Invasive ductal carcinoma of the breast - Revision history

Mark: wikify sub-types

2018-09-29T21:29:44Z

wikify sub-types

← Older revision		Revision as of 21:29, 29 September 2018
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	*Most common type of [[invasive breast cancer]].		*Most common type of [[invasive breast cancer]].

	The WHO bluebook classifies certain breast carcinomas as 'special' types, if they show certain characteristic histological features. These special types are sometimes loosely included in the loose label of invasive ductal carcinoma to distinguish them from invasive lobular carcinoma. These include:		The WHO bluebook classifies certain breast carcinomas as 'special' types, if they show certain characteristic histological features. These special types are sometimes loosely included in the loose label of invasive ductal carcinoma to distinguish them from invasive lobular carcinoma. These include (see individual pages for specific features):
	*Tubular carcinoma		*[[Tubular carcinoma of the breast\|Tubular carcinoma]]
	*Cribriform carcinoma		*[[Invasive_cribriform_carcinoma_of_the_breast\|Cribriform carcinoma]]
	*Apocrine carcinoma		*[[Apocrine carcinoma of the breast\|Apocrine carcinoma]]
	*Mucinous carcinoma		*[[Mucinous breast carcinoma\|Mucinous carcinoma]]
	*Micropapillary/papillary carcinoma		*[[Invasive_micropapillary_carcinoma_of_the_breast\|Micropapillary]]/[[Invasive_papillary_carcinoma_of_the_breast\|papillary]] carcinoma
	*Medullary-like carcinoma		*[[Medullary breast carcinoma\|Medullary-like carcinoma]]
			*[[Metaplastic breast carcinoma\|Metaplastic carcinoma]]

	If a >90% of a tumour is composed of a 'special type', it is considered pure and labelled as in the list above. If one of the special types accounts for 50%, then is is classed as a mixed tumour, e.g. invasive carcinoma of mixed mucinous and no special type. All other tumours are classed as invasive carcinoma of no special type.		If a >90% of a tumour is composed of a 'special type', it is considered pure and labelled as in the list above. If one of the special types accounts for 50%, then is is classed as a mixed tumour, e.g. invasive carcinoma of mixed mucinous and no special type. All other tumours are classed as invasive carcinoma of no special type.

Mark: add images of some sub-types

2018-09-29T21:16:27Z

add images of some sub-types

← Older revision		Revision as of 21:16, 29 September 2018
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	<gallery>		<gallery>
	Image:Breast invasive scirrhous carcinoma histopathology (2) HER2 expression.JPG\|IDC HER2 positive.		Image:Breast invasive scirrhous carcinoma histopathology (2) HER2 expression.JPG\|IDC HER2 positive.
			Image:18S08891_tubular_carcinoma_x20a.jpg \| Tubular carcinoma - medium mag. (WC)
			Image:Breast mucinous carcinoma.jpg\|Mucinous carcinoma - medium mag. (WC)
			Image:Breast micropapillary carcinoma.jpg\|Micropapillary carcinoma - medium mag. (WC)
			Image:Breast apocrine carcinoma.jpg\|Apocrine carcinoma - medium mag. (WC)
			Image:Breast metaplastic carcinoma.jpg\|Metaplastic carcinoma - medium mag. (WC)
	</gallery>		</gallery>

Mark: sub-types, grading, IHC

2018-09-28T21:55:24Z

sub-types, grading, IHC

← Older revision		Revision as of 21:55, 28 September 2018
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	\| Tx =		\| Tx =
	}}		}}
	'''Invasive ductal carcinoma of the breast''', also '''breast invasive ductal carcinoma''', is the most common form of [[invasive breast cancer]]. It ~~arises~~ from [[ductal carcinoma in situ]].		'''Invasive ductal carcinoma of the breast''', also '''breast invasive ductal carcinoma''', is the most common form of [[invasive breast cancer]]. It may arise from [[ductal carcinoma in situ]].

	It is also known as '''NST''' (No Specific Type). ~~Generically, it may be referred to~~ as ~~''invasive mammary~~ carcinoma''.		It is also known as breast carcinoma of '''NST''' (No Specific/Special Type). Some pathologists prefer this terminology as the sub-typing of breast carcinoma essentially involves exclusion of special types, identified by certain characteristic features. It is also a more appropriate term for high grade tumours which typically lack any acinar or ductal differentiation.

	In the context of the [[breast]], the meaning of '''[[invasive ductal carcinoma]]''' is clear; if the context is ''not'' the breast, it may refer to other (unrelated) cancers.		Generically, it may be referred to as ''invasive mammary carcinoma''. In the context of the [[breast]], the meaning of '''[[invasive ductal carcinoma]]''' is clear; if the context is ''not'' the breast, it may refer to other (unrelated) cancers.

