Breast malignant disease

1. Malignant Breast Disease
Dr. Moh.Mujib Sakhi
Cosultant of general surgery
Fellow surgical oncology
1398

2. Classification
► Normal histology
► Two types of cell
► Epithelial cell
► Non Epithelial cell (Stroma)

3. Epithelial cancers
► In situ carcinoma
- ductal carcinoma in situ (DCIS)
- Lobular carcinoma in situ (LCIS)
► Invasive carcinoma
- Invasive Ductal carcinoma
Tubular/cribriform carcinoma
Medulary carcinoma
 Papillary carcinoma
 Inflammatory carcinoma
- Invasive Lobular carcinoma
Non Epithelial cell
(Mixed) Cancers
 Carcinosarcoma
 Angiosarcoma
 Adenocarcinoma
 phyllodes tumor(Malignant)

4. Ductal carcinoma in situ
► May represent up to 25% of breast carcinoma
► Incapable of capacity to invade:
► basement membrane
► distant metastasis
► Among mammographically detected cancers
► Almost half are DCIS
► High grade of the in situ carcinoma
► predicts multifocality (LCIS >DCIS)
► propensity for invasion(HNG ,ING,LNG)

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Ductal Carcinomas In Situ..
•Histopathologically- 4-subtypes-
Comedocarcinoma
Solid or non comedo DCIS
Cribriform DCIS
Micropapillary DCIS

6. Lobular Carcinoma In Situ (LCIS)
► Neoplastic transformation of epithelial cells
► Lining terminal ducts and acini of small size
► Mