Difference between revisions of "Invasive breast cancer"

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== Basal-like breast cancer ==<ref>{{Cite journal  | last1 = Badve | first1 = S. | last2 = Dabbs | first2 = DJ. | last3 = Schnitt | first3 = SJ. | last4 = Baehner | first4 = FL. | last5 = Decker | first5 = T. | last6 = Eusebi | first6 = V. | last7 = Fox | first7 = SB. | last8 = Ichihara | first8 = S. | last9 = Jacquemier | first9 = J. | title = Basal-like and triple-negative breast cancers: a critical review with an emphasis on the implications for pathologists and oncologists. | journal = Mod Pathol | volume = 24 | issue = 2 | pages = 157-67 | month = Feb | year = 2011 | doi = 10.1038/modpathol.2010.200 | PMID = 21076464 }}
== Basal-like breast carcinoma==<ref>{{Cite journal  | last1 = Badve | first1 = S. | last2 = Dabbs | first2 = DJ. | last3 = Schnitt | first3 = SJ. | last4 = Baehner | first4 = FL. | last5 = Decker | first5 = T. | last6 = Eusebi | first6 = V. | last7 = Fox | first7 = SB. | last8 = Ichihara | first8 = S. | last9 = Jacquemier | first9 = J. | title = Basal-like and triple-negative breast cancers: a critical review with an emphasis on the implications for pathologists and oncologists. | journal = Mod Pathol | volume = 24 | issue = 2 | pages = 157-67 | month = Feb | year = 2011 | doi = 10.1038/modpathol.2010.200 | PMID = 21076464 }}
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*Overview  
*Overview  
**A type of breast cancer defined by gene expression profiling
**Somewhere between 15-30% of breast carcinomas.
**A category of breast carcinomas defined by gene expression profiling
**Can be identified by immunohistochemistry - basal markers (CK14, p63, calponin, SMA)
**Can be identified by immunohistochemistry - basal markers (CK14, p63, calponin, SMA)
**Not derived from myoepithelial cells, merely express a phenotype more in keeping with basal cells than ductal cells
**Not derived from myoepithelial cells, merely express a phenotype more in keeping with basal cells than ductal cells
**Most triple negative (ER, PgR, Her-2); therefore cannot be treated with the usual therapeutic agents  
**Most triple negative (ER, PgR, Her-2); therefore cannot be treated with the usual therapeutic agents  
**There is an association in young women between basal-like breast cancer and BRCA mutation.
**There is an association in young women between basal-like breast cancer and BRCA mutation.
**Increased incidence in some populations - African-Americans, young women
**Sporadic basal-like cancers do not have a BRCA mutation but may have a dysfunctional BRCA1 pathway.
**Sporadic basal-like cancers do not have a BRCA mutation but may have a dysfunctional BRCA1 pathway.


*This molecular group includes a variety of morphologic phenotypes including:
*This molecular group includes a variety of morphologic phenotypes including:
**High grade invasive ductal mammary carcinoma of no special type.
**High grade invasive ductal carcinoma of no special type.
**Medullary-like mammary carcinoma (a carcinoma with some but not all the features of medullary carcinoma).
**Medullary-like carcinoma (a carcinoma with some but not all the features of medullary carcinoma).
**Medullary mammary carcinomas
**Medullary carcinomas
**Metaplastic mammary carcinomas
**Metaplastic carcinomas
**Mammary adenoid cystic carcinoma
**Adenoid cystic carcinoma
**Secretory mammary carcinoma
**Secretory carcinoma


*Classic morphological clues of a basal type cancer usually refer to medullary carcinoma features:
*Classic morphological clues of a basal type cancer usually refer to medullary carcinoma features:
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**Basal-like breast cancer is a heterogeneous group.
**Basal-like breast cancer is a heterogeneous group.
**The behaviour of basal-like breast cancer appears to fall into two groups:
**The behaviour of basal-like breast cancer appears to fall into two groups:
***The tumours that do not metastasise have a better prognosis than other grade 3 IDC
***The tumours that do not metastasise have a better prognosis than other types of breast carcinoma.
***Tumours with early metastasis
***Tumours with early metastasis may behave more aggressively
****Hematogenous spread -greater tendency to metastasise to visceral sites associated with poorer prognosis (such as lung and brain)  instead of to nodes and bone
****Hematogenous spread -greater tendency to metastasise to visceral sites associated with poorer prognosis (such as lung and brain)  instead of to nodes and bone




== Triple Negative Breast Carcinomas ==<ref>{{Cite journal  | last1 = Badve | first1 = S. | last2 = Dabbs | first2 = DJ. | last3 = Schnitt | first3 = SJ. | last4 = Baehner | first4 = FL. | last5 = Decker | first5 = T. | last6 = Eusebi | first6 = V. | last7 = Fox | first7 = SB. | last8 = Ichihara | first8 = S. | last9 = Jacquemier | first9 = J. | title = Basal-like and triple-negative breast cancers: a critical review with an emphasis on the implications for pathologists and oncologists. | journal = Mod Pathol | volume = 24 | issue = 2 | pages = 157-67 | month = Feb | year = 2011 | doi = 10.1038/modpathol.2010.200 | PMID = 21076464 }}</ref>
== Triple Negative Breast Carcinoma ==<ref>{{Cite journal  | last1 = Badve | first1 = S. | last2 = Dabbs | first2 = DJ. | last3 = Schnitt | first3 = SJ. | last4 = Baehner | first4 = FL. | last5 = Decker | first5 = T. | last6 = Eusebi | first6 = V. | last7 = Fox | first7 = SB. | last8 = Ichihara | first8 = S. | last9 = Jacquemier | first9 = J. | title = Basal-like and triple-negative breast cancers: a critical review with an emphasis on the implications for pathologists and oncologists. | journal = Mod Pathol | volume = 24 | issue = 2 | pages = 157-67 | month = Feb | year = 2011 | doi = 10.1038/modpathol.2010.200 | PMID = 21076464 }}</ref>


**A category of breast carcinomas defined by immunohistochemical/FISH expression of ER, PR and HER2.
**About 15% of breast carcinomas.
**About 15% of breast carcinomas.
**Important group due to a lack of tailored therapies for this group
**Important group due to a lack of tailored therapies for this group
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