Difference between revisions of "Invasive breast cancer"

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==Tubular carcinoma of the breast==
==Tubular carcinoma of the breast==
*[[AKA]] ''tubular carcinoma''.
*[[AKA]] ''tubular carcinoma''.
===General===
{{Main|Tubular carcinoma of the breast}}
Epidemiology:
*Typically excellent prognosis.
*Hormone receptors commonly present (ER +ve, PR +ve).
*Usually HER2 -ve.
*Classically seen in post-menopausal women.
 
Note:
*May be seen in association with [[lobular carcinoma in situ]] and columnar cell lesions - known as '''Rosen triad'''.<ref name=pmid18434766>{{Cite journal  | last1 = Brandt | first1 = SM. | last2 = Young | first2 = GQ. | last3 = Hoda | first3 = SA. | title = The "Rosen Triad": tubular carcinoma, lobular carcinoma in situ, and columnar cell lesions. | journal = Adv Anat Pathol | volume = 15 | issue = 3 | pages = 140-6 | month = May | year = 2008 | doi = 10.1097/PAP.0b013e31816ff313 | PMID = 18434766 }}</ref>
**Memory device ''TLC'' = '''T'''ubular ca., '''L'''CIS, '''C'''olumnar cell lesions.
 
===Microscopic===
Features:<ref name=Ref_PBoD1146>{{Ref PBoD|1146}}</ref><ref>URL: [http://www.bweems.com/nsj3mp2.jpg http://www.bweems.com/nsj3mp2.jpg].</ref><ref>URL: [http://surgpathcriteria.stanford.edu/breast/tubularcabr/ http://surgpathcriteria.stanford.edu/breast/tubularcabr/].</ref>
*Well-formed tubules.
**Typically have angled ducts - "prows" - '''important feature''' (low power).
**Myoepithelial cells absent - diagnostic - may be have to appreciated without IHC.
**>70% of the tumour cells should be adjacent to lumen.<ref name=pmid10836300>{{Cite journal  | last1 = Stalsberg | first1 = H. | last2 = Hartmann | first2 = WH. | title = The delimitation of tubular carcinoma of the breast. | journal = Hum Pathol | volume = 31 | issue = 5 | pages = 601-7 | month = May | year = 2000 | doi =  | PMID = 10836300 }}</ref>
*+/- Cribriform spaces.
*Apocrine snouts typical.
*+/-Calcification.
 
Notes:
*Prow = front of a ship.
*Looks benign to the uninitiated -- '''important'''.
 
DDx:
*[[Sclerosing adenosis]].
*[[Microglandular adenosis]].
 
Image:
*[http://radiology.uchc.edu/eAtlas/Breast/1714.htm Tubular carcinoma - (uchc.edu)].
 
===IHC===
*ER +ve.
*PR +ve.
*HER2 -ve.
**HER2 positivity should prompt consideration of another diagnosis!


==Metaplastic breast carcinoma==
==Metaplastic breast carcinoma==
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