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Breast malignant, males, children

Carcinoma subtypes

General

Reviewer: Monika Roychowdhury, M.D. (see Reviewers page)
Revised: 14 January 2013, last major update February 2012
Copyright: (c) 2001-2012, PathologyOutlines.com, Inc.

General
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● Histological subtypes (also called special types) other than ductal NOS account for up to 25% of invasive breast carcinomas, although lobular constitutes about 10% of invasive breast carcinoma
● Have distinctive clinical features only if “pure”; i.e. if histologic features are present in >90% of tumor
● Histological subtypes often differ greatly in age of onset (Cancer Epidemiol Biomarkers Prev 2006;15:1899), clinical presentation and hormone receptor profiles (Br J Cancer 2005;93:1046), prognosis (Int J Cancer 2007;121:127, Br J Cancer 2004;91:1263), and response to therapy (Breast Cancer 2009;16:168)
● Subtypes can often be suspected / diagnosed by fine needle aspiration (Diagn Cytopathol 2007;35:408)
● Subtypes should be assigned a histologic grade

Molecular
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● DNA microarray profiling studies have divided invasive breast carcinoma into molecular subtypes: luminal A (ER+, HER2-), luminal B (ER+, HER2+), HER2 positive (ER-, HER2+), normal breast-like (ER+, PR+, HER2-) and basal-like (ER-, HER2-, EGFR+ or cytokeratin 5/6+)
● Most histologic subtypes other than lobular and apocrine belong to only one molecular subtype (J Pathol 2008;216:141)
● By hierarchical clustering analysis, some histological subtypes types appear to be discrete entities (micropapillary carcinoma), but others appear similar to each other (tubular and lobular)

Stains
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● Breast carcinomas are usually CK7+, CK20-, except mucinous/colloid (often CK20+) and < 5% of special types (Ann Diagn Pathol 1999;3:350)

Additional references
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● Am J Surg Pathol 2003;27:832

End of Breast malignant, males, children > Carcinoma subtypes > General

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