Breast Cancer and its Precursor Lesions (eBook)

Preface 6
Contents 8
Contributors 10
Chapter 1: Overview 11
Introduction 11
Incidence and Epidemiology 12
Risk Factors 12
Race/Ethnicity and Culture 13
Prognostic and Predictive Factors 14
References 16
Chapter 2: Common Benign Conditions of Low Concern 17
Benign Conditions Associated with No Risk 18
Reactive and inflammatory lesions 19
Nonproliferative fibrocystic changes 21
Deciphering the Pathology Report 21
References 22
Chapter 3: Benign Conditions Associated with a Risk for the Subsequent Development of Cancer 23
Proliferative Breast Disease Without Atypia 24
Usual Ductal Hyperplasia 24
Deciphering the Pathology Report 26
Sclerosing Adenosis 26
Deciphering the Pathology Report 27
Complex Sclerosing Lesion (Radial Scar) 27
Deciphering the Pathology Report 28
Papilloma 28
Deciphering the Pathology Report 30
Atypical Ductal Hyperplasia 30
Deciphering the Pathology Report 33
Lobular Hyperplasia with Atypia 33
Deciphering the Pathology Report 33
Flat Epithelial Atypia 33
Deciphering the Pathology Report 34
References 35
Chapter 4: Precursor Lesions and Noninvasive Cancers 36
Lobular Neoplasia 36
Clinical Presentation 39
Risk Factors and Diagnosis 40
Implications and Relationship to Malignancy 41
Implications for Management 41
Deciphering the Pathology Report 43
Ductal Carcinoma In Situ 43
Clinical Presentation 44
Risk Factors and Diagnosis 44
Deciphering the Pathology Report 44
References 46
Chapter 5: Breast Cancer 49
Invasive Ductal Carcinoma 49
Clinical Presentation 51
Risk Factors and Diagnosis 51
Deciphering the Pathology Report 53
Invasive Lobular Carcinoma 54
Clinical Presentation 55
Risk Factors and Diagnosis 56
Deciphering the Pathology Report 56
Breast Cancer: The Special Types 56
Terminology, Clinical Presentation and Implications for Management 56
Deciphering the Pathology Report 59
References 59
Chapter 6: Things Pathologists Must Always Consider 60
Mimics of Malignancy 60
Fibromatosis 60
Fat Necrosis 61
Granulomatous Mastitis 62
Radial Scar 62
Granular Cell Tumor 64
What Should Always Be in Any Pathology Report? 65
The Pathology Report 65
What Are the Limitations of Biopsy Techniques? 67
Core Needle Biopsy 67
What Are the Limitations of Fine Needle Aspiration Biopsy? 68
References 68
Chapter 7: Nuances and Details of the Pathology Report 70
Equivocal or Non-committal Diagnoses 70
In Situ vs. Microinvasive vs. Invasive Breast Carcinoma 71
Lobular Extension/Pagetoid Spread 71
Prognostic Information That Can Be Obtained from the Pathology Report 72
Tumor Size 72
Histologic Grade 73
Lymph Node Status 74
Lymphovascular Invasion 74
Perineural Invasion 74
Tumor Margins 74
Extent of Ductal Carcinoma In Situ 75
Involvement of Skin and Nipple 75
Molecular Markers in Breast Cancer 76
Molecular Subtypes of Invasive Breast Cancer 78
Clinical and Pathologic Stage 80
Neoadjuvant vs. Adjuvant Therapy and Pathologists’ Role 80
References 81
Index 83