Breast – Malignant, Males, Children

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Breast-malignant, males, children

Morphologic variants of DCIS

Basal-like DCIS

Author: Nat Pernick, M.D, PathologyOutlines.com, Inc.

Reviewer: Daniel Visscher, M.D., University of Michigan Hospitals, February 2009 (see Reviewers page)

Revised: 13 August 2009

Last major update: August 2009

Definition

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● Classified based on immunohistochemistry or gene expression profiling (Breast Cancer Res 2006;8:R61), not morphology

● 8% of DCIS

● Of academic interest only, not currently used clinically

Epidemiology

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● Associated with high grade nuclei, p53 overexpression, increased Ki-67 index (Hum Path 2007;38:197), but only a small percentage of high grade DCIS has basal-like phenotype (Mod Path 2006;19:617)

● Commonly found with invasive basal-like carcinomas (Mod Path 2006;19:1506)

● DCIS lesions in BRCA1 mutation carriers are mostly basal-like (J Clin Pathol 2009 Jul 24 [Epub ahead of print])

Microscopic description

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● Solid, flat or micropapillary

● High nuclear grade, comedonecrosis, intense lymphocytic infiltrate

Micro images

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H&E and stains

H&E and variable CK5/6 staining

Positive stains

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● CK 5/6, CK14 or CK17

● Usually EGFR or c-kit/CD117

● Also vimentin, alphaB-crystallin (Ann Diagn Pathol 2008;12:33), P-cadherin (Virchows Arch 2007;450:73)

Negative stains

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● By definition is ER-, PR- and HER2-

End of Breast – Malignant, Males, Children > Basal-like DCIS

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