Basal-like invasive ductal carcinoma

Breast malignant, males, children
Carcinoma subtypes
Basal-like invasive ductal carcinoma

Author: Monika Roychowdhury, M.D. (see Authors page)

Revised: 26 December 2016, last major update March 2012

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PubMed search: basal-like invasive [title] ductal carcinoma breast

Table of Contents

Cite this page: Basal-like invasive ductal carcinoma. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/breastmalignantbasallike.html. Accessed July 14th, 2017.

Definition / general

Not rigidly defined, usually positive for CK5 / 6, CK14 or CK17, and triple negative (ER-, PR-, HER2-), often positive for EGFR
Original definition based on gene expression profile (Nature 2000;406:747, Proc Natl Acad Sci USA 2001;98:10869)
Generally considered to not be comparable to triple negative tumors by immunostains (Clin Cancer Res 2008;14:1368, Med Mol Morphol 2009;42:128), but see Breast Cancer Res 2007;9:R65
Classification of particular tumors may vary based on which classification system is used (Hum Pathol 2008;39:506)
Tumors are clinically heterogeneous

Terminology

Not in WHO breast classification
"Basal like" because tumors have high expression of genes characteristic of basal epithelial cells of normal mammary gland, including CK 5 / 6, CK14, CK15 and CK17

Epidemiology

15% of all invasive ductal carcinoma NOS (Breast Cancer 2010;17:118), higher percentage (26% - 30%) of CNS metastases or primaries that metastasize to CNS (Mod Pathol 2007;20:864); higher percentage (34%) in Africa (APMIS 2007;115:1391)
Basal-like expression also present in 17% of infiltrating lobular carcinoma based on CK5 / 6 expression, these cases are more likely to be ER- (Hum Pathol 2008;39:331)
Associated with younger age, African-American women, high grade tumors, metaplastic subtype (Mol Cancer Ther 2008;7:944), medullary subtype (Breast Cancer Res 2007;9:R24), high stage, angiolymphatic invasion, BRCA1 (Oncogene 2006;25:5846)
Not a common subtype in men (Breast Cancer Res 2009;11:R28)

Clinical features

Of academic interest, not currently used clinically (Arch Pathol Lab Med 2009;133:860); may not be a distinct clinical entity (Pathobiology 2008;75:119, J Biophotonics 2012;5:345)
Associated with epithelial-mesenchymal transition, defined by the loss of epithelial characteristics and the acquisition of a mesenchymal phenotype (Cancer Res 2008;68:989)
Poorer survival if express CK 17 or CK 5 / 6 (Am J Pathol 2002;161:1991), CK 5 / 6 or EGFR (BMC Cancer 2007;7:134), HER2+ (not common, Hum Pathol 2008;39:167)

Microscopic (histologic) description

High grade or metaplastic morphology, may have medullary features (Am J Surg Pathol 2007;31:501)
Also geographic necrosis, pushing borders, stromal lymphocytic response, increased mitotic count
Subtypes include pure (negative for S100 and actin) or myoepithelial (S100+ or actin+, Mod Pathol 2007;20:1200)
Includes secretory breast carcinomas with ETV6-NTRK3 fusion gene (Mod Pathol 2009;22:291)
Core biopsy: solid growth pattern, high nuclear grade, marked lymphocytic infiltrate and geographic necrosis are helpful features, also immunostains (Appl Immunohistochem Mol Morphol 2008;16:411)

Microscopic (histologic) images

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