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

Recommendations

Info

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
Page 1 and 2: 33 Special Types of Invasive Breast
Page 3 and 4: Special Types of Invasive Breast Ca
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
Page 13 and 14: ER/PR Positive HER2 Negative INVASI
Page 15 and 16: Tubulolobular Signet-ring Histiocyt
Page 17 and 18: Illustrative Example: 61 y/o female
Page 19 and 20: E-Cadherin ER PR 10/8/2011 17
Page 21 and 22: LCIS vs DCIS • Patients with lobu
Page 23 and 24: Examples of E-cadherin staining in
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
Page 33 and 34: 10/8/2011 31
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
Page 41 and 42: 10/8/2011 39
Page 43: SYNAPTOPHYSIN SMA 10/8/2011 41
Page 47 and 48: Special Types of Invasive Breast Ca
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
Page 75 and 76: 10/8/2011 73
Page 77 and 78: 10/8/2011 75
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
Page 89 and 90: Diagnosis: Benign g (Low-grade) Phy
Page 91 and 92: Diagnosis: Malignant (High-grade) P
Page 93 and 94: 10/8/2011 91
Page 95 and 96:
10/8/2011 93
Page 97 and 98:
Illustrative Case 10/8/2011 95
Page 99 and 100:
SMA Calponin 10/8/2011 97
Page 101 and 102:
Dx: Mixed Spindle-cell & Cl Classic
Page 103 and 104:
Dx: Adenomyoepithelioma, Epithelioi
Page 105 and 106:
10/8/2011 103
Page 107 and 108:
10/8/2011 105
Page 109 and 110:
Case 1 • 40 year old female • B
Page 111 and 112:
What is your diagnosis? 1. Invasive
Page 113 and 114:
Case 4 • Irregular large breast m
Page 115 and 116:
Case 6 • Needle core biopsy of a
Page 117 and 118:
343 What is your best diagnosis? 1.
Page 119 and 120:
349 Case 9 What is your diagnosis?
Page 121 and 122:
Case 11 Case 11 Case 12 • A 68 ye
Page 123 and 124:
Case 13 • Needle core biopsy of a
Page 125 and 126:
What is your diagnosis? 1. Intracys
Page 127 and 128:
What is your best interpretation? 1
Page 129 and 130:
Case 18 What is your best interpret
Page 131 and 132:
Case 20 • 35 year old female with
Page 133 and 134:
Negative ER stain NEG ER Case 22
Page 135 and 136:
What is your best interpretation? 1
Page 137 and 138:
What is your diagnosis? 1. Secretor
Page 139 and 140:
American Soiety of Clinical Patholo
Page 141 and 142:
SPECIAL TYPES OF INVASIVE BREAST CA
Page 143 and 144:
INVASIVE BREAST CARCINOMAS THAT ARE
Page 145 and 146:
of lymphoid cells between sheets of
Page 147 and 148:
studied, this taxonomy identifies s
Page 149 and 150:
molecular subtypes. Indeed, the pea
Page 151 and 152:
In summary, basal-like breast cance
Page 153 and 154:
Page et al. (15) described a pleomo
Page 155 and 156:
The classical pattern of infiltrati
Page 157 and 158:
pathologic findings indistinguishab
Page 159 and 160:
east carcinomas with overlapping fe
Page 161 and 162:
standard" LCIS (their figure 2), wh
Page 163 and 164:
References (lobular carcinoma): 1.
Page 165 and 166:
25. Richter GO, Dockerty MB, Claget
Page 167 and 168:
Breast Cancer Cooperative Group). L
Page 169 and 170:
invasive micropapillary carcinoma m
Page 171 and 172:
whether these lesions are in situ o
Page 173 and 174:
irregular margin suggests the prese
Page 175 and 176:
ich in elastic fibers. The connecti
Page 177 and 178:
(i.e., much better than an antibody
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
Page 185 and 186:
carcinoma in almost all tubular car
Page 187 and 188:
Sclerosing papillary proliferations
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
Page 195 and 196:
mucinous carcinoma. A fine-needle a
Page 197 and 198:
with long-term follow-up [Abstract]
Page 199 and 200:
cystic hypersecretory duct carcinom
Page 201 and 202:
considerable secretion and/or morph
Page 203 and 204:
4. Tavassoli FA, Norris HJ. Secreto
Page 205 and 206:
Case 6: History: 66 year old female
Page 207 and 208:
Adenoid cystic carcinoma (AdCC) is
Page 209 and 210:
Because more than half of adenoid c
Page 211 and 212:
Another family of salivary gland-ty
Page 213 and 214:
Collagenous spherulosis is a recent
Page 215 and 216:
cases: review of the literature and
Page 217 and 218:
Case 7 the breast associated with l
Page 219 and 220:
size (14). Metaplastic breast carci
Page 221 and 222:
adenoma by others who prefer to avo
Page 223 and 224:
survival rate than is usually repor
Page 225 and 226:
it arises in other soft tissue site
Page 227 and 228:
implies a relative risk for develop
Page 229 and 230:
sclerosing adenosis wherein the str
Page 231 and 232:
overgrowth (136). While acknowledgi
Page 233 and 234:
As noted above, any soft-tissue sar
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
Page 247 and 248:
secondary peripheral tumor nodules
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
show all

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

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?