Account-creators
179
edits
(→IHC) |
(→Invasive versus non-invasive: added information from recent study on microinvasion) |
||
(59 intermediate revisions by 2 users not shown) | |||
Line 1: | Line 1: | ||
[[Image:Breast_cancer.JPG|thumb|300px|Breast cancer at [[cut-up]]. (WC/John Hayman)]] | |||
The article deals with '''invasive [[breast]] cancer''' and the evaluation of hormone receptor & HER2 status. Non-invasive breast cancer is dealt with in ''[[non-invasive breast cancer]]''. | The article deals with '''invasive [[breast]] cancer''' and the evaluation of hormone receptor & HER2 status. Non-invasive breast cancer is dealt with in ''[[non-invasive breast cancer]]''. | ||
Line 28: | Line 29: | ||
*[[Invasive ductal carcinoma of the breast|Invasive ductal carinoma]], not otherwise specified. | *[[Invasive ductal carcinoma of the breast|Invasive ductal carinoma]], not otherwise specified. | ||
*[[Invasive lobular carcinoma]]. | *[[Invasive lobular carcinoma]]. | ||
*Invasive cribriform carcinoma. | *[[Invasive cribriform carcinoma of the breast|Invasive cribriform carcinoma]]. | ||
*[[Invasive papillary carcinoma of the breast|Invasive papillary carcinoma]]. | *[[Invasive papillary carcinoma of the breast|Invasive papillary carcinoma]]. | ||
*[[Invasive micropapillary carcinoma of the breast|Invasive micropapillary carcinoma]]. | *[[Invasive micropapillary carcinoma of the breast|Invasive micropapillary carcinoma]]. | ||
Line 45: | Line 46: | ||
Epithelial tumours seen in the [[salivary gland]]: | Epithelial tumours seen in the [[salivary gland]]: | ||
*[[Adenoid cystic carcinoma]]. | *[[Adenoid cystic carcinoma of the breast]]. | ||
*[[Acinic cell carcinoma]]. | *[[Acinic cell carcinoma]]. | ||
*[[Carcinoma ex pleomorphic adenoma]]. | *[[Carcinoma ex pleomorphic adenoma]]. | ||
Line 68: | Line 69: | ||
Papillary: | Papillary: | ||
*[[Intraductal papilloma|Papilloma]]. | *[[Intraductal papilloma of the breast|Papilloma]]. | ||
*Atypical papilloma. | *Atypical papilloma. | ||
*Intraductal papillary carcinoma. | *Intraductal papillary carcinoma. | ||
Line 147: | Line 148: | ||
|} | |} | ||
The above is not applied clinically. A panel of [[immunostains]] (ER, PR, HER2, EGFR, CK5/6) can reproduce the molecular groupings; however, these groupings originate from gene expression profiling studies<ref name=pmid19704256>{{Cite journal | last1 = Tang | first1 = P. | last2 = Skinner | first2 = KA. | last3 = Hicks | first3 = DG. | title = Molecular classification of breast carcinomas by immunohistochemical analysis: are we ready? | journal = Diagn Mol Pathol | volume = 18 | issue = 3 | pages = 125-32 | month = Sep | year = 2009 | doi = 10.1097/PDM.0b013e31818d107b | PMID = 19704256 }}</ref> | The above is not applied clinically. A panel of [[immunostains]] ([[ER]], PR, HER2, EGFR, [[CK5/6]]) can reproduce the molecular groupings; however, these groupings originate from gene expression profiling studies<ref name=pmid19704256>{{Cite journal | last1 = Tang | first1 = P. | last2 = Skinner | first2 = KA. | last3 = Hicks | first3 = DG. | title = Molecular classification of breast carcinomas by immunohistochemical analysis: are we ready? | journal = Diagn Mol Pathol | volume = 18 | issue = 3 | pages = 125-32 | month = Sep | year = 2009 | doi = 10.1097/PDM.0b013e31818d107b | PMID = 19704256 }}</ref> | ||
