Difference between revisions of "Invasive breast cancer"

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===Microscopic===
===Microscopic===
Features:
Features:
*Lesion confined to a duct (intraductal) ''or'' cyst (intracystic).
*Lesion confined to a cyst.
**May have a thick fibrous capsule = ''encapsulated papillary carcinoma''.<ref name=pmid21057133/>
**May have a thick fibrous capsule
**The involved space in intracystic papillary carcinoma is ''not'' lined by myoepithelial cells.
**The involved space is ''not'' lined by myoepithelial cells.
*Loss of myoepithelial cells - '''key feature'''.
*The cyst contains an abnormal epithelial proliferation with cribriform, solid or papillary architecture.
*Scattered large cells with pale eosinophilic cytoplasm may be observed<ref>{{Cite journal  | last1 = Collins | first1 = LC. | last2 = Schnitt | first2 = SJ. | title = Papillary lesions of the breast: selected diagnostic and management issues. | journal = Histopathology | volume = 52 | issue = 1 | pages = 20-9 | month = Jan | year = 2008 | doi = 10.1111/j.1365-2559.2007.02898.x | PMID = 18171414 }}
**Loss of myoepithelial cells within the epithelial proliferation is a '''key feature'''.
**Scattered large cells with pale eosinophilic cytoplasm may be observed<ref>{{Cite journal  | last1 = Collins | first1 = LC. | last2 = Schnitt | first2 = SJ. | title = Papillary lesions of the breast: selected diagnostic and management issues. | journal = Histopathology | volume = 52 | issue = 1 | pages = 20-9 | month = Jan | year = 2008 | doi = 10.1111/j.1365-2559.2007.02898.x | PMID = 18171414 }}
</ref>.  
</ref>.  
**These cells are so-called globoid cells or clear cells and are immunoreactive for GCDFP-15.  
***These cells are so-called globoid cells or clear cells and are immunoreactive for GCDFP-15.  
**They should not be mistaken for myoepithelial cells.
***They should not be mistaken for myoepithelial cells.
*Neoplastic epithelial cells:
**Neoplastic epithelial cells:
**[[Nuclear atypia]] - including: nucleoli, [[nuclear pleomorphism]].
***[[Nuclear atypia]] - including: nucleoli, [[nuclear pleomorphism]].
**Abnormal architecture - including cribriform, solid, micropapillary, papillary.
 
IHC:
*Calponin/p63/SMA/CK5-6
**Loss of myoepithelial cells within the tumor.
**Loss of myoepithelial cells at the cyst wall.
*ER - Homogenous staining of the epithelial proliferation.


Photos:
Photos:
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