	==General==		==General==
	*Most common type of [[invasive breast cancer]].		*Most common type of [[invasive breast cancer]].

			The WHO bluebook classifies certain breast carcinomas as 'special' types, if they show certain characteristic histological features. These special types are sometimes loosely included in the loose label of invasive ductal carcinoma to distinguish them from invasive lobular carcinoma. These include:
			*Tubular carcinoma
			*Cribriform carcinoma
			*Apocrine carcinoma
			*Mucinous carcinoma
			*Micropapillary/papillary carcinoma
			*Medullary-like carcinoma

			If a >90% of a tumour is composed of a 'special type', it is considered pure and labelled as in the list above. If one of the special types accounts for 50%, then is is classed as a mixed tumour, e.g. invasive carcinoma of mixed mucinous and no special type. All other tumours are classed as invasive carcinoma of no special type.

			Molecular sub-typing through gene expression analysis suggests that are at least 5 distinct types.

	==Gross==		==Gross==
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	==Microscopic==		==Microscopic==
	~~Features~~:		The histological features are highly variable. They are typically graded using the modified Bloom-Richardson grading system, sometimes toponymously referred to as the Nottingham grading system. This has 3 components: tubule formation, nuclear pleomorphism and a mitotic count. Each of the 3 components is scored between 1 and 3 with a final score out of 9.

	*Atypical cells:		*Atypical cells:
	**Usually >2x [[RBC]] diameter.		**Usually >2x [[RBC]] diameter, but may be bland, especially in tubular carcinomas
	**Nucleoli common.		**Nucleoli common.
	**Forming ducts ''or'' sheets.		**Forming ducts ''or'' sheets.
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	*p63 -ve.		*p63 -ve.

	Prognostic markers ~~- may be useful for metastates:~~		Prognostic markers are performed to guide treatment
	*ER ~~+ve~~ (~~diffuse~~).		*ER - about 75% are positive (typically assessed using the Allred/Quick score)
	*PR +ve (~~diffuse~~).		*PR staining is more variable, but ER-/PR+ tumours are rare (<1%), so some question the value of PR staining
	*HER2 -~~ve.~~		*HER2 - about 15-20% are positive
			*Ki67 - this correlates with prognosis, but lack of standardisation in quantification hampers more widespread use

	Invasive lobular carcinoma versus invasive ductal carcinoma:<ref name=pmid22595945>{{Cite journal \| last1 = de Deus Moura \| first1 = R. \| last2 = Wludarski \| first2 = SC. \| last3 = Carvalho \| first3 = FM. \| last4 = Bacchi \| first4 = CE. \| title = Immunohistochemistry applied to the differential diagnosis between ductal and lobular carcinoma of the breast. \| journal = Appl Immunohistochem Mol Morphol \| volume = 21 \| issue = 1 \| pages = 1-12 \| month = Jan \| year = 2013 \| doi = 10.1097/PAI.0b013e318255bafa \| PMID = 22595945 }}</ref>		Invasive lobular carcinoma versus invasive ductal carcinoma:<ref name=pmid22595945>{{Cite journal \| last1 = de Deus Moura \| first1 = R. \| last2 = Wludarski \| first2 = SC. \| last3 = Carvalho \| first3 = FM. \| last4 = Bacchi \| first4 = CE. \| title = Immunohistochemistry applied to the differential diagnosis between ductal and lobular carcinoma of the breast. \| journal = Appl Immunohistochem Mol Morphol \| volume = 21 \| issue = 1 \| pages = 1-12 \| month = Jan \| year = 2013 \| doi = 10.1097/PAI.0b013e318255bafa \| PMID = 22595945 }}</ref>
	*E-cadherin -ve (~~includes~~ incomplete ~~membrane staining~~).		*E-cadherin typically shows strong membranous positivity in invasive ductal/NST carcinoma
			*However, up to 3-5% may be negative, especially higher grade tumours
			*Invasive lobular carcinoma is typically negative, but up to 15% may show some staining (though typically weak/incomplete)

	===Images===		===Images===

Michael: mamma

2018-09-28T15:43:03Z

mamma

← Older revision		Revision as of 15:43, 28 September 2018
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	\| Stains =		\| Stains =
	\| IHC =		\| IHC =
	\| EM = usu. ER and PR +ve, usu. HER2 -ve, ~~mammoglobin~~ +ve, CK7 +ve, CK20 -ve		\| EM = usu. ER and PR +ve, usu. HER2 -ve, mammaglobin +ve, CK7 +ve, CK20 -ve
	\| Molecular =		\| Molecular =
	\| IF =		\| IF =