A newer classification outlines 10 subtypes based on molecular drivers identified by analysis of genomic and transcriptomic data from 2,000 breast tumors.<ref>{{Cite journal | last1 = Curtis | first1 = C. | last2 = Shah | first2 = SP. | last3 = Chin | first3 = SF. | last4 = Turashvili | first4 = G. | last5 = Rueda | first5 = OM. | last6 = Dunning | first6 = MJ. | last7 = Speed | first7 = D. | last8 = Lynch | first8 = AG. | last9 = Samarajiwa | first9 = S. | title = The genomic and transcriptomic architecture of 2,000 breast tumours reveals novel subgroups. | journal = Nature | volume = 486 | issue = 7403 | pages = 346-52 | month = Jun | year = 2012 | doi = 10.1038/nature10983 | PMID = 22522925 }}</ref> | A newer classification outlines 10 subtypes based on molecular drivers identified by analysis of genomic and transcriptomic data from 2,000 breast tumors.<ref>{{Cite journal | last1 = Curtis | first1 = C. | last2 = Shah | first2 = SP. | last3 = Chin | first3 = SF. | last4 = Turashvili | first4 = G. | last5 = Rueda | first5 = OM. | last6 = Dunning | first6 = MJ. | last7 = Speed | first7 = D. | last8 = Lynch | first8 = AG. | last9 = Samarajiwa | first9 = S. | title = The genomic and transcriptomic architecture of 2,000 breast tumours reveals novel subgroups. | journal = Nature | volume = 486 | issue = 7403 | pages = 346-52 | month = Jun | year = 2012 | doi = 10.1038/nature10983 | PMID = 22522925 }}</ref> | ||
== Basal-like breast carcinoma== | |||
*Overview | *Overview:<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 }} | ||
**A category of breast carcinomas defined by gene expression profiling | </ref> | ||
**''Not used'' in clinical practice | **A category of breast carcinomas defined by gene expression profiling. | ||
**''Not used'' in clinical practice. | |||
**Somewhere between 15-30% of breast carcinomas. | **Somewhere between 15-30% of breast carcinomas. | ||
**Can be roughly be identified by immunohistochemistry - basal markers (CK14, p63, calponin, SMA) | **Can be roughly 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 BRCA1 mutation. | **There is an association in young women between basal-like breast cancer and BRCA1 mutation. | ||
**Discussions of BRCA1 associated tumors, TNBC and BLBC are typically muddied by the overlap. | **Discussions of BRCA1 associated tumors, TNBC and BLBC are typically muddied by the overlap. | ||
**Increased incidence in some populations - African-Americans, young women | **Increased incidence in some populations - African-Americans, young women | ||
**Sporadic basal-like cancers do not have a BRCA1 mutation but may have a dysfunctional BRCA1 pathway. | **Sporadic basal-like cancers do not have a BRCA1 mutation but may have a dysfunctional BRCA1 pathway. | ||
**p53 mutations are frequent | **p53 mutations are frequent. | ||
*This molecular group includes a variety of morphologic phenotypes including: | *This molecular group includes a variety of morphologic phenotypes including: | ||
**High grade invasive ductal carcinoma of no special type. | **High grade [[invasive ductal carcinoma]] of no special type. | ||
**Medullary-like 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 | **[[Medullary breast carcinoma|Medullary carcinoma]] | ||
**Metaplastic | **[[Metaplastic breast carcinoma|Metaplastic carcinoma]]. | ||
**Adenoid cystic carcinoma | **[[Adenoid cystic carcinoma of the breast|Adenoid cystic carcinoma]]. | ||
**Secretory 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: | ||
**Relatively circumscribed | **Relatively circumscribed. | ||
**Geographic necrosis | **Geographic necrosis. | ||
**Abundant mitoses | **Abundant mitoses. | ||
**Pushing margins | **Pushing margins. | ||
**Central fibrosis or necrosis | **Central fibrosis or necrosis. | ||
**High histological grade | **High histological grade. | ||
**Exceptionally high mitotic rate | **Exceptionally high mitotic rate. | ||
**Pushing borders | **Pushing borders. | ||
**Conspicuous lymphocytic infiltrate | **Conspicuous lymphocytic infiltrate. | ||
*Behaviour | *Behaviour: | ||
**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: | ||
Line 199: | Line 200: | ||
Minireview: Basal-Like Breast Cancer: From Molecular Profiles to Targeted Therapies <http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3035993/> | Minireview: Basal-Like Breast Cancer: From Molecular Profiles to Targeted Therapies <http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3035993/> | ||
