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DUCTAL CARCINOMA

[more common than lobular carcinoma]




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INVASIVE WITH SPECIFIC CLINICAL
MANIFESTATION

DUCTAL CARCINOMA IN SITU (DCIS)
Tumor is confined to the duct system
Ductal basement membrane is intact
Morphology :
Grossly
 palpable mass can be felt
 Slight pressure on the transacted breast
duct may lead to extrusion of necrotic
tissue from their lumina
Microscopically
 May take comedo, solid, papillary /
cribriform pattern
 Comeda carcinoma :
malignant cell have a central areas of
necrosis
may undergo microcalcification (dystrophic)
40%  invasive ductal carcinoma




INFLAMMATORY CARCINOMA
Highly aggressive
Erythematous breast with dimpling of skin
(peau d’ orange) usually without a palpable
mass
The underlying carcinoma is poorly
differentiated and diffusely infiltrates the
breast
Plugs of tumor cell blocks lumen of dermal
lymphatics causing localized oedema
Very poor prognosis
May resemble acute mastitis




INVASIVE WITH NO SPECIFIC CLINICAL MANIFESTATION
INFILTRATING DUCT CARCINOMA (NOS)
 Most common type of breast carcinoma (70-80%)
 GROSS ;
 Stellate shaped indurated grayish white mass
 Gritty on cut section
 Poorly defined
 Irregular, non encapsulated
 Firm in consistency
 The desmoplastic reaction causes
1. clinical induration 2. Retraction of nipple
3. Mammographic density
 MP ; carcinomatous cell are arranged in cluster
and masses as well as tubular formation with
surrounding dense fibroCT stroma

MEDULLARY CARCINOMA










Soft in consistency
Well defined mass
Movable
Non encapsulated
Occurs to 50 yrs old
CS ; areas of hemorrhage and
necrosis
MP ;
Sheets of large anaplastic cells
with poorly defined border
Dense stromal infiltration by
lymphocytes
Better prognosis than NST
1% of breast cancer

TUBULAR CARCINOMA


Small, firm mass
Tumor is formed of
well formed tubules
with low grade
nuclei
Lymph node
metastasis are rare
Prognosis are
excellent because
it’s well
differentiated

PAGET’S DISEASE OF THE NIPPLE
Rare manifestation of breast cancer (1-2%)
Malignant cell extend from ductal carcinoma
in situ within the ductal system into the skin
of the nipple without crossing the basement
membrane
Palpable mass is 50-60% of women with
paget’s disease and almost all of these
women have underlaying invasive ductal
carcinoma
Present with a unilateral erythematous
eruption with a scale crust in a nipple.
It’s accompanied by pruritis and may be
mistaken for eczema
Prognosis depends on the extent and
differentiation of the underlying invasive
carcinoma
COLLOID / MUCINOUS CARCINOMA







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Less common than medullary carcinoma
Occurs in older women
Better prognosis than NST/NOS
Lesser tendency to metastasis to lymph node
GROSSLY ;
Soft, bulky, gelatinous and grey-blue mass
MP ;
Mucin producing tumor cells floating in loose
mucinous EC matrix

** invasive papillary carcinoma (rare)**