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

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distinct types. Sem Diag Pathol 1990;7:90-101. 24. Rosen PP Adenoid cystic carcinoma of the breast: a morphologically heterogenous neoplasm. Pathol Annu 1989;24(Pt 2):237-54. 25. Taylor HB, Norris HJ: Well-differentiated carcinoma of the breast. Cancer 1970;25:687-692 26. Cooper HS, Patchefsky AS, Krall RA: Tubular carcinoma of the breast. Cancer 1978;42:2334-2342. 27. Oberman HA, Fidler WJ: Tubular carcinoma of the breast. Am J Surg Pathol 1979;3:387-395. 28. Deos PH, Norris HJ: Well-differentiated (tubular) carcinoma of the breast. Am J Clin Pathol 1982;78:1-7. 29. Parl FF, Richardson LD: The histologic and biologic spectrum of tubular carcinoma of the breast. Hum pathol 1983;14:694-698. 30. Rosen PP. Microglandular adenosis: a benign lesion simulating invasive mammary carcinoma. Am J Surg Pathol 1983;7:137-144. 31. Rosen PP: Microglandular adenosis. A benign lesion simulating invasive mammary carcinoma. Am J Surg Pathol 1983;7:137-144. 32. Tavassoli FA, Norris HJ: Microglandular adenosis of the breast. Am J Surg Pathol 1983;7:731-737. 33. James BA, Cranor ML, Rosen PP. Carcinoma of the breast arising in microglandular adenosis. Am J Clin Pathol 1993;100:507-513. 34. Haagensen CD. "Adenosis tumor," In: Diseases of the Breast, 2nd Edition, 1971, pp. 177-184, W.B. Saunders, Philadelphia, PA. 35. Azzopardi JG."Fibroadenoma," In: Problems in Breast Pathology, 1st Edition, 1979, pp.39-56, W.B. Saunders, Philadelphia, PA. 36. Urban JA, Adair FE. Sclerosing adenosis. Cancer 1949;2:625-634. 37. Sloane JP, Mayers MM. Carcinoma and atypical hyperplasia in radial scars and complex sclerosing lesions: importance of lesion size and patient age. Histopathol 1993;23:225-231. 38. Azzopardi JG. Ductal adenoma of the breast: a lesion which can mimic carcinoma. J Pathol 1984;144:15-23.. 39. Lammie GA, Millis RR. Ductal adenoma of the breast - a review of fifteen cases. Hum Pathol 1989;20:903-908 40. Fisher ER, Gregorio RM, Redmond C, et al: Tubulo-lobular invasive breast cancer: A variant of lobular invasive cancer. Hum Pathol 1977;8:679-683. 41. Cangiarella J, Waisman J, Shapiro R, et al: Cytologic features of tubular adenocarcinoma of the breast by aspiration biopsy. Diagnostic Cytopathology, 2010;25:5,311-315 42. Rosen PP. Rosen’s Breast Pahology, third edition 2010. P: 406-421 53
43. Green I, McCormick B, Cranor M, et al. A comparateve study of pure tubular and tubulolobular carcinoma of breast. Am J Surg Pathol 1997;21:653-657 44. Wheeler DT, Tai LH, Bratthauer GL, et al. Tubulolobular carcinoma of breast. An analysis of 27 cases of tumor with a hybrid morphology and immunoprofile. Am J Surg Pathol 2004;28:1587-1593. Case 4: History: 57 y/o female with palpable breast mass. Patient was participating in the breast cancer awareness month function when she examined her own breasts and noticed the left breast mass. Mammogram found 2 cm suspicious mass at 5 o'clock position of the left breast Submitted diagnosis: Invasive mucinous carcinoma, "pure” (welldifferentiated invasive breast carcinoma, overall mBR grade 1; nuclear grade 1, tubular grade “1", mitotic grade 1). MUCINOUS CARCINOMA Background: Mucinous carcinoma contains large amounts of extracellular epithelial mucin, sufficient to be visible grossly, and recognizable microscopically surrounding and, sometimes, within tumor cells. These tumors have blunt, rather irregular borders. Mucin can be found in most carcinomas of the breast, but the term mucinous 54
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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
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Case 6 • Needle core biopsy of a
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343 What is your best diagnosis? 1.
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349 Case 9 What is your diagnosis?
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Case 11 Case 11 Case 12 • A 68 ye
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Case 13 • Needle core biopsy of a
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What is your diagnosis? 1. Intracys
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What is your best interpretation? 1
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Case 18 What is your best interpret
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Case 20 • 35 year old female with
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Negative ER stain NEG ER Case 22
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What is your best interpretation? 1
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What is your diagnosis? 1. Secretor
Page 139 and 140: American Soiety of Clinical Patholo
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Page 151 and 152: In summary, basal-like breast cance
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Page 165 and 166: 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
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Page 189: 9. Bondeson L, Lindholm K. Aspirati
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Page 213 and 214: Collagenous spherulosis is a recent
Page 215 and 216: cases: review of the literature and
Page 217 and 218: Case 7 the breast associated with l
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Page 235 and 236: J Med 73:1078-1082, 1973. 11. Barne
Page 237 and 238: 40. Thorner PS, Kahn HJ, Baumal R,
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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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