Proliferative Lesions and Breast Cancer Histopathology

2018 ◽  
Author(s):  
Sophia K. Apple ◽  
Lawrence W. Bassett
Keyword(s):  
Breast Cancer ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Lobular Carcinoma ◽  
Phyllodes Tumor ◽  
Breast Cancers ◽  
Cancer Subtypes ◽  
Radiologic Findings ◽  
Invasive Carcinomas

Breast in situ lesions and invasive carcinomas are a heterogeneous group of tumors comprising many different morphological and biological subtypes. The majority of invasive breast cancers thought to arise in the terminal ductal lobular unit (TDLU). As multidisciplinary diagnosis and detection of early breast carcinomas is the gold standard, an understanding of histopathology in correlation with radiologic findings is critical. This chapter reviews the histopathology of high-risk proliferative lesions, ductal carcinoma in situ (DCIS), lobular carcinoma in situ (LCIS), and invasive breast carcinoma. Tumor progression and some of the frequently seen invasive breast cancer subtypes are described. Histopathology of other malignancies arising from mesenchymal origin, including phyllodes tumor, is also described.

scholarly journals Ultrasonography alone for diagnosis of breast cancer in women under 40

2014 ◽  
Vol 96 (3) ◽  
pp. 202-206 ◽  
Author(s):  
DC Appleton ◽  
L Hackney ◽  
S Narayanan
Keyword(s):  
Breast Cancer ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Imaging Modality ◽  
Imaging Techniques ◽  
Lobular Carcinoma ◽  
Clinical Findings ◽  
Breast Cancers ◽  
Breast Clinic

Introduction Recent guidelines suggest that ultrasonography should be used as the primary imaging modality in women under 40 years of age with mammography being offered if further imaging is required. The aim of this study was to assess the adequacy of ultrasonography and the utility of mammography in this patient group by reviewing the role these imaging techniques had in the diagnosis of breast cancer in our unit. Methods All breast cancers diagnosed in patients 39 years or younger from June 2009 to June 2011 were reviewed. This was a retrospective review of presentation, clinical findings, imaging modality (ultrasonography, mammography, magnetic resonance imaging [MRI]) and histology. Mammography was the primary imaging modality until May 2011 in women between 35 and 39 years of age. Both invasive and intraductal carcinoma were included in the study but lobular carcinoma in situ was excluded. Results A total of 2,495 patients were referred to the symptomatic breast clinic in this age group during the study period. Thirty women were identified with either invasive cancer (n=27) or ductal carcinoma in situ (n=3). Twenty-eight patients underwent mammography, graded as uncertain, suspicious or malignant in the majority. Malignancy was missed in one patient. All 30 patients underwent ultrasonography, reported as uncertain, suspicious or malignant, an indication for diagnostic core biopsy. Ultrasonography alone did not miss any cancers but did fail to detect multifocal disease in one patient. Conclusions In this study group, ultrasonography was reliable as the primary imaging modality for women under 40, identifying all cancers in this cohort. Mammography and/or MRI remain essential adjuncts to accurately determine multifocality and/or the extent of disease.

Pleomorphic lobular carcinoma in situ: A distinct entity of controversial significance.

2012 ◽  
Vol 30 (27_suppl) ◽  
pp. 177-177
Author(s):  
Marina De Brot ◽  
Shirin Muhsen ◽  
Victor P. Andrade ◽  
Starr Koslow Mautner ◽  
Melissa Murray ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Lobular Carcinoma ◽  
Previous History ◽  
Prior History ◽  
Lobular Carcinoma In Situ ◽  
Pleomorphic Lobular Carcinoma ◽  
History Of

177 Background: Pleomorphic lobular carcinoma in situ (PLCIS) is an increasingly diagnosed variant of lobular carcinoma in situ. Histologically, it resembles ductal carcinoma in situ (DCIS), leading to controversy over proper management. Yet, the natural history of PLCIS is unknown. Here we describe our experience with PLCIS. Methods: Review of pathology reports (1995–2012) identified 233 cases of LCIS variants. Patients with synchronous ipsilateral DCIS or invasive cancer (IC) were excluded leaving 25 cases for review. Consensus review by 3 pathologists further excluded 7; leaving 18 cases, 12 of which were classified as PLCIS and 6 as LCIS with pleomorphic features (LCIS-PF). (Table) PLCIS was defined by cellular dyshesion, nuclear pleomorphism with a 2-3 fold size variation, conspicuous nucleoli, mitoses and abundant cytoplasm; lesions not meeting all parameters were classified as LCIS-PF. Loss of e-cadherin was confirmed; clinical data were obtained from medical records. Results: Mean patient age at diagnosis of PLCIS/LCIS-PF was 57 yrs (42-67 yrs). All cases presented with imaging abnormalities. A previous history of breast cancer was present in 7/18 (39%) pts (3/7, ipsilateral; 4/7, contralateral). Following PLCIS/LCIS-PF diagnosis, 6/18 (33%) pts underwent mastectomy and 12/18 had excision alone, with (n=3) or without chemoprevention (n=9). Margin status was negative in 4/12 pts; close in 3/12 pts and positive in 5/12 pts undergoing excision. At a median follow-up of 27 mos (2-148 mos), 2/12 pts treated with excision developed ipsilateral breast cancer (1 DCIS; 1 IC). Both had close margins at initial excision; median time to cancer, 54 mos. Conclusions: Pure PLCIS is an uncommon lesion. Synchronous malignancy or prior history of breast cancer are often present in patients with PLCIS, contributing to the difficulty in determining the actual risk conferred by this lesion and appropriate management. Efforts to systematically characterize LCIS variants and prospective documentation of outcomes are needed to clarify the significance of these lesions. [Table: see text]

