Difference between revisions of "Invasive breast cancer"

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→‎Invasive micropapillary carcinoma of the breast: split out
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==Invasive micropapillary carcinoma of the breast==
==Invasive micropapillary carcinoma of the breast==
*[[AKA]] ''micropapillary carcinoma''.
*[[AKA]] ''micropapillary carcinoma''.
===General===
{{Main|Invasive micropapillary carcinoma of the breast}}
*Poor prognosis.
*LVI common.<ref name=pmid20304650>{{Cite journal  | last1 = Yu | first1 = JI. | last2 = Choi | first2 = DH. | last3 = Park | first3 = W. | last4 = Huh | first4 = SJ. | last5 = Cho | first5 = EY. | last6 = Lim | first6 = YH. | last7 = Ahn | first7 = JS. | last8 = Yang | first8 = JH. | last9 = Nam | first9 = SJ. | title = Differences in prognostic factors and patterns of failure between invasive micropapillary carcinoma and invasive ductal carcinoma of the breast: matched case-control study. | journal = Breast | volume = 19 | issue = 3 | pages = 231-7 | month = Jun | year = 2010 | doi = 10.1016/j.breast.2010.01.020 | PMID = 20304650 }}</ref>
 
===Microscopic===
Features:<ref>{{Cite journal  | last1 = Pettinato | first1 = G. | last2 = Manivel | first2 = CJ. | last3 = Panico | first3 = L. | last4 = Sparano | first4 = L. | last5 = Petrella | first5 = G. | title = Invasive micropapillary carcinoma of the breast: clinicopathologic study of 62 cases of a poorly recognized variant with highly aggressive behavior. | journal = Am J Clin Pathol | volume = 121 | issue = 6 | pages = 857-66 | month = Jun | year = 2004 | doi = 10.1309/XTJ7-VHB4-9UD7-8X60 | PMID = 15198358 }}</ref>
*Small micropapillary tufts of tumour cells or tubuloalveolar structures.
*Central '''avascular''' stromal core. 
*Clear spaces/clefting around the small clusters of tumor cells - '''diffuse/through-out the tumour''' - '''key feature'''.
**Described as "small clusters of tumour lying within dilated vascular channel-like spaces".<ref name=pmid20444748>{{Cite journal  | last1 = Yamaguchi | first1 = R. | last2 = Tanaka | first2 = M. | last3 = Kondo | first3 = K. | last4 = Yokoyama | first4 = T. | last5 = Kaneko | first5 = Y. | last6 = Yamaguchi | first6 = M. | last7 = Ogata | first7 = Y. | last8 = Nakashima | first8 = O. | last9 = Kage | first9 = M. | title = Characteristic morphology of invasive micropapillary carcinoma of the breast: an immunohistochemical analysis. | journal = Jpn J Clin Oncol | volume = 40 | issue = 8 | pages = 781-7 | month = Aug | year = 2010 | doi = 10.1093/jjco/hyq056 | PMID = 20444748 | URL = http://jjco.oxfordjournals.org/content/40/8/781.long }}</ref>
**Can appear sponge like or swiss cheese like. 
*Abundant finely granular cytoplasm. 
*Mucin cytoplasmic but not in the surrounding clear spaces. 
*Nuclear atypia is moderate or severe. 
*Mixed(micropapillary + other) histological pattern common.
*Can show psamomma bodies or other calcifications.
 
DDX
*Invasive mammary carcinoma of no special type with micropapillary features.
*Metastatic papillary serous carcinoma of the ovary (WT1, PAX8 positive).<ref>{{Cite journal  | last1 = Nonaka | first1 = D. | last2 = Chiriboga | first2 = L. | last3 = Soslow | first3 = RA. | title = Expression of pax8 as a useful marker in distinguishing ovarian carcinomas from mammary carcinomas. | journal = Am J Surg Pathol | volume = 32 | issue = 10 | pages = 1566-71 | month = Oct | year = 2008 | doi = 10.1097/PAS.0b013e31816d71ad | PMID = 18724243 }}
</ref>
 
