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

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east: a review. Breast 10:27–31, 1984. 25. Shousha S, James AH, Fernandez MD, Bull TB: Squamous cell carcinoma of the breast. Arch Pathol Lab Med 108:893–896, 1984. 26. Eusebi V, Lamovec J, Cattani MG, Fedeli F, Millis RR. Acantholytic variant of squamous-cell carcinoma of the breast. Am J Surg Pathol 10:855-861, 1986 27. Kerawala CJ. Acantholytic squamous cell carcinoma of the oral cavity: a more aggressive entity? Br J Oral Maxillofac Surg. 2009 Mar;47(2):123-5. Epub 2008 Jun 18. 28. Cassarino DS, Derienzo DP, Barr RJ. Cutaneous squamous cell carcinoma: a comprehensive clinicopathologic classification. Part one. J Cutan Pathol. 2006 Mar;33(3):191-206. 29. 28a. Ho BC, Tan HW, Lee VK, Tan PH. Preoperative and intraoperative diagnosis of low-grade adenosquamous carcinoma of the breast: potential diagnostic pitfalls. Histopathology 2006;49:603-11. 30. Davis WG, Hennessy B, Babiera G, Hunt K, Valero V, Buchholz TA, Sneige N, Gilcrease MZ. Metaplastic sarcomatoid carcinoma of the breast with absent or minimal overt invasive carcinomatous component: a misnomer. Am J Surg Pathol. 2005 Nov;29(11):1456-63. 31. Carter MR, Hornick JL, Lester S, Fletcher CD. Spindle cell (sarcomatoid) carcinoma of the breast: a clinicopathologic and immunohistochemical analysis of 29 cases. Am J Surg Pathol. 2006 Mar;30(3):300-9. 32. Hurt MA, Diaz-Arias AA, Rosenholtz MJ, et al: Post-traumatic lobular squamous metaplasia of breast. An unusual pseudosarcomatous metaplasia resembling squamous (necrotizing) sialometaplasia of the salivary gland. Mod Pathol 1:385–390, 1988. 33. Shousha S: An unusual cyst (of the breast). Histopathology 14:423–425, 1989. 34. Gottfried MR: Extensive squamous metaplasia in gynecomastia. Arch Pathol Lab Med 110:971–973, 1986. 35. Zuska JJ, Crile G, Ayres W: Fistulas of lactiferous ducts. Am J Surg 81:312– 317, 1951. 36. Crile G, Chatty EM: Squamous metaplasia of lactiferous ducts. Arch Surg 102:533–534, 1971. 37. Habif DV, Perzin KH, Lipton R, Lattes R: Subareolar abscess associated with squamous metaplasia of lactiferous ducts. Am J Surg 119:523–526, 1970. 38. Raju GC, Wee A: Spindle cell carcinoma of the breast. Histopathology 16:497– 499, 1990. 39. Schurch W, Potvin C, Seemayer TA: Malignant myoepithelioma (myoepithelial carcinoma) of the breast: an ultrastructural and immunocytochemical study. Ultrastruct Pathol 8:1–11, 1985. 99
40. Thorner PS, Kahn HJ, Baumal R, et al: Malignant myoepithelioma of the breast: an immunohistochemical study by light and electron microscopy. Cancer 57:745–750, 1986. 41. Tavassoli FA: Myoepithelial lesions of the breast. Myoepitheliosis, adenomyoepithelioma, and myoepithelial carcinoma. Am J Surg Pathol 15:554–568, 1991. 42. Loose JH, Patchefsky AS, Hollander IJ, et al: Adenomyoepithelioma of the breast. A spectrum of biological behavior. Am J Surg Pathol 16:868–876, 1992. 43. Michal M, Baumruk L, Burger J, Manhalova M: Adenomyoepithelioma of the breast with undifferentiated carcinoma component. Histopathology 24:274– 276, 1994. 44. Clarke D, Curtis JL, Martinez A, et al: Fat necrosis of the breast simulating recurrent carcinoma after primary radiotherapy in the management of early stage breast carcinoma. Cancer 52:442–445, 1983. 45. Rosen Y, Papasozomenos SC, Gardner B: Fibromatosis of the breast. Cancer 41:1409–1413, 1978. 46. Ali M, Fayemi AO, Braun EV, Remy R: Fibromatosis of the breast. Am J Surg Pathol 3:501–505, 1979. 47. Schwartz IS: Infiltrative fibromatosis (desmoid) of the breast. Dis Breast 9:2–3, 1983. 48. Hanna WM, Jambrosic J, Fish E: Aggressive fibromatosis of the breast. Arch Pathol Lab Med 109:260–262, 1985. 49. Rosen PP, Ernsberger D: Mammary fibromatosis: a benign spindle-cell tumor with significant risk for local recurrence. Cancer 63:1363–1369, 1989. 50. Wargotz ES, Norris HJ, Austin RM, Enzinger FM: Fibromatosis of the breast: a clinical and pathological study of 28 cases. Am J Surg Pathol 11:38–45, 1987. 51. Peters U, Schoenegg WD, Minguillon C, et al: Fibromatosis of the breast [in German]. Geburtshilfe Frauenheilkd 52:434–435, 1992. 52. Pettinato G, Manivel JC, Gould EW, Albores-Saavedra J: Inclusion body fibromatosis of the breast: two cases with immunohistochemical and ultrastructural findings. Am J Clin Pathol 191:714–718, 1994. 53. Lammie GA, Bobrow LG, Staunton MDM, et al: Sclerosing lymphocytic lobulitis of the breast—evidence for an autoimmune pathogenesis. Histopathology 19:13–20, 1991. 54. Soler NG, Khardori R: Fibrous disease of the breast, thyroiditis and cheiroarthropathy in type 1 diabetes mellitus. Lancet 1:193–194, 1984. 55. Bryd BF, Harmann WH, Graham LS, Hogle HH: Mastopathy in insulindependent diabetics. Ann Surg 205:529–532, 1987. 56. Logan WW, Hoffmann NY: Diabetic fibrous breast disease. Radiology 100
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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 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 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.
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25. Richter GO, Dockerty MB, Claget
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Breast Cancer Cooperative Group). L
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invasive micropapillary carcinoma m
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whether these lesions are in situ o
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irregular margin suggests the prese
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ich in elastic fibers. The connecti
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(i.e., much better than an antibody
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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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Page 235: J Med 73:1078-1082, 1973. 11. Barne
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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 251 and 252: Pathol 1988;19:1340-6. 12. Rosen PP
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Page 255: Am J Clin Pathol 1979;72:383-389. 1
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