MALIGNANT NEOPLASMS SPECIAL TYPES II

Question 1

Invasive Carcinoma: Good Prognosis

• 2% incidence; women in their 50s-60s
• Small (1 cm), angular, infiltrating tubules with open lumens and lowgrade nuclei
• > 90 % tubules
• Excellent prognosis even with positive lymph nodes

Answer 1

Tubular carcinoma

Question 2

Invasive Carcinoma: Good Prognosis

• 2% incidence, older women
• Well-circumscribed, round, soft, gelatinous lesion
• Pools of extravasated mucin with floating ductal cells
• > 80% 10 year survival

Answer 2

Colloid/Mucinous carcinoma

Question 3

Invasive Carcinoma: Good Prognosis

• 1-7% incidence, younger women (<50 yo)
• Well-circumscribed mass that can be mistaken for
fibroadenoma
• Well-defined margins with pushing borders
• Large pleomorphic cells with solid, syncytial growth
pattern (>75 % syncytial formation)
• Dense lymphoplasmacytic infiltrate
• No desmoplasia

Answer 3

Carcinoma with medullary features

Question 4

Invasive Carcinoma: Poor Prognosis

• Uncommon, poorly differentiated ductal carcinoma
• Well-circumscribed mass
• Metaplastic changes include squamous metaplasia, chondroid or osteoid metaplasia
• Spindle cell proliferation or sarcomatous changes

Answer 4

Metaplastic carcinoma

Question 5

• Clinical term for acute swelling, redness
and tenderness of the breast
• Aggressive lesion with poor prognosis
• Histology:
  Tumor cells plugging dermal 
   lymphatics

Associated with high
incidence of systemic
disease

Answer 5

Inflammatory Carcinoma

Question 6

• Clinical term for thickened skin due to lymphedema
• Histology:
   Tumor cells within dermal 
    lymphatics with subsequent 
    blockage of skin drainage

Answer 6

Peau d’orange

Question 7

• Presents as an ulcerated, oozing lesion on skin of nipple or areola
• Subtype of ductal CA arising in main lactiferous duct and extending into overlying epidermis
• Large atypical cells with abundant cytoplasm and prominent nucleoli within epidermis
• Invariably associated with underlying DCIS or invasive ductal CA

Answer 7

Paget’s Disease of the Nipple

Question 8

spread of ductal carcinoma how?

Answer 8

lymph nodes in axillary tail

distant metastases

Question 9

spread of breast cancer can be described as?

Answer 9

lobular carcinoma

peritoneum
retroperitoneum
leptomeninges

Question 10

prognostic indicators for carcinoma of the breast?

Answer 10

*tumor stage

size of tumor
number of LN
distant metastasis

• histologic grade and subtype
• ER,PR,HER2 receptor status

Question 11

poor prognostic indicators for carcinoma of the breast?

Answer 11

• Increased proliferative rate and degree of aneuploidy
• Triple negative tumors (ER, PR, and HER2)
• Tumor angiogenesis

Question 12

treatment?

Answer 12

Early detection

Local resection, mastectomy, LN dissection, chemotherapy, radiation