Note:
*[[Invasive ductal carcinoma of the breast|Ductal carcinoma]] commonly has clefting... but it isn't diffuse.
*Even a minor component of this tumor type should be identified and reported due to the high rate of associated lymphatic invasion and nodal involvement.
*Skin involvement has been reported to be strongly correlated with a poor prognosis for this subtype.
*Micropapillary architectural is retained in node metastases, dermal lymphatic invasion, and recurrences.<ref>{{Cite journal  | last1 = Pettinato | first1 = G. | last2 = Manivel | first2 = CJ. | last3 = Panico | first3 = L. | last4 = Sparano | first4 = L. | last5 = Petrella | first5 = G. | title = Invasive micropapillary carcinoma of the breast: clinicopathologic study of 62 cases of a poorly recognized variant with highly aggressive behavior. | journal = Am J Clin Pathol | volume = 121 | issue = 6 | pages = 857-66 | month = Jun | year = 2004 | doi = 10.1309/XTJ7-VHB4-9UD7-8X60 | PMID = 15198358 }}</ref>
 
Images:
<gallery>
Image:Breast Breast MicropapillaryCarcinoma Invasive PA.JPG|Breast - Invasive Micropapillary Carcinoma - High power (SKB)
Image:Breast MicropapillaryCarcinoma Invasive 2 PA.JPG|Breast - Invasive Micropapillary Carcinoma - High power (SKB)
</gallery>
 
*[http://www.flickr.com/photos/euthman/5300126397/ Invasive micropapillary carcinoma (flickr.com/euthman)].
*[http://www.breast-cancer.ca/images/invasive-micropapillary-breast-carcinoma-cells1.jpg Invasive micropapillary carcinoma - poor quality image (breast-cancer.ca)].<ref>URL: [http://www.breast-cancer.ca/type/micropapillary-breast-carcinoma.htm http://www.breast-cancer.ca/type/micropapillary-breast-carcinoma.htm]. Accessed on: 30 May 2012.</ref>
 
===IHC===
*[[EMA]] +ve (periphery of nests); described as inside-out pattern.<ref name=pmid20444748>{{Cite journal  | last1 = Yamaguchi | first1 = R. | last2 = Tanaka | first2 = M. | last3 = Kondo | first3 = K. | last4 = Yokoyama | first4 = T. | last5 = Kaneko | first5 = Y. | last6 = Yamaguchi | first6 = M. | last7 = Ogata | first7 = Y. | last8 = Nakashima | first8 = O. | last9 = Kage | first9 = M. | title = Characteristic morphology of invasive micropapillary carcinoma of the breast: an immunohistochemical analysis. | journal = Jpn J Clin Oncol | volume = 40 | issue = 8 | pages = 781-7 | month = Aug | year = 2010 | doi = 10.1093/jjco/hyq056 | PMID = 20444748 | URL = http://jjco.oxfordjournals.org/content/40/8/781.long }}</ref>
*E-cadherin +ve (centre of nests). (???)
*p63 +ve/-ve.
 
EMA limited to the cytoplasmic membrane oriented toward the stroma.
E-cadherin  absent on the cytoplasmic membrane oriented toward the stroma.
Hypothesized to indicate an inversion of cell polarization and a disturbance in the cell adhesion molecules.<ref>{{Cite journal  | last1 = Pettinato | first1 = G. | last2 = Manivel | first2 = CJ. | last3 = Panico | first3 = L. | last4 = Sparano | first4 = L. | last5 = Petrella | first5 = G. | title = Invasive micropapillary carcinoma of the breast: clinicopathologic study of 62 cases of a poorly recognized variant with highly aggressive behavior. | journal = Am J Clin Pathol | volume = 121 | issue = 6 | pages = 857-66 | month = Jun | year = 2004 | doi = 10.1309/XTJ7-VHB4-9UD7-8X60 | PMID = 15198358 }}</ref>


==Apocrine carcinoma of the breast==
==Apocrine carcinoma of the breast==
Michael
48,833

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