Michael: gross

2016-09-08T11:35:31Z

gross

← Older revision		Revision as of 11:35, 8 September 2016
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	\| IF =		\| IF =
	\| Gross =		\| Gross =
	\| Grossing = [[~~mastectomy~~ grossing]]		\| Grossing = [[breast grossing]]
	\| Staging = [[breast cancer staging]]		\| Staging = [[breast cancer staging]]
	\| Site = [[breast]]		\| Site = [[breast]]

Michael at 04:08, 1 May 2016

2016-05-01T04:08:37Z

← Older revision		Revision as of 04:08, 1 May 2016
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	\| IF =		\| IF =
	\| Gross =		\| Gross =
	\| Grossing =		\| Grossing = [[mastectomy grossing]]
	\| Staging = [[breast cancer staging]]		\| Staging = [[breast cancer staging]]
	\| Site = [[breast]]		\| Site = [[breast]]

Michael at 04:04, 1 May 2016

2016-05-01T04:04:30Z

← Older revision		Revision as of 04:04, 1 May 2016
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	\| IF =		\| IF =
	\| Gross =		\| Gross =
	\| Grossing =		\| Grossing =
			\| Staging = [[breast cancer staging]]
	\| Site = [[breast]]		\| Site = [[breast]]
	\| Assdx =		\| Assdx =

Michael: sm fix

2015-04-05T07:33:52Z

sm fix

← Older revision		Revision as of 07:33, 5 April 2015
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	\| Image = Breast_invasive_scirrhous_carcinoma_histopathology_(1).jpg		\| Image = Breast_invasive_scirrhous_carcinoma_histopathology_(1).jpg
	\| Width =		\| Width =
	\| Caption =		\| Caption = Invasive ductal carcinoma. [[H&E stain]].
	\| Synonyms =		\| Synonyms =
	\| Micro = ~~Invasive ductal carcinoma. [[H&E stain]].~~		\| Micro =
	\| Subtypes =		\| Subtypes =
	\| LMDDx = [[DCIS]], [[invasive lobular carcinoma]]		\| LMDDx = [[DCIS]], [[invasive lobular carcinoma]]

Michael: /* IHC */

2014-02-23T02:15:10Z

IHC

← Older revision		Revision as of 02:15, 23 February 2014
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	Invasive lobular carcinoma versus invasive ductal carcinoma:<ref name=pmid22595945>{{Cite journal \| last1 = de Deus Moura \| first1 = R. \| last2 = Wludarski \| first2 = SC. \| last3 = Carvalho \| first3 = FM. \| last4 = Bacchi \| first4 = CE. \| title = Immunohistochemistry applied to the differential diagnosis between ductal and lobular carcinoma of the breast. \| journal = Appl Immunohistochem Mol Morphol \| volume = 21 \| issue = 1 \| pages = 1-12 \| month = Jan \| year = 2013 \| doi = 10.1097/PAI.0b013e318255bafa \| PMID = 22595945 }}</ref>		Invasive lobular carcinoma versus invasive ductal carcinoma:<ref name=pmid22595945>{{Cite journal \| last1 = de Deus Moura \| first1 = R. \| last2 = Wludarski \| first2 = SC. \| last3 = Carvalho \| first3 = FM. \| last4 = Bacchi \| first4 = CE. \| title = Immunohistochemistry applied to the differential diagnosis between ductal and lobular carcinoma of the breast. \| journal = Appl Immunohistochem Mol Morphol \| volume = 21 \| issue = 1 \| pages = 1-12 \| month = Jan \| year = 2013 \| doi = 10.1097/PAI.0b013e318255bafa \| PMID = 22595945 }}</ref>
	*E-cadherin -ve (includes incomplete membrane staining).		*E-cadherin -ve (includes incomplete membrane staining).

			===Images===
			<gallery>
			Image:Breast invasive scirrhous carcinoma histopathology (2) HER2 expression.JPG\|IDC HER2 positive.
			</gallery>

	==See also==		==See also==

Michael at 02:13, 23 February 2014

2014-02-23T02:13:22Z

← Older revision		Revision as of 02:13, 23 February 2014
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	It is also known as '''NST''' (No Specific Type). Generically, it may be referred to as ''invasive mammary carcinoma''.		It is also known as '''NST''' (No Specific Type). Generically, it may be referred to as ''invasive mammary carcinoma''.

	In the context of '''[[invasive ductal carcinoma]]''' is clear; if the context is ''not'' the breast, it may refer to other (unrelated) cancers.		In the context of the [[breast]], the meaning of '''[[invasive ductal carcinoma]]''' is clear; if the context is ''not'' the breast, it may refer to other (unrelated) cancers.

	==General==		==General==