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

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1990;98:921-6. 26. Rosen PP, Oberman HA. “Invasive carcinoma,” In: Atlas of Tumor Pathology, Tumors of the Mammary Gland; 3rd Series, Fascicle 7; ARP; AFIP, Washington, DC, pp. 157-243, 1993. 27. Rigaud CR, Theobald S, Noel P, Badreddine J, Barlier C, Delobelle A, Gentile A, Jacquemier J, Maisongrosse V, Peffault le Latour M, Trojani M, Zabrani B. Medullary carcinoma of the breast. A multicenter study of its diagnostic consistency. Arch Pathol Lab Med 1993;117:1005-1008. 28. Gaffey MJ, Mills SE, Frierson HF, Zarbo RJ, Boyd JC, Simpson JF, Weiss LM. Medullary carcinoma of the breast: interobserver variability in histopathologic diagnosis. Mod Pathol 1995;8:31-38. 29. Ponsky JL, Gliga L, Reynolds S. Medullary carcinoma of the breast: an association with negative hormonal receptors. J Surg Oncol 1984;25:76-8. 30. Rosen, Menendez-Botet CJ, Nisselbaum JS, et al. Pathological review of breast lesions analyzed for estrogen receptor protein. Cancer Res 1975;35:3187-94. 31. Reiner A, Reiner G, Spona J, Schemper M. Holzner JH. Histopathologic characterization of human breast cancer in correlation with estrogen receptor status. A comparison of immunocytochemical and biochemical analysis. Cancer 1988;61:1149-54. 32. Meyer JS, Friedman E, McCrate MM, Bauer WC. Prediction of early course of breast carcinomas by thymidine labeling. Cancer 1983;51:1879-86. 33. Kallioniemi OP, Blanco G, Alavaikko M, et al. Tumour DNA ploidy as an independent prognostic factor in breast cancer. Br J Cancer 1987;56:63-82. 34. Di Bonito L, Giarelli L, Falconieri G, Viehl P. Metastatic tumors to the female breast. An autopsy study of 12 cases. Path Res Pract 1991;187:432-435. 35. Green LK, Klima M. The use of immunohistochemistry in metastatic prostate adenocarcinoma to the breast. Hum Pathol 1991;22:242-246. 36. Cormier WJ, Gaffey TA, Welch JM, Welch JS, Edmonson JH. Linitis plastica caused by metastatic lobular carcinoma of the breast. Mayo Clin Proc 1980;55: 747-753. 37. Bonetti F, Colombari R, Manfrin E, Zamboni G, Martignoni G, Mombello A, Chilosi M. Breast carcinoma with positive results for melanoma marker (HMB-45). HMB-45 immunoreactivity in normal and neoplastic breast. Am J Clin Pathol 1989;92:491-495. 38. Cummings OW, Mazur MT. Breast carcinoma diffusely metastatic to the spleen. A report of two cases presenting as idiopathic thrombocytopenic purpura. Am J Clin Pathol 1992;97:484-489. 39. Warner TFCS, Seo IS. Bronchial carcinoid appearing as a breast mass. Arch Pathol Lab Med 1980;104:531-534. 115
40. Di Bonito; Royen PM, Ziter FMH. Ovarian carcinoma metastatic to the breast. Br J Radiol 1974;47:356-357. 41. Frauenhoffer EE, Ro JY, Silva E.G., El-Naggar A. Well-differentiated serous ovarian carcinoma presenting as a breast mass: a case report and flow cytometric DNA study. Int J Gyn Pathol 1991;10:79-87. 42. Roen PP. Rosen’s Breast Pathology, third edition 2010. P: 449-468 43. Rodriguez-Pinilla SM, Rodrigues-Gil Y, Moreno-Bueno G, et al. Sporadic invasvie duct carcinmas with medullary features display a basal-like phenotype. An immunohistochemical and gene amplification study. Am J Surg Pathol 2007;31:501-508 116
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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.
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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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carcinoma in almost all tubular car
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Sclerosing papillary proliferations
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9. Bondeson L, Lindholm K. Aspirati
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43. Green I, McCormick B, Cranor M,
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mucinous carcinoma (7,11,12,14). In
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mucinous carcinoma. A fine-needle a
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with long-term follow-up [Abstract]
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cystic hypersecretory duct carcinom
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Page 215 and 216: 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,
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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: Pathol 1988;19:1340-6. 12. Rosen PP
Page 255: Am J Clin Pathol 1979;72:383-389. 1
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