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Difference between revisions of "Invasive breast cancer"
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→Breast IHC
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== Basal-like breast | == Basal-like breast carcinoma==<ref>{{Cite journal | last1 = Badve | first1 = S. | last2 = Dabbs | first2 = DJ. | last3 = Schnitt | first3 = SJ. | last4 = Baehner | first4 = FL. | last5 = Decker | first5 = T. | last6 = Eusebi | first6 = V. | last7 = Fox | first7 = SB. | last8 = Ichihara | first8 = S. | last9 = Jacquemier | first9 = J. | title = Basal-like and triple-negative breast cancers: a critical review with an emphasis on the implications for pathologists and oncologists. | journal = Mod Pathol | volume = 24 | issue = 2 | pages = 157-67 | month = Feb | year = 2011 | doi = 10.1038/modpathol.2010.200 | PMID = 21076464 }} | ||
</ref> | </ref> | ||
*Overview | *Overview | ||
**A | **Somewhere between 15-30% of breast carcinomas. | ||
**A category of breast carcinomas defined by gene expression profiling | |||
**Can be identified by immunohistochemistry - basal markers (CK14, p63, calponin, SMA) | **Can be identified by immunohistochemistry - basal markers (CK14, p63, calponin, SMA) | ||
**Not derived from myoepithelial cells, merely express a phenotype more in keeping with basal cells than ductal cells | **Not derived from myoepithelial cells, merely express a phenotype more in keeping with basal cells than ductal cells | ||
**Most triple negative (ER, PgR, Her-2); therefore cannot be treated with the usual therapeutic agents | **Most triple negative (ER, PgR, Her-2); therefore cannot be treated with the usual therapeutic agents | ||
**There is an association in young women between basal-like breast cancer and BRCA mutation. | **There is an association in young women between basal-like breast cancer and BRCA mutation. | ||
**Increased incidence in some populations - African-Americans, young women | |||
**Sporadic basal-like cancers do not have a BRCA mutation but may have a dysfunctional BRCA1 pathway. | **Sporadic basal-like cancers do not have a BRCA mutation but may have a dysfunctional BRCA1 pathway. | ||
*This molecular group includes a variety of morphologic phenotypes including: | *This molecular group includes a variety of morphologic phenotypes including: | ||
**High grade invasive ductal | **High grade invasive ductal carcinoma of no special type. | ||
**Medullary-like | **Medullary-like carcinoma (a carcinoma with some but not all the features of medullary carcinoma). | ||
**Medullary | **Medullary carcinomas | ||
**Metaplastic | **Metaplastic carcinomas | ||
** | **Adenoid cystic carcinoma | ||
**Secretory | **Secretory carcinoma | ||
*Classic morphological clues of a basal type cancer usually refer to medullary carcinoma features: | *Classic morphological clues of a basal type cancer usually refer to medullary carcinoma features: | ||
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**Basal-like breast cancer is a heterogeneous group. | **Basal-like breast cancer is a heterogeneous group. | ||
**The behaviour of basal-like breast cancer appears to fall into two groups: | **The behaviour of basal-like breast cancer appears to fall into two groups: | ||
***The tumours that do not metastasise have a better prognosis than other | ***The tumours that do not metastasise have a better prognosis than other types of breast carcinoma. | ||
***Tumours with early metastasis | ***Tumours with early metastasis may behave more aggressively | ||
****Hematogenous spread -greater tendency to metastasise to visceral sites associated with poorer prognosis (such as lung and brain) instead of to nodes and bone | ****Hematogenous spread -greater tendency to metastasise to visceral sites associated with poorer prognosis (such as lung and brain) instead of to nodes and bone | ||
== Triple Negative Breast | == Triple Negative Breast Carcinoma ==<ref>{{Cite journal | last1 = Badve | first1 = S. | last2 = Dabbs | first2 = DJ. | last3 = Schnitt | first3 = SJ. | last4 = Baehner | first4 = FL. | last5 = Decker | first5 = T. | last6 = Eusebi | first6 = V. | last7 = Fox | first7 = SB. | last8 = Ichihara | first8 = S. | last9 = Jacquemier | first9 = J. | title = Basal-like and triple-negative breast cancers: a critical review with an emphasis on the implications for pathologists and oncologists. | journal = Mod Pathol | volume = 24 | issue = 2 | pages = 157-67 | month = Feb | year = 2011 | doi = 10.1038/modpathol.2010.200 | PMID = 21076464 }}</ref> | ||
**A category of breast carcinomas defined by immunohistochemical/FISH expression of ER, PR and HER2. | |||
**About 15% of breast carcinomas. | **About 15% of breast carcinomas. | ||
**Important group due to a lack of tailored therapies for this group | **Important group due to a lack of tailored therapies for this group | ||