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Breast Cancer

Breast Cancer. INCIDENCE. Breast cancer-most frequently diagnosed cancer and leading cause of cancer death among females [1] 23% of all cancer and 14% of all cancer death. Clinical Presentation. Early breast carcinoma are asymptomatic Larger tumors presents as painless

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Breast Cancer

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  1. Breast Cancer

  2. INCIDENCE • Breast cancer-most frequently diagnosed cancer and leading cause of cancer death among females [1] • 23% of all cancer and 14% of all cancer death

  3. Clinical Presentation • Early breast carcinoma are asymptomatic • Larger tumors presents as painless • Most shows productive fibrosis of epithelial and stromal tissues • Skin retraction • Localized edema (peaud'orange) • Skin ulceration • Axillary lymph nodes

  4. Histopathology of Breast Cancer • Carcinoma in Situ • Cancer cells are in situ or invasive depending on whether or not they invade through the basement membrane • absence of invasion of cells into the surrounding stroma and their confinement within natural ductal and alveolar boundaries

  5. Carcinoma in Situ • Lobar Carcinoma in Situ • originates from the terminal duct lobular units and develops only in the female breast • characterized by distention and distortion of the terminal duct lobular units by cancer cells • Cancer cells are large but maintain a normal nuclear:cytoplasmic ratio • Cytoplasmicmucoid globules are a distinctive cellular feature

  6. Carcinoma in Situ • Ductal Carcinoma in Situ • predominantly seen in the female breast, it accounts for 5% of male breast cancers • characterized by a proliferation of the epithelium that lines the minor ducts, resulting in papillary growths within the duct lumina • Initially, cancer cells do not show pleomorphism, mitoses, or atypia →cribriform growth pattern→solid growth pattern→comedo growth pattern

  7. Histopathology of Breast Cancer • Invasive Breast Carcinoma • described as lobular or ductal in origin • defined by specific histologic features • at least 90% of the cancer must contain the defining histologic features

  8. INCIDENCE

  9. Invasive Breast Carcinoma • Invasive ductal carcinoma • solitary, firm mass • poorly defined margins and its cut surfaces show a central stellate configuration with chalky white or yellow streaks extending into surrounding breast tissues • cancer cells often are arranged in small clusters with variable cellular and nuclear grade

  10. Invasive Breast Carcinoma • Invasive lobar carcinoma • Varied presentation • from clinically inapparent cancers to those that replace the entire breast with a poorly defined mass • frequently multifocal, multicentric, and bilateral • histopathologic features of this cancer include small cells with rounded nuclei, inconspicuous nucleoli, and scant cytoplasm

  11. Invasive Breast Carcinoa • Paget’s Disease • presents as a chronic, eczematous eruption of the nipple, which may be subtle but may progress to an ulcerated, weeping lesion • palpable mass may or may not be present • Pathognomonic of this cancer is the presence of large, pale, vacuolated cells (Paget cells) in the rete pegs of the epithelium

  12. Invasive Breast Carcinoma • Medullary carcinoma • frequent phenotype of BRCA1 hereditary breast cancer • Grossly, the cancer is soft and hemorrhagic • rapid increase in size may occur secondary to necrosis and hemorrhage

  13. Invasive Breast Carcinoma • Medullary carcinoma is characterized microscopically by : • (a) a dense lymphoreticular infiltrate composed predominantly of lymphocytes and plasma cells; • (b) large pleomorphic nuclei that are poorly differentiated and show active mitosis; and (c) • a sheet-like growth pattern with minimal or absent ductal or alveolar differentiation

  14. Invasive Breast Carcinoma • Mucinous carcinoma (colloid carcinoma) • Bulky tumor • defined by extracellular pools of mucin, which surround aggregates of low-grade cancer cells • cut surface of this cancer is glistening and gelatinous in quality

  15. Invasive Breast Carcinoma • Papillary carcinoma • small and rarely attain a size of 3 cm in diameter • defined by papillae with fibrovascular stalks and multilayered epithelium

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