{"id":6790,"date":"2021-09-14T19:48:34","date_gmt":"2021-09-14T17:48:34","guid":{"rendered":"https:\/\/meddists.com\/learn\/pre-clinical\/pathology\/breast-pathology\/breast-carcinoma\/"},"modified":"2021-09-14T19:49:11","modified_gmt":"2021-09-14T17:49:11","slug":"breast-carcinoma","status":"publish","type":"page","link":"https:\/\/meddists.com\/learn\/pre-clinical\/pathology\/breast-pathology\/breast-carcinoma\/","title":{"rendered":"Breast carcinoma"},"content":{"rendered":"\n<ul class=\"wp-block-list\"><li>Most common malignancy in women (except for skin carcinoma)<\/li><li>Various of factors, but most important ones include estrogen exposure, age, genetics<ul><li>In particular &#8212; BRCA1\/2 and TP53tumor suppressor genes<\/li><\/ul><\/li><li>Nearly all are adenocarcinomas<\/li><li>The prevalence, tumor behavior and prognosis depend on the biologic and morphological features<\/li><li>Biologic classification systems:<ul><li><strong>Based on the receptor expression<\/strong><\/li><li>Based on genetic profiling<\/li><\/ul><\/li><li>Morphological classification:<ul><li><strong>Noninvasive<\/strong> (CIS)<\/li><li><strong>Invasive<\/strong><\/li><\/ul><\/li><\/ul>\n\n\n<span class=\"block-heading\" id=\"header_1\">\n<h4 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title1\">Biologic classification systems<\/h4>\n<\/span><span class=\"block-content\" id=\"contents_1\">\n\n\n<p class=\"wp-block-paragraph\">ER = estrogen receptor, HER2 = human epidermal growth factor receptor 2, PR = progesterone receptor<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>ER(+) and HER2(-)<ul><li>In older women<\/li><li>Germline BRCA2 mutations<\/li><\/ul><\/li><li>HER2(+) and ER(+\/-)<ul><li>In younger women<\/li><li>Germline TP53 mutations<\/li><\/ul><\/li><li>Triple negative (ER, HER2, PR negative)<ul><li>In younger women<\/li><li>Germline BRCA1 mutations<\/li><\/ul><\/li><\/ul>\n\n\n<\/span><span class=\"block-heading\" id=\"header_2\">\n<h4 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title1\">Noninvasive<\/h4>\n<\/span><span class=\"block-content\" id=\"contents_2\">\n\n\n<p class=\"wp-block-paragraph\">The two types of noninvasive carcinomas differ in their <strong>morphology&nbsp;<\/strong>and behavior &#8212; their names are slightly misleading, as they both arise from the same location (ductal cells giving rise to lobules). Both tumors do not invade through the basal lamina and stay confined within the duct.<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li><strong>Lobular carcinoma in-situ (LCIS)<\/strong><ul><li>Uniform appearance of loosely-cohesive cells that do not compress the duct<\/li><li>Mostly an accidental finding, as it does not have any gross features<\/li><li>LCIS marks an increased risk for carcinoma in both breasts<\/li><\/ul><\/li><li><strong>Ductal carcinoma in-situ (DCIS)<\/strong><ul><li>Cells proliferate within the epithelium so much that the lobule &#8220;collapses&#8221; and gives an appearance of a duct<\/li><li>Since the cells proliferate so much, there will be a necrotic core of cells deprived of nutrients that will <strong>calcify<\/strong><ul><li>This dystrophic calcification is an important indicator that is not seen in LCIS<\/li><\/ul><\/li><li>In some cases, the necrotic core will accumulate within the lumen, giving rise to a distinctive viscous material &#8212; this is known as <strong>comedo<\/strong><\/li><\/ul><\/li><li><strong>Paget disease of the nipple<\/strong><ul><li>In some cases of DCIS, tumor cells will <strong>extend<\/strong> distally towards the nipple<\/li><li>Appears as a crusty lesion on the surface of the nipple<\/li><li>It is an indicator of DCIS (<strong>invasion to the skin<\/strong>) &#8212; unlike extramammary Paget disease (of the vulva), which arises on its own<\/li><li>Histologically, <strong>Paget cells<\/strong> will be seen (lightly staining, vacuolated cells)<\/li><\/ul><\/li><\/ul>\n\n\n<\/span><span class=\"block-heading\" id=\"header_3\">\n<h4 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title1\">Invasive<\/h4>\n<\/span><span class=\"block-content\" id=\"contents_3\">\n\n\n<p class=\"wp-block-paragraph\">Upon the breakdown of the basement membrane.