== 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> | == Triple Negative Breast Carcinoma == | ||
Features:<ref name=pmid21076464>{{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. | **A category of breast carcinomas defined by immunohistochemical/FISH expression of ER, PR and HER2. | ||
Line 205: | Line 207: | ||
**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 | ||
***Some triple negatives also express androgen receptor and have and [apocrine carcinoma] morphology.<ref>{{Cite journal | last1 = Niemeier | first1 = LA. | last2 = Dabbs | first2 = DJ. | last3 = Beriwal | first3 = S. | last4 = Striebel | first4 = JM. | last5 = Bhargava | first5 = R. | title = Androgen receptor in breast cancer: expression in estrogen receptor-positive tumors and in estrogen receptor-negative tumors with apocrine differentiation. | journal = Mod Pathol | volume = 23 | issue = 2 | pages = 205-12 | month = Feb | year = 2010 | doi = 10.1038/modpathol.2009.159 | PMID = 19898421 }}</ref> | |||
****May respond to therapies targeting the androgen receptor. | |||
***BCL11A overexpression recently identified as an oncogenic driver for some triple negatives <ref>{{Cite journal | last1 = Khaled | first1 = WT. | last2 = Choon Lee | first2 = S. | last3 = Stingl | first3 = J. | last4 = Chen | first4 = X. | last5 = Raza Ali | first5 = H. | last6 = Rueda | first6 = OM. | last7 = Hadi | first7 = F. | last8 = Wang | first8 = J. | last9 = Yu | first9 = Y. | title = BCL11A is a triple-negative breast cancer gene with critical functions in stem and progenitor cells. | journal = Nat Commun | volume = 6 | issue = | pages = 5987 | month = | year = 2015 | doi = 10.1038/ncomms6987 | PMID = 25574598 }}</ref> | |||
****Targeted therapies may include inhibitors of BCL11A. | |||
**Triple-negative and basal-like phenotypes are not synonymous but overlap | **Triple-negative and basal-like phenotypes are not synonymous but overlap | ||
***About 70% of triple-negative tumours are basal-like. | ***About 70% of triple-negative tumours are basal-like. | ||
Line 210: | Line 216: | ||
**Discussions of BRCA1 associated tumors, TNBC and BLBC are typically muddied by the overlap. | **Discussions of BRCA1 associated tumors, TNBC and BLBC are typically muddied by the overlap. | ||
**Classic 'morphological clues' to a triple negative cancer usually refer to medullary carcinoma features. | **Classic 'morphological clues' to a triple negative cancer usually refer to medullary carcinoma features. | ||
==Immunostains for typing and diagnosis== | ==Immunostains for typing and diagnosis== | ||
Line 258: | Line 263: | ||
| stains myofibroblasts & blood vessels | | stains myofibroblasts & blood vessels | ||
|} | |} | ||
Respecting findings that might indicate a more extensive search for microinvasion be undertaken in cases of pure ductal carcinoma in situ (DCIS), a recent study found 1) intermediate or high DCIS grade, 2) tumor thickness, and 3) diffuse peritumoral retraction clefts, but not such things as lymph node metastases, or HER2 score, independently increased the likelihood of finding a microinvasive component. <ref name=pmid28434924>{{cite journal |author=Mori K, Takeda M, Kodama Y, Kiyokawa H, Yasojima H, Mizutani M, Otani Y, Morikawa N, Masuda N, Mano M|title= Tumor thickness and histological features as predictors of invasive foci within preoperatively diagnosed ductal carcinoma in situ |journal=Human Pathology |volume=64 |issue= |pages=145-155 |year=2017 | pmid=28434924 |doi=10.1016/j.humpath.2017.04.004 }}</ref> | |||
===Usual ductal hyperplasia versus ductal carcinoma in situ=== | ===Usual ductal hyperplasia versus ductal carcinoma in situ=== | ||
Line 263: | Line 270: | ||
{| class="wikitable sortable" | {| class="wikitable sortable" | ||
!Disease | !Disease | ||
!CK5/6 | ![[CK5/6]] | ||
!ER | ![[ER]] | ||
|- | |- | ||
|UDH | |UDH | ||
Line 280: | Line 287: | ||
*CD31 - marks lymphovascular spaces. | *CD31 - marks lymphovascular spaces. | ||
