 89 and 90: Diagnosis: Benign g (Low-grade) Phy
Page 91 and 92: Diagnosis: Malignant (High-grade) P
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Page 97 and 98: Illustrative Case 10/8/2011 95
Page 99 and 100: SMA Calponin 10/8/2011 97
Page 101 and 102: Dx: Mixed Spindle-cell & Cl Classic
Page 103 and 104: Dx: Adenomyoepithelioma, Epithelioi
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Page 109 and 110: Case 1 • 40 year old female • B
Page 111 and 112: What is your diagnosis? 1. Invasive
Page 113 and 114: Case 4 • Irregular large breast m
Page 115 and 116: Case 6 • Needle core biopsy of a
Page 117 and 118: 343 What is your best diagnosis? 1.
Page 119 and 120: 349 Case 9 What is your diagnosis?
Page 121 and 122: Case 11 Case 11 Case 12 • A 68 ye
Page 123 and 124: Case 13 • Needle core biopsy of a
Page 125 and 126: What is your diagnosis? 1. Intracys
Page 127 and 128: What is your best interpretation? 1
Page 129: Case 18 What is your best interpret
Page 133 and 134: Negative ER stain NEG ER Case 22
Page 135 and 136: What is your best interpretation? 1
Page 137 and 138: What is your diagnosis? 1. Secretor
Page 139 and 140: American Soiety of Clinical Patholo
Page 141 and 142: SPECIAL TYPES OF INVASIVE BREAST CA
Page 143 and 144: INVASIVE BREAST CARCINOMAS THAT ARE
Page 145 and 146: of lymphoid cells between sheets of
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Page 151 and 152: In summary, basal-like breast cance
Page 153 and 154: Page et al. (15) described a pleomo
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Page 163 and 164: References (lobular carcinoma): 1.
Page 165 and 166: 25. Richter GO, Dockerty MB, Claget
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Page 179 and 180: outcome of patients with intracysti
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Case 3: History: A 73 year old fema
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cases. In this small tubular carcin
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carcinoma in almost all tubular car
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Sclerosing papillary proliferations
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9. Bondeson L, Lindholm K. Aspirati
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43. Green I, McCormick B, Cranor M,
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mucinous carcinoma (7,11,12,14). In
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mucinous carcinoma. A fine-needle a
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with long-term follow-up [Abstract]
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cystic hypersecretory duct carcinom
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considerable secretion and/or morph
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4. Tavassoli FA, Norris HJ. Secreto
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Case 6: History: 66 year old female
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Adenoid cystic carcinoma (AdCC) is
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Because more than half of adenoid c
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Another family of salivary gland-ty
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Collagenous spherulosis is a recent
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cases: review of the literature and
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Case 7 the breast associated with l
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size (14). Metaplastic breast carci
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adenoma by others who prefer to avo
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survival rate than is usually repor
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it arises in other soft tissue site
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implies a relative risk for develop
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sclerosing adenosis wherein the str
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overgrowth (136). While acknowledgi
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As noted above, any soft-tissue sar
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J Med 73:1078-1082, 1973. 11. Barne
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40. Thorner PS, Kahn HJ, Baumal R,
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75. Fekete P, Petrek J, Majmudar B,
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microscopic, ultrastructural, and i
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2006 Apr;30(4):450-6 143. Liberman
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Case 8 Case history: A 50 year old
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secondary peripheral tumor nodules
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Definitive diagnosis of medullary c
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Pathol 1988;19:1340-6. 12. Rosen PP
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40. Di Bonito; Royen PM, Ziter FMH.
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Am J Clin Pathol 1979;72:383-389. 1
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