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General
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Terminology
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Clinical description
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Case reports
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Clinical images
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Images courtesy of Dr. Mark R. Wick

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Invasive

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Mammogram

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Spot film

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Fungating, breast skin

Gross description
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Gross images
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Courtesy of Dr. Mark R. Wick

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Irregular borders, infiltrating into adjacent tissue

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Central necrosis and hemorrhage

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AFIP image

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Large irregular mass

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Possible central necrosis

Micro description
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Micro images
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Courtesy of Dr. Mark R. Wick:

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Cancerization of lobules

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Ductal NOS

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Involving skin

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Pseduo DCIS



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Cadherin

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Desmin

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Estrogen receptor

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HER2

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Ki-67

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p53

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Popoplanin

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Progesteron receptor


Common histologic features:

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Infiltration of fibroadipose

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With cribriform DCIS

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Occult invasive carcinoma and DCIS (arrows) - AFIP

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Desmoplastic stroma

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Focal lobular features

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Resembling comedo DCIS but negative for myoepithelial markers (cocktail)

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Multinucleated giant cells (fig 3c, arrows)

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Minimal tumor in core biopsy (fig 3a and 3b)

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Perineural invasion



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Primary tumor, lymphocytic infiltration & fibrous stromal reaction, contains invasive carcinoma around duct with DCIS



Angiolymphatic invasion:

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Courtesy of Dr. Mark R. Wick

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Podoplanin - courtesy of Dr. Mark R. Wick

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Vein invaded by tumor cells

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Arrow: possible blood vessel invaded by carcinoma (AFIP)

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Elastic stain accentuates venous elastica involved by carcinoma and artery below

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Not angiolymphatic invasion

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Not angiolymphatic invasion, shrinkage artifact with partly necrotic tumor in space created by shrinkage, no endothelial cells are present, elastic stain highlights elastic tissue in walls of vessels; marked lymphoplasmacytic infiltrate




Grading:

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Grade I, courtesy of Dr. Mark R. Wick

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Low grade, mixed, courtesy of Dr. Mark R. Wick

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Low grade

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Grade II, courtesy of Dr. Mark R. Wick

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Intermediate grade


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Grade III, courtesy of Dr. Mark R. Wick

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High grade

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High grade, courtesy of Dr. Mark R. Wick


Stains:

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ER+

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HER2 (3+)

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E-cadherin+

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Mast cells (stained with tryptase)

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Topo II IHC

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PR+

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Calponin negative (normal ducts are positive)

Cytology description
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Cytology images
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Courtesy of Dr. Mark R. Wick:

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Needle biopsy

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FNAB

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Diff quik



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47 year old woman with 3 x 2 cm painless retroareolar mass and ipsilateral axillary lymphadenopathy (contributed by Dr. Abdulaziz Mohamed, Aga Khan University Hospital, Nairobi, Kenya)

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Ductal carcinoma, Figure A

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Poorly differentiated ductal carcinoma

Virtual slides
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Core biopsy

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With cancerization of lobules

Positive stains
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Negative stains
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Molecular images
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Electron microscopy
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Videos
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Differential diagnosis
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Additional references
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End of Breast malignant, males, children > Carcinoma subtypes > Ductal carcinoma, NOS - general


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