Breast malignant, males, children - Cribriform carcinoma

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Breast malignant, males, children

Carcinoma subtypes

Cribriform carcinoma - invasive

Reviewer: Monika Roychowdhury, M.D., (see Reviewers page)
Revised: 1 October 2012, last major update October 2012
Copyright: (c) 2001-2012, PathologyOutlines.com, Inc.

General
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● Invasive tumor with cribriform pattern similar to cribriform DCIS
● May have minor (<50%) component of tubular carcinoma

Clinical description
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● Rare (1-3% of breast carcinomas), related to tubular carcinoma (Histopathology 1983;7:525)
● Nodal metastases in 14%
● Mixed patterns have intermediate prognosis between invasive cribriform and invasive ductal carcinomas

Case reports
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● 64 year old man with tumor microcalcifications (Breast Cancer 2005;12:145)
● Perineural invasion (Hum Pathol 1992;23:202)
● Internal mammary node metastasis (Tumori 2006;92:241)

Treatment and prognosis
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● Excellent prognosis, even with nodal metastases, if restrict diagnosis to pure pattern (Histopathology 1983;7:525, Eur J Gynaecol Oncol 1996;17:228)

Micro description
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● Low grade, cribriform appearance (well defined spaces formed by arches of cells) similar to cribriform DCIS but with larger cells, more cytoplasm and more vesicular nuclei
● Tumor cells are small, often have apical snouts, mild/moderate nuclear pleomorphism
● Also stromal invasion by islands of cells, often angulated
● May have predominantly solid appearance
● Associated with cribriform DCIS
● Often mixed with tubular carcinoma
● No/rare mitotic figures, no mucin production
● Note: pure pattern is defined as 90%+ cribriform; also considered “classic” even if minor component of tubular carcinoma

Micro images
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Various images

Perineural invasion

Luminal microcalcifications

Low grade nuclei

Extensive secondary lumen formation with angular clusters of tumor cells

ER+

Cytology description
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● Cohesive sheets and three dimensional cribriform clusters of bland ductal cells in a blood-stained background
● Variable osteoclast-like giant cells (Acta Cytol 2001;45:593, Acta Cytol 1992;36:48)

Positive stains
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● ER, PR (usually)

Electron microscopy description
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● Numerous mitochondria
● Luminal surfaces have abundant microvilli (Ultrastruct Pathol 1994;18:519)

Differential diagnosis
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● Adenoid cystic carcinoma: second cell population, intracystic basement membrane material and secretory material
● Carcinoid tumor: intracytoplasmic granules, positive for neuroendocrine markers
● Collagenous spherulosis: intense eosinophilic secretions, circumscribed, not invasive (Am J Surg Pathol 1995;19:1366)
● Cribriform DCIS: non infiltrative, clusters are more regularly distributed, myoepithelial layer is present

Additional references
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● Hum Pathol 1990;21:333
● Cribriform Carcinoma of the Breast, Stanford University

End of Breast malignant, males, children > Carcinoma subtypes > Cribriform carcinoma - invasive

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