Invasive ductal carcinoma of the breast
|Invasive ductal carcinoma of the breast|
|Diagnosis in short|
Invasive ductal carcinoma. H&E stain.
|LM DDx||DCIS, invasive lobular carcinoma|
|EM||usu. ER and PR +ve, usu. HER2 -ve, mammoglobin +ve, CK7 +ve, CK20 -ve|
|Grossing notes||breast grossing|
|Staging||breast cancer staging|
|Signs||+/-palpable breast mass|
|Prognosis||dependent on stage and grade, good to poor|
|Clin. DDx||other breast tumours|
It is also known as NST (No Specific Type). Generically, it may be referred to as invasive mammary carcinoma.
- Most common type of invasive breast cancer.
- White, firm stellate lesion.
- Atypical cells:
- Usually >2x RBC diameter.
- Nucleoli common.
- Forming ducts or sheets.
- Evidence of invasion:
- Atypical nucleus adjacent to adipocyte - diagnostic.
- "Infiltrative" pattern:
- Small glands of variable size within desmoplastic stroma.
- Glands lined by a single layer of cells.
Myoepithelial markers - diagnostic for invasion:
- SMMS -ve.
- p63 -ve.
Prognostic markers - may be useful for metastates:
- ER +ve (diffuse).
- PR +ve (diffuse).
- HER2 -ve.
Invasive lobular carcinoma versus invasive ductal carcinoma:
- E-cadherin -ve (includes incomplete membrane staining).