33 Special Types of Invasive Breast Carcinoma: Diagnostic Criteria ...
33 Special Types of Invasive Breast Carcinoma: Diagnostic Criteria ... 33 Special Types of Invasive Breast Carcinoma: Diagnostic Criteria ...
CHROMO Solid Papillary Carcinoma (SPC) • Sometimes the “intracystic” proliferation is so dense that the basic papillary or cribriform patterns is obscured (i.e., becomes solid). • Such tumors may be so-called solid papillary carcinomas (SPCs) (SPCs). • SPCs uncommon, circumscribed, large cellular nodules separated by bands of fibrosis. • Sometimes neuroendocrine differentiation • Often mucin secretion (focal to marked), may be extravasated mucin or mucinous carcinoma. • Can have other types of invasive carcinoma. Nassar et al. (AJSP 2006;30:501-7.) • 58 with SPC component (SPCs), mean f/u, 9.4 yrs. • Mean age 72 years, tumor sizes 0.3 to 15 cm. • Carcinomas divided into 3 groups: 1) SPC only (~33%), 2) SPC with extravasated mucin (~10%), 3) SPC with ith invasive i i components t (~60%) ( 60%) - neuroendocrine-like (~30%), - colloid (~25%), - ductal, not otherwise specified (~15%), - lobular (~3%), - tubular (~3%) - mixed (~25%). • All estrogen receptor positive and ~90% grade 1. • Axillary LNs positive in 13% (all had invasive tumor). 10/8/2011 42
Nassar et al. (AJSP 2006;30:501-7.) • Local recurrence in 5 pts, all with invasive carcinoma. • ~12% died of tumor in 1 to 4 yrs (mean, 2.3 yrs). • None died of noninvasive SPC. • 5 of 6 patients who DOD had invasive components. • Sixth pt died with “metastatic metastatic signet signet-ring ring cell carcinoma” carcinoma at 10 years had SPC with extravasated mucin, but the SPC lesion had signetring cells. • Conclusion: SPCs heterogeneous, arise in older pts, & have indolent behavior. LN & distant mets uncommon & limited to SPCs with (conventional) invasive components. Differential Diagnosis: 4. Intraductal papilloma. 5. Sclerosing papillary lesions or proliferations: scleroelastotic lesion simulating malignancy - scleroelastotic lesion simulating malignancy. - nonencapsulated sclerosing lesion. - indurative mastopathy. - complex sclerosing lesion. - invasive epitheliosis. - radial scar. - duct adenoma (? spectrum of sclerosing papillary lesions). 10/8/2011 43
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- Page 5 and 6: INVASIVE BREAST CARCINOMAS CONSIDER
- Page 7 and 8: ER Neg. PR Neg. HER2 Neg. CK 5/6 Po
- Page 9 and 10: Triple-negative Breast Carcinomas
- Page 11 and 12: E-cadherin E-cadherin EGFR ++ ER ne
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- Page 17 and 18: Illustrative Example: 61 y/o female
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- Page 21 and 22: LCIS vs DCIS • Patients with lobu
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- Page 25 and 26: Classic Low-grade DCIS - E-cadherin
- Page 27 and 28: E-cadherin IHC CASE D 10/8/2011 25
- Page 29 and 30: E-cadherin IHC CASE E 10/8/2011 27
- Page 31 and 32: Literature Summary: Correlation of
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- Page 35 and 36: CD10 SMA MIB-1 10/8/2011 33
- Page 37 and 38: Carter et al. Cancer 1977 & 1983
- Page 39 and 40: Differential Diagnosis: 1. Invasive
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- Page 43: SYNAPTOPHYSIN SMA 10/8/2011 41
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- Page 49 and 50: Tubular carcinoma • It has been d
- Page 51 and 52: Tubular carcinoma Histopathology
- Page 53 and 54: Flat Epithelial Atypia When should
- Page 55 and 56: Microglandular adenosis + reticulin
- Page 57 and 58: mitosis ductal ductal, NST tubular
- Page 59 and 60: Treatment • Breast conservation t
- Page 61 and 62: Cribriform carcinoma Histopathology
- Page 63 and 64: Cribriform carcinoma Prognosis •
- Page 65 and 66: Cribriform Carcinoma Pearls of Path
- Page 67 and 68: Clinicopathological features Mucino
- Page 69 and 70: Case 4 Mucinous carcinoma Mixed muc
- Page 71 and 72: Treatment • Breast conservation a
- Page 73 and 74: Incipient mucocele-like lesion Cyst
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- Page 79 and 80: SMA Dx: Spindle-cell Breast Carcino
- Page 81 and 82: Dx: Pure Squamous Carcinoma 10/8/20
- Page 83 and 84: Osseous Differentiation (Osteosarco
- Page 85 and 86: Spindle-cell Carcinoma of the Breas
- Page 87 and 88: Phyllodes y Tumors Phyllodes Tumor
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CHROMO<br />
Solid Papillary <strong>Carcinoma</strong> (SPC)<br />
• Sometimes the “intracystic” proliferation is so<br />
dense that the basic papillary or cribriform<br />
patterns is obscured (i.e., becomes solid).<br />
• Such tumors may be so-called solid papillary<br />
carcinomas (SPCs) (SPCs).<br />
• SPCs uncommon, circumscribed, large cellular<br />
nodules separated by bands <strong>of</strong> fibrosis.<br />
• Sometimes neuroendocrine differentiation<br />
• Often mucin secretion (focal to marked), may be<br />
extravasated mucin or mucinous carcinoma.<br />
• Can have other types <strong>of</strong> invasive carcinoma.<br />
Nassar et al. (AJSP 2006;30:501-7.)<br />
• 58 with SPC component (SPCs), mean f/u, 9.4 yrs.<br />
• Mean age 72 years, tumor sizes 0.3 to 15 cm.<br />
• <strong>Carcinoma</strong>s divided into 3 groups:<br />
1) SPC only (~<strong>33</strong>%),<br />
2) SPC with extravasated mucin (~10%),<br />
3) SPC with ith invasive i i components t (~60%) ( 60%)<br />
- neuroendocrine-like (~30%),<br />
- colloid (~25%),<br />
- ductal, not otherwise specified (~15%),<br />
- lobular (~3%),<br />
- tubular (~3%)<br />
- mixed (~25%).<br />
• All estrogen receptor positive and ~90% grade 1.<br />
• Axillary LNs positive in 13% (all had invasive tumor).<br />
10/8/2011<br />
42
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