*CD34 - marks lymphovascular spaces, less specific than CD31. | *CD34 - marks lymphovascular spaces, less specific than CD31. | ||
===Lymph node metastases=== | |||
Immunostaining of sentinel lymph nodes to look for [[isolated tumour cells]] and small [[lymph node metastases]] may be done. | |||
*CAM5.2 may be used. | |||
*'''Not''' done routinely. | |||
==Treatment-related markers - overview== | ==Treatment-related markers - overview== | ||
*ER (estrogen receptor). | *ER (estrogen receptor). | ||
**Positive in most breast cancers; +ve in ~75-80%.<ref name=Ref_Lester241-2>{{Ref Lester|241-2}}</ref> | **Positive in most breast cancers; +ve in ~75-80%.<ref name=Ref_Lester241-2>{{Ref Lester|241-2}}</ref> | ||
Line 293: | Line 303: | ||
**In the context of HER2 positivity, PTEN/PI3K/Akt/mTOR pathway dysregulation is a poor prognosticator.<ref name=pmid22454081>{{Cite journal | last1 = Gallardo | first1 = A. | last2 = Lerma | first2 = E. | last3 = Escuin | first3 = D. | last4 = Tibau | first4 = A. | last5 = Muñoz | first5 = J. | last6 = Ojeda | first6 = B. | last7 = Barnadas | first7 = A. | last8 = Adrover | first8 = E. | last9 = Sánchez-Tejada | first9 = L. | title = Increased signalling of EGFR and IGF1R, and deregulation of PTEN/PI3K/Akt pathway are related with trastuzumab resistance in HER2 breast carcinomas. | journal = Br J Cancer | volume = 106 | issue = 8 | pages = 1367-73 | month = Apr | year = 2012 | doi = 10.1038/bjc.2012.85 | PMID = 22454081 }}</ref><ref name=pmid22172323>{{Cite journal | last1 = Jensen | first1 = JD. | last2 = Knoop | first2 = A. | last3 = Laenkholm | first3 = AV. | last4 = Grauslund | first4 = M. | last5 = Jensen | first5 = MB. | last6 = Santoni-Rugiu | first6 = E. | last7 = Andersson | first7 = M. | last8 = Ewertz | first8 = M. | title = PIK3CA mutations, PTEN, and pHER2 expression and impact on outcome in HER2-positive early-stage breast cancer patients treated with adjuvant chemotherapy and trastuzumab. | journal = Ann Oncol | volume = | issue = | pages = | month = Dec | year = 2011 | doi = 10.1093/annonc/mdr546 | PMID = 22172323 }}</ref> | **In the context of HER2 positivity, PTEN/PI3K/Akt/mTOR pathway dysregulation is a poor prognosticator.<ref name=pmid22454081>{{Cite journal | last1 = Gallardo | first1 = A. | last2 = Lerma | first2 = E. | last3 = Escuin | first3 = D. | last4 = Tibau | first4 = A. | last5 = Muñoz | first5 = J. | last6 = Ojeda | first6 = B. | last7 = Barnadas | first7 = A. | last8 = Adrover | first8 = E. | last9 = Sánchez-Tejada | first9 = L. | title = Increased signalling of EGFR and IGF1R, and deregulation of PTEN/PI3K/Akt pathway are related with trastuzumab resistance in HER2 breast carcinomas. | journal = Br J Cancer | volume = 106 | issue = 8 | pages = 1367-73 | month = Apr | year = 2012 | doi = 10.1038/bjc.2012.85 | PMID = 22454081 }}</ref><ref name=pmid22172323>{{Cite journal | last1 = Jensen | first1 = JD. | last2 = Knoop | first2 = A. | last3 = Laenkholm | first3 = AV. | last4 = Grauslund | first4 = M. | last5 = Jensen | first5 = MB. | last6 = Santoni-Rugiu | first6 = E. | last7 = Andersson | first7 = M. | last8 = Ewertz | first8 = M. | title = PIK3CA mutations, PTEN, and pHER2 expression and impact on outcome in HER2-positive early-stage breast cancer patients treated with adjuvant chemotherapy and trastuzumab. | journal = Ann Oncol | volume = | issue = | pages = | month = Dec | year = 2011 | doi = 10.1093/annonc/mdr546 | PMID = 22172323 }}</ref> | ||
Notes: | |||
