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

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histologic grading and proliferative activity. Am J Surg Pathol 1998;22(5):569-75. 32. 32. Pastolero G, Hanna W, Zbieranowski I, Kahn HJ. Proliferative activity and p53 expression in adenoid cystic carcinoma of the breast. Mod Pathol 1996;9:215-9. 33. Vargas H, Sudilovsky D, Kaplan MJ, Regezi JA, Weidner N. Mixed tumor, polymorphous low-grade adenocarcinoma, and adenoid cystic carcinoma of the salivary gland: pathogenic implications and differential diagnosis by ki-67 (MIB-1), bcl2, and S-100 immunohistochemistry. Appl Immunohistochem.1997;5:8-16. 34. Jones MW, Norris HJ, Snyder RC. Infiltrating syringomatous adenoma of the nipple. A clinical and pathologic study of 11 cases. Am J Surg Pathol 1989;13:197-201. 35. Ward BE, Cooper PH, Subramony C. Syringomatous tumor of the nipple. Am J Clin Pathol 1989;92:692-696. 36. Rosen PP. Syringomatous adenoma of the nipple. Am J Surg Pathol 1983;7:739-745. 37. Van Hoeven KH, Drudis T, Cranor ML, Erlandson RA, Rosen PP. Low-grade adenosquamous carcinoma of the breast. A Clinicopathologic study of 32 Cases with Ultrastructural Analysis. Am J Surg Pathol 1993;17:248-258. 38. Smith BH, Taylor HB. The occurrence of bone and cartilage in mammary tumors. Am J Clin Pathol 1969;51:610-618. 39. Chen KTK. Pleomorphic adenoma of the breast. Am J Clin Pathol 1990;93:792-794. 40. McClure J, Smith PS, Jamieson GG. Mixed salivary type adenoma of the human female breast. Arch Pathol Lab Med 1982;106:615-619. 41. Moran CA, Suster S, Carter D. Benign mixed tumors (pleomorphic adenomas) of the breast. Am J Surg Pathol 1990;14:913-921. 42. Ballance WA, Ro JY, El-Naggar AK, Grignon DJ, Ayala AG, Romsdahl MG. Pleomorphic adenoma (benign mixed tumor) of the breast. Am J Clin Pathol 1990;93:795-801. 43. Diaz NM, McDivitt RW, Wick MR. Pleomorphic adenoma of the breast: a clinicopathologic and immunohistochemical study of 10 cases. Hum Pathol 1991;22:1206-1214. 44. Finck FM, Schwinn CP, Keasbey LE. Clear cell hidradenoma of the breast. Cancer 1968;22:125-135. 45. Hertel BF, Zaloudek C, Kempson RL. Breast adenomas. Cancer 1976;37:2891- 2905. 46. Foschini MP; Pizzicannella G; Peterse JL; Eusebi V. Adenomyoepithelioma of 79
Case 7 the breast associated with low-grade adenosquamous and sarcomatoid carcinomas. Virchows Arch (Germany), 1995, 427(3) p243-50. History: A 57 year old female with 3.4 cm well definied breast mass with firm, solid white cut surfaces. Submitted diagnosis: Metaplastic carcinoma, spindle-cell carcinoma variant (poorly differentiated invasive breast carcinoma, overall mBR grade 2; nuclear grade 3, tubule/papillary grade 3, mitotic grade 2). Metaplastic Breast Carcinoma 80
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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
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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
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Page et al. (15) described a pleomo
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The classical pattern of infiltrati
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pathologic findings indistinguishab
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east carcinomas with overlapping fe
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standard" LCIS (their figure 2), wh
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References (lobular carcinoma): 1.
Page 165 and 166: 25. Richter GO, Dockerty MB, Claget
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Page 181 and 182: Case 3: History: A 73 year old fema
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Page 189 and 190: 9. Bondeson L, Lindholm K. Aspirati
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Page 215: cases: review of the literature and
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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.
Page 255: Am J Clin Pathol 1979;72:383-389. 1
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