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

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21. Roddy HJ, Silverberg SG. Ultrastructural analysis of apocrine carcinoma of the human breast. Ultrastruct Pathol 1980;1:385-93. 22. Frable WJ, Kay S. Carcinoma of the breast. Histologic and clinical features of apocrine tumors. Cancer 1968;21:756-63. 23. 393. Johnson TL, Kini SR. The significance of atypical apocrine cells in fineneedle aspirates of the breast. Diagn Cytopathol 1989;5:248-54. 24. Eusebi V, Betts C, Haagensen DE Jr. Gugliotta P, Bussolati G, Azzopardi JG. Apocrine differentiation in lobular carcinoma of the breast: a morphologic, immunologic, and ultrastructural study. Hum Pathol 1984;15:134-40. 25. Mazoujian G, Bodian C, Haagensen DE Jr, Haagensen CD. Expression of GCDFP-15 in breast carcinomas. Relationship to pathologic and clinical factors. Cancer 1989;63:2156-61. 26. Bussolati G, Cattani MG, Gugliotta P, Patriarca E, Eusebi V. Morphologic and functional aspects of apocrine metaplasia in dysplastic and neoplastic breast tissue. Ann NY Acad Sci 464:262-74. 27. Eisenberg BL, Bagnall JW, Harding CT Ill. Histiocytoid carcinoma: a variant of breast cancer. J Surg Oncol 1986;31:271-4. 28. Shousha S, Bull TB, Southall PJ, Mazoujian G. Apocrine carcinoma of the breast containing foam cells. An electron microscopic and immunohistochemical study. Histopathology 1987;11:611-20. 29. Yates AJ, Ahmed A. Apocrine carcinoma and apocrine metaplasia. Histopathology 1988:13:228-31. 30. 380.Abati AD, Kimmel M, Rosen PP. Apocrine mammary carcinoma. A clinicopathologic study of 72 cases. Am J Clin Pathol 1990;94:371-7. 31. d'Amore ES, Terrier-Lacombe MJ, Travagli JP, Friedman S, Contesso G. Invasive apocrine carcinoma of the breast: a long term follow-up study of 34 cases. Breast Cancer Res Treat 1988;12:37-44. 32. Lee BJ, Pack GT, Scharnagel I. Sweat gland cancer of the breast. Surg Gynecol Obstet 1933;56:975-96. 67
Case 6: History: 66 year old female with 2.5 cm cystic-solid left breast mass with soft, tan cut surfaces. Submitted diagnosis: Adenoid Cystic Carcinoma Background: A variety of breast lesions exhibit myoepithelial differentiation, both benign and malignant. This should cause no surprise, since typical breast ducts are composed of a duct luminal epithelial-cell layer encircled by myoepithelial cells; and, 68
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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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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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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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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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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
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American Soiety of Clinical Patholo
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SPECIAL TYPES OF INVASIVE BREAST CA
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INVASIVE BREAST CARCINOMAS THAT ARE
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of lymphoid cells between sheets of
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studied, this taxonomy identifies s
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molecular subtypes. Indeed, the pea
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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
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 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 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 231 and 232: overgrowth (136). While acknowledgi
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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,
Page 239 and 240: 75. Fekete P, Petrek J, Majmudar B,
Page 241 and 242: microscopic, ultrastructural, and i
Page 243 and 244: 2006 Apr;30(4):450-6 143. Liberman
Page 245 and 246: Case 8 Case history: A 50 year old
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Page 249 and 250: Definitive diagnosis of medullary c
Page 251 and 252: Pathol 1988;19:1340-6. 12. Rosen PP
Page 253 and 254: 40. Di Bonito; Royen PM, Ziter FMH.
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Am J Clin Pathol 1979;72:383-389. 1
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