*Male breast cancer is usually hormone receptor positive (~97%), and HER2 positivity is quite rare (~6%).<ref name=pmid24080492>{{Cite journal | last1 = Schildhaus | first1 = HU. | last2 = Schroeder | first2 = L. | last3 = Merkelbach-Bruse | first3 = S. | last4 = Binot | first4 = E. | last5 = Büttner | first5 = R. | last6 = Kuhn | first6 = W. | last7 = Rudlowski | first7 = C. | title = Therapeutic strategies in male breast cancer: Clinical implications of chromosome 17 gene alterations and molecular subtypes. | journal = Breast | volume = | issue = | pages = | month = Sep | year = 2013 | doi = 10.1016/j.breast.2013.08.008 | PMID = 24080492 }}</ref> | *Male breast cancer is usually hormone receptor positive (~97%), and HER2 positivity is quite rare (~6%).<ref name=pmid24080492>{{Cite journal | last1 = Schildhaus | first1 = HU. | last2 = Schroeder | first2 = L. | last3 = Merkelbach-Bruse | first3 = S. | last4 = Binot | first4 = E. | last5 = Büttner | first5 = R. | last6 = Kuhn | first6 = W. | last7 = Rudlowski | first7 = C. | title = Therapeutic strategies in male breast cancer: Clinical implications of chromosome 17 gene alterations and molecular subtypes. | journal = Breast | volume = | issue = | pages = | month = Sep | year = 2013 | doi = 10.1016/j.breast.2013.08.008 | PMID = 24080492 }}</ref> | ||
*ASCO/CAP guidelines recommend that cold ischemia time be <1 hour.<ref name=pmid22460807 >{{Cite journal | last1 = Yildiz-Aktas | first1 = IZ. | last2 = Dabbs | first2 = DJ. | last3 = Bhargava | first3 = R. | title = The effect of cold ischemic time on the immunohistochemical evaluation of estrogen receptor, progesterone receptor, and HER2 expression in invasive breast carcinoma. | journal = Mod Pathol | volume = 25 | issue = 8 | pages = 1098-105 | month = Aug | year = 2012 | doi = 10.1038/modpathol.2012.59 | PMID = 22460807 }}</ref> | |||
===ER & PR scoring=== | ===ER & PR scoring=== | ||
Nuclear staining:<ref name=Ref_Lester241-2>{{Ref Lester|241-2}}</ref> | Nuclear staining:<ref name=Ref_Lester241-2>{{Ref Lester|241-2}}</ref> | ||
Line 409: | Line 421: | ||
==Invasive micropapillary carcinoma of the breast== | ==Invasive micropapillary carcinoma of the breast== | ||
*[[AKA]] ''micropapillary carcinoma''. | *[[AKA]] ''micropapillary carcinoma''. | ||
{{Main|Invasive micropapillary carcinoma of the breast}} | |||
==Apocrine carcinoma of the breast== | ==Apocrine carcinoma of the breast== | ||
Line 439: | Line 432: | ||
==Adenoid cystic carcinoma of the breast== | ==Adenoid cystic carcinoma of the breast== | ||
*[[AKA]] ''breast adenoid cystic carcinoma''. | *[[AKA]] ''breast adenoid cystic carcinoma''. | ||
{{Main|Adenoid cystic carcinoma of the breast}} | |||
== | ==Intracystic papillary breast carcinoma== | ||
*[[AKA]] ''encapsulated or encysted papillary carcinoma of the breast'', abbreviated ''EPC''. | |||
{{Main|Intracystic papillary breast carcinoma}} | |||
*[[AKA]] ''encapsulated papillary carcinoma of the breast'', abbreviated ''EPC''. | |||
==Glycogen-rich clear cell carcinoma of the breast== | ==Glycogen-rich clear cell carcinoma of the breast== | ||
Line 508: | Line 446: | ||
{{Main|Secretory carcinoma of the breast}} | {{Main|Secretory carcinoma of the breast}} | ||
= | ==Invasive cribriform carcinoma of the breast== | ||
{{Main|Invasive cribriform carcinoma of the breast}} | |||
==Invasive papillary carcinoma of the breast== | |||
{{Main|Invasive papillary carcinoma of the breast}} | |||
*Should '''not''' be confused with the indolent behaving [[intracystic papillary carcinoma of the breast]], also known as ''encapsulated papillary carcinoma of the breast''. | |||
== | =Grading breast cancer= | ||
{{Main|Breast cancer grading}} | |||
=Staging breast cancer= | =Staging breast cancer= | ||
{{Main|Breast cancer staging}} | |||
{{Main| | |||
=Lymphovascular invasion= | =Lymphovascular invasion= | ||
Line 718: | Line 550: | ||
=External links= | =External links= | ||
*[http://ww5.komen.org/BreastCancer/SubtypesofBreastCancer.html About breast cancer - molecular subtypes (komen.org)]. | *[http://ww5.komen.org/BreastCancer/SubtypesofBreastCancer.html About breast cancer - molecular subtypes (komen.org)]. | ||
[[Category:Breast pathology]] | [[Category:Breast pathology]] | ||
[[Category:Invasive breast cancer]] | [[Category:Invasive breast cancer]] |