Breast carcinoma pathology

Dr. P. Karpagam Kiruba Rajeswari, M.B.B.S.,D.C.P., Tutor in Pathology, MAPIMS

BREAST CARCINOMA – RISK FACTORS

PATHOGNESIS – GENETIC FACTORS ,[object Object]

BRCA -1  Breast Cancer 1,Early onset ( Chr.17) BRCA-2, Breast Cancer 2,Early onset( Chr.13) p53( Chr.17) CHEK2( Chr. 22) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Germline point mutations/Deletions of BRCA1 gene  Hereditary breast & ovarian cancers. Mutations  20% Hereditary breast cancer, ovarian cancer, increased cancer risk in male carriers. Mutations  Sporadic breast cancers.  Li fraumeni syndrome Mutations - rare (<5%). Li fraumeni variant Increase breast cancer risk after radiation exposure

HER2/neu ,[object Object],[object Object],[object Object],[object Object],[object Object]

PATHOGENESIS – HORMONAL FACTORS ,[object Object],[object Object],[object Object],[object Object],[object Object]

ESTROGEN DEPENDENT TUMOURS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

CLASSIFICATION – BREAST CARCINOMA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

DUCTAL CARCINOMA IN SITU ,[object Object],[object Object],[object Object]

Comedocarcinoma ,[object Object],[object Object],[object Object],[object Object],[object Object]

Noncomedo DCIS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Noncomedo DCIS ,[object Object],[object Object],[object Object],[object Object],[object Object]

PAGET’S DISEASE OF NIPPLE ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

DCIS WITH MICROINVASION ,[object Object],[object Object],[object Object]

MANAGEMENT AND PROGNOSIS OF DCIS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

LOBULAR CARCINOMA IN SITU ,[object Object],[object Object],[object Object],[object Object]

LOBULAR CARCINOMA IN SITU - MORPHOLOGY ,[object Object],[object Object],[object Object],[object Object]

LOBULAR CARCINOMA IN SITU ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

INVASIVE CARCINOMA – CLINICALFEATURES ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Invasive Carcinoma, No Special Type (NST; Invasive Ductal Carcinoma) ,[object Object],[object Object],[object Object]

Invasive Carcinoma – NST- HPE Features Well diff. Ca Mod. diff.Ca Poorly diff. Ca. Tubule formation Prominent Less,solid clusters/single infiltrating cells Ragged nests/solid sheets of cells Nuclei Small,round,monomorphic Greater nuclear pleomorphism Nuclei – enlarged,irregular. Mitotic figures Rare Present Numerous Proliferation rate - - High Tumour necrosis - - Present

INVASIVE LOBULAR CARCINOMA ,[object Object],[object Object],[object Object]

INVASIVE LOBULAR CARCINOMA ,[object Object],[object Object],[object Object],[object Object]

MEDULLARY CARCINOMA ,[object Object],[object Object],[object Object]

MEDULLARY CARCINOMA - HPE ,[object Object],[object Object],[object Object],[object Object],[object Object]

MUCINOUS/COLLOID CARCINOMA ,[object Object],[object Object]

MUCINOUS CARCINOMA - HPE ,[object Object],[object Object],[object Object],[object Object]

TUBULAR CARCINOMA ,[object Object],[object Object],[object Object],[object Object],[object Object]

INVASIVE PAPILLARY & MICROPAPILLARY CARCINOMA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

INFLAMMATORY CARCINOMA ,[object Object],[object Object],[object Object],[object Object]

METAPLASTIC CARCINOMA ,[object Object],[object Object],[object Object],[object Object]

PROGNOSTIC FACTORS - MAJOR ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Stage T: Primary Cancer Lymph Nodes (LNs) M: Distant Metastasis 5-Year Survival (%) 0 DCIS or LCIS No metastases Absent 92 I Invasive carcinoma ≤2 cm No metastases Absent 87 II Invasive carcinoma >2 cm No metastases Absent 75 Invasive carcinoma <5 cm 1 to 3 positive LNs Absent III Invasive carcinoma >5 cm 1 to 3 positive LNs Absent 46 Any size invasive carcinoma ≥ 4 positive LNs Absent Invasive carcinoma with skin or chest wall involvement or inflammatory carcinoma 0 to >10 positive LNs. Absent IV Any size invasive carcinoma Negative or positive lymph nodes Present 13

FIBROADENOMA ,[object Object],[object Object],[object Object],[object Object],[object Object],GROSS: Spherical, sharply circumscribed, rubbery, grayish white, freely movable nodules -bulge above the surrounding tissue and contain slitlike spaces. < 1 cm – large tumors.

FIBROADENOMA - HPE ,[object Object],[object Object],[object Object]

FIBROADENOMA - TYPES ,[object Object],[object Object],In pericanalicular histologic pattern, the glands maintain their round or oval profiles. There is no prognostic or clinical significance attached to the pericanalicular and intracanalicular patterns. Both may be seen within the same lesion.

PHYLLODES TUMOUR  Phyllodes – leaf-like ,[object Object],[object Object],[object Object],[object Object],[object Object]

PHYLLODES TUMOUR ,[object Object],[object Object],[object Object],[object Object],[object Object]

NORMAL MALE BREAST ,[object Object]

GYNAECOMASTIA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Breast carcinoma pathology

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Breast carcinoma pathology