scholarly journals Ductal Carcinoma in situ and Lobular Carcinoma in situ Arising in a Phyllodes Tumor

2015 ◽  
Vol 76 (4) ◽  
pp. 693-698
Author(s):  
Yoshiaki NAKANO ◽  
Toshio NISHI ◽  
Ayaka NISHIMAE ◽  
Masaru YAMASAKI ◽  
Tetsuya YOSHIDA ◽  
...  
Keyword(s):  
Ductal Carcinoma In Situ ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Lobular Carcinoma ◽  
Phyllodes Tumor ◽  
Lobular Carcinoma In Situ

Occult Nipple Involvement in Breast Cancer: Clinicopathologic Findings in 316 Consecutive Mastectomy Specimens

2009 ◽  
Vol 27 (30) ◽  
pp. 4948-4954 ◽  
Author(s):  
Elena F. Brachtel ◽  
Jennifer E. Rusby ◽  
James S. Michaelson ◽  
L. Leon Chen ◽  
Alona Muzikansky ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Lobular Carcinoma ◽  
Univariate Analysis ◽  
Oncological Safety ◽  
En Face ◽  
Nipple Sparing Mastectomy ◽  
Nipple Sparing

Purpose Although breast-conserving surgery is a standard approach for patients with breast cancer, mastectomy often becomes necessary. Surgical options now include nipple-sparing mastectomy but its oncological safety is still controversial. This study evaluates frequency and patterns of occult nipple involvement in a large contemporary cohort of patients with the retroareolar margin as possible indicator of nipple involvement. Patients and Methods Three hundred sixteen consecutive mastectomy specimens (232 therapeutic, 84 prophylactic) with grossly unremarkable nipples were evaluated by coronal sections through the entire nipple and subareolar tissue. Extent and location of nipple involvement by carcinoma was assessed with the tissue deep to the skin as potential retroareolar en-face resection margin. Results Seventy-one percent of nipples from therapeutic mastectomies showed no pathologic abnormality, 21% had ductal carcinoma in situ (DCIS), invasive carcinoma (IC), or lymphovascular invasion (LVI), and 8% lobular neoplasia (lobular carcinoma in situ). Human epidermal growth factor receptor 2 amplification, tumor size, and tumor-nipple distance were associated with nipple involvement by multivariate analysis (P = .0047, .0126, and .0176); histologic grade of both DCIS (P = .002) and IC (P = .03), LVI (P = .03), and lymph node involvement (P = .02) by univariate analysis. Nipple involvement by IC or DCIS was identified in the retroareolar margin with a sensitivity of 0.8 and a negative predictive value of 0.96. None of the 84 prophylactic mastectomies showed nipple involvement by IC or DCIS. Conclusion Nipple-sparing mastectomy may be suitable for selected cases of breast carcinoma with low probability of nipple involvement by carcinoma and prophylactic procedures. A retroareolar en-face margin may be used to test for occult involvement in patients undergoing nipple-sparing mastectomy.

scholarly journals A Clinical Case Study of Synchronous Breast Cancer

2021 ◽  
Vol 28 (3) ◽  
pp. 329-332
Author(s):  
Mihai MEHEDINTU-IONESCU ◽  
◽  
Stefan-Andrei COMAN ◽  
Horia-Alexandru TOADER ◽  
◽  
...  
Keyword(s):  
Breast Cancer ◽  
Carcinoma In Situ ◽  
Clinical Case ◽  
Ductal Carcinoma ◽  
Lobular Carcinoma ◽  
Clinical Case Study ◽  
The Right ◽  
Synchronous Breast Cancer

The following article represents a clinical case study of a synchronous breast cancer in a 47 year old woman with no prior significant comorbidities.Up to 10% of all breast cancers can be synchronous (usually found with the help of breast MRI). The occurrence of bilaterally is considerable with invasive lobular carcinoma. The patient observed after self-palpating her breast a nodule in the infero-external quadrant of the right breast. During almost 4 months the patient underwent punch biopsy of the right breast, lumpectomy and finally double mastectomy with immediate reconstruction using Mentor implants and AMD. The histopathological result showed ductal carcinoma in situ in the right breast and lobular carcinoma in situ in both breasts. Postoperatively the patient is free of cancer, but under clinical and imagistic surveillance.

Sign in / Sign up

Export Citation Format

Share Document