<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li><strong>Invasive ductal carcinoma<\/strong><ul><li>Most common type of invasive carcinoma<\/li><li>Desmoplastic response &#8212; nearby fibrosis<\/li><\/ul><\/li><li><strong>Invasive lobular carcinoma<\/strong><ul><li>Cells have reduced E-cadherin expression, allowing them to invade one-by-one<ul><li>Indian-file or single-file morphology<\/li><\/ul><\/li><\/ul><\/li><li><strong>Carcinoma with medullary features<\/strong><ul><li>Triple-negative<\/li><li>Rounded masses that are difficult to distinguish from normal breast tissue<\/li><\/ul><\/li><li><strong>Mucinous carcinoma<\/strong><ul><li>ER(+), HER2(-)<\/li><li>The tumor islets are engulfed by mucin<\/li><li>Favorable prognosis<\/li><\/ul><\/li><li><strong>Tubular carcinoma<\/strong><ul><li>ER(+), HER2(-)<\/li><li>Well-formed tubes<\/li><li>Favorable prognosis<\/li><\/ul><\/li><li><strong>Inflammatory carcinoma<\/strong><ul><li>Seen as erythema of the breast (simulating general inflammation), as the carcinoma invades and obstructs the lymph<\/li><li>Poor prognosis<\/li><\/ul><\/li><\/ul>\n\n\n<\/span><span class=\"block-heading\" id=\"header_4\">\n<h4 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title1\">Grading<\/h4>\n<\/span><span class=\"block-content\" id=\"contents_4\">\n\n\n<p class=\"wp-block-paragraph\">3 grades (I-III) based on the differentiation, Nottingham system.<\/p>\n\n\n<\/span><span class=\"block-heading\" id=\"header_5\">\n<h4 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title1\">Staging<\/h4>\n<\/span><span class=\"block-content\" id=\"contents_5\">\n\n\n<p class=\"wp-block-paragraph\">TNM.<\/p>\n<\/span><div id=\"the_titles\" style=\"display:none;\"><h4 class=\"wp-block-heading\" class=\"wp-block-heading\">Biologic classification systems<\/h4><h4 class=\"wp-block-heading\" class=\"wp-block-heading\">Noninvasive<\/h4><h4 class=\"wp-block-heading\" class=\"wp-block-heading\">Invasive<\/h4><h4 class=\"wp-block-heading\" class=\"wp-block-heading\">Grading<\/h4><h4 class=\"wp-block-heading\" class=\"wp-block-heading\">Staging<\/h4><\/div>","protected":false},"excerpt":{"rendered":"<p>Most common malignancy in women (except for skin carcinoma) Various of factors, but most important ones include estrogen exposure, age, genetics In particular &#8212; BRCA1\/2 and TP53tumor suppressor genes Nearly all are adenocarcinomas The prevalence, tumor behavior and prognosis depend on the biologic and morphological features Biologic classification systems: Based on the receptor expression Based [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":6784,"menu_order":2,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-6790","page","type-page","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.8 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Breast carcinoma &#8211; Meddists<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/meddists.com\/learn\/pre-clinical\/pathology\/breast-pathology\/breast-carcinoma\/\" \/>\n<meta name=\"twitter:label1\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data1\" content=\"2 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/meddists.com\\\/learn\\\/pre-clinical\\\/pathology\\\/breast-pathology\\\/breast-carcinoma\\\/\",\"url\":\"https:\\\/\\\/meddists.com\\\/learn\\\/pre-clinical\\\/pathology\\\/breast-pathology\\\/breast-carcinoma\\\/\",\"name\":\"Breast carcinoma &#8211; 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