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Difference between revisions of "Invasive breast cancer"
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==Types of invasive breast cancer== | ==Types of invasive breast cancer== | ||
*Ductal also known as no specific type (NST) - 79% | Types:Ref.: <ref name=Ref_PBoD1143>{{Ref PBoD|1143}}</ref> | ||
*Lobular 10% | *Ductal - also known as no specific type (NST) - 79%. | ||
*Cribriform (tubular) 6% | *Lobular 10%. | ||
*Mucinous (colloid) 2% | *Cribriform (tubular) 6%. | ||
*Medullary 2% | *Mucinous (colloid) 2%. | ||
*Papillary 1% | *Medullary 2%. | ||
*Metaplastic <1% | *Papillary 1%. | ||
*Metaplastic <1%. | |||
==Standard IHC work-up== | ==Standard IHC work-up== | ||
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**Sunnybrook uses ''CAM5.2''. | **Sunnybrook uses ''CAM5.2''. | ||
*ER (estrogen receptor). | *ER (estrogen receptor). | ||
**Positive in most breast cancers; +ve in ~75-80%.<ref>Lester | **Positive in most breast cancers; +ve in ~75-80%.<ref name=Ref_Lester241-2>{{Ref Lester|241-2}}</ref> | ||
*PR (progesterone receptor). | *PR (progesterone receptor). | ||
**Positive in most breast cancers; +ve in ~65-70%.<ref>Lester | **Positive in most breast cancers; +ve in ~65-70%.<ref name=Ref_Lester241-2>{{Ref Lester|241-2}}</ref> | ||
*HER2/neu. | *HER2/neu. | ||
**Usually negative; -ve in 70-80%.<ref>Lester | **Usually negative; -ve in 70-80%.<ref name=Ref_Lester241-2>{{Ref Lester|241-2}}</ref> | ||
**Positivity association with a worse prognosis. | **Positivity association with a worse prognosis. | ||
===ER & PR scoring<ref>Lester | ===ER & PR scoring<ref name=Ref_Lester241-2>{{Ref Lester|241-2}}</ref>=== | ||
*Give a percentage, i.e. 0-100%. | *Give a percentage, i.e. 0-100%. | ||
**Important cut points: 1% and 10%. | **Important cut points: 1% and 10%. | ||
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*Normal breast epithelial cells have a patchy staining for ER and PR. | *Normal breast epithelial cells have a patchy staining for ER and PR. | ||
*Evaluated on the invasive component. | *Evaluated on the invasive component. | ||
===HER2 scoring<ref>Lester | ===HER2 scoring<ref name=Ref_Lester241-2>{{Ref Lester|241-2}}</ref>=== | ||
{| class="wikitable" | {| class="wikitable" | ||
| '''Score''' | | '''Score''' | ||
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**Useful to assess lymphovascular invasion. | **Useful to assess lymphovascular invasion. | ||
*ADH and DCIS:<ref>Lester | *ADH and DCIS:<ref name=Ref_Lester122>{{Ref Lester|122}}</ref> | ||
**E-cadherin. | **E-cadherin. | ||
***Present in most epithelial cells. | ***Present in most epithelial cells. | ||
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===General=== | ===General=== | ||
*Cells in the epithelium, i.e. skin, that look like they don't belong. | *Cells in the epithelium, i.e. skin, that look like they don't belong. | ||
*Associated with underlying breast carcinoma.<ref name=emed_pagets>[http://emedicine.medscape.com/article/1101235-diagnosis http://emedicine.medscape.com/article/1101235-diagnosis]</ref> | *Associated with underlying breast carcinoma.<ref name=emed_pagets>URL: [http://emedicine.medscape.com/article/1101235-diagnosis http://emedicine.medscape.com/article/1101235-diagnosis]</ref> | ||
Note: | Note: | ||
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Images: | Images: | ||
*[http://commons.wikimedia.org/wiki/File:Extramammary_Pagets_disease_low.jpg Paget's disease - low mag. (WC)]. | *[http://commons.wikimedia.org/wiki/File:Extramammary_Pagets_disease_low.jpg Paget's disease - low mag. (WC)]. | ||
*[http://commons.wikimedia.org/wiki/File:Extramammary_Pagets_disease_high.jpg Paget's disease - high mag. (WC) ]. | *[http://commons.wikimedia.org/wiki/File:Extramammary_Pagets_disease_high.jpg Paget's disease - high mag. (WC)]. | ||
===DDx=== | ===DDx=== | ||