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

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40. Lipponen P, Pietilaninen T, Kosma VM, Aaltomaa S, Eskelinen M, Syrjanen K. Apoptosis suppressing protein bcl-2 is expressed in well-differentiated breast carcinomas with favorable prognosis. J Pathol 1995;177:49-55. 41. Gamallo C; Palacios J; Suarez A; Pizarro A; Navarro P; Quintanilla M; Cano A. Correlation of E-cadherin expression with differentiation grade and histological type in breast carcinoma. Am J Pathol 1993, 142:987-993. 42. Domagala W; Harezga B; Szadowska A; Markiewski M; Weber K; Osborn M. Nuclear p53 protein accumulates preferentially in medullary and high-grade ductal but rarely in lobular breast carcinomas. Am J Pathol 1993;142:669-74. 43. Taniere P, Poulard G, Frappart L, Berger g, Goncalves M, Vauzelle JL, Delecluse DJ, Bailly C, Boucheon S, Berger F. Diabetic mastopathy with epithelioid fibroblasts: differential diagnosis from an infiltrating lobular carcinoma of the breast. Report of two cases. Ann Pathol (France) 1996;16:33- 36. 44. Rosen PP, Lieberman PH, Braun DW, Kosloff C, Adair F. Lobular carcinoma in situ of the breast. Detailed analysis of 99 patients with average follow-up of 24 years. Am J Surg Pathol 1978;2:225-251. 45. Elston CW, Ellis IO. Pathology and breast screening. Histopathology 1990;16:109-118. 46. Dupont WD, Page DL. Relative risk of breast cancer varies with time since diagnosis of atypical hyperplasia. Hum Pathol 1989;20:723-725. 47. Sonnenfeld MR, Frenna TH, Weidner N, Meyer JE. Lobular carcinoma in situ detected in needle directed breast biopsies: radiology-pathology correlation. Radiology 1991;181:363-367. 48. Page DL, Anderson TJ, Rogers LW. Carcinoma in situ (CIS). In: Page DL, Anderson TJ (eds), Diagnostic Histopathology of the Breast; pp. 157-192. Churchill Livingstone, New York, 1987.Rosen PP. 49. Coexistent lobular carcinoma in situ and intraductal carcinoma in a single lobular-duct unit. Am J Surg Pathol 1980;4:241-246. 50. Page DL, Kidd TE, DuPont WD, Simpson JF, Rogers LW. Lobular neoplasia of the breast: higher risk for subsequent invasive cancer predicted by more extensive disease. Hum Pathol 1991;22:1232-1239. 51. Fechner RE. Epithelial alterations in extralobular ducts of breast with lobular carcinoma. Arch Pathol Lab Med 1972;93:164-171. 52. Ottesen GL, Graversen HP, Blicher-Toft M, Zedeler K, Andersen JA (Danish -29-
Breast Cancer Cooperative Group). Lobular carcinoma in situ of the female breast. Short-term results of a prospective nationwide study. Am J Surg Pathol 1993;17:14-21. 53. Wellings SR, Jensen HM. On the origin and progression of ductal carcinoma in the human breast. J Natl Cancer Instit 1973;50:1111-1118. 54. Barwick KW, Kashgarian M, Rosen PP. "Clear-cell" change within duct and lobular epithelium of the human breast. Pathol Annu 1982;17:319-328.Tavassoli FA, Yeh IT. 55. Lactational and clear cell changes of the breast in nonlactating, nonpregnant women. Am J Clin Pathol 1987;87:23-29. 56. Schnitt SJ, Connolly JL, Harris JR, Cohen RB. Radiation-induced changes in the breast. Hum Pathol 1984;15:45-550. 57.Orvieto E, Maiorano E, et al. Clinicopathologic characteristics of invasive lobular carcinoma of the breast: results of an analysis of 530 cases from a single institution. Cancer. 2008 Oct 1;113(7):1511-20. 58. Rakha EA, Patel A, et al. Clinical and biological significance of E-Cadherine protein expression in invasvie lobular carcinoma of the breast. Am J Surg Pathol 2010;34 (10): 1472-1479. 59. Harigopal M, Shin SJ, et all. Aberrent E-cadherin staining patterns in invasvie mammary carcinoma. World J of Surg Pathol 2005;3:73-83. 60. De Leeuw WJ, Berx G, Vos CB, et al. Simultaneous loss of E-cadherin and catenin in invasive lobular breast cancer and lobular carcinoma in-situ. J Pahol 1997;183:404-411. 61. Jayasinghe UW, Bilous M et al. Is survival from infiltrating Lobular caricnoma of breast different from that of infiltrating ductal caricnma? Breast J 2007;13:479- 485 30
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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
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SMA Dx: Spindle-cell Breast Carcino
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Dx: Pure Squamous Carcinoma 10/8/20
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Osseous Differentiation (Osteosarco
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Spindle-cell Carcinoma of the Breas
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Phyllodes y Tumors Phyllodes Tumor
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Diagnosis: Benign g (Low-grade) Phy
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Diagnosis: Malignant (High-grade) P
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10/8/2011 91
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10/8/2011 93
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Illustrative Case 10/8/2011 95
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SMA Calponin 10/8/2011 97
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Dx: Mixed Spindle-cell & Cl Classic
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Dx: Adenomyoepithelioma, Epithelioi
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10/8/2011 103
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10/8/2011 105
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Case 1 • 40 year old female • B
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What is your diagnosis? 1. Invasive
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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
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Page 129 and 130: Case 18 What is your best interpret
Page 131 and 132: Case 20 • 35 year old female with
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
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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 165: 25. Richter GO, Dockerty MB, Claget
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Page 179 and 180: outcome of patients with intracysti
Page 181 and 182: Case 3: History: A 73 year old fema
Page 183 and 184: cases. In this small tubular carcin
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Page 187 and 188: Sclerosing papillary proliferations
Page 189 and 190: 9. Bondeson L, Lindholm K. Aspirati
Page 191 and 192: 43. Green I, McCormick B, Cranor M,
Page 193 and 194: mucinous carcinoma (7,11,12,14). In
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Page 203 and 204: 4. Tavassoli FA, Norris HJ. Secreto
Page 205 and 206: Case 6: History: 66 year old female
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Page 213 and 214: Collagenous spherulosis is a recent
Page 215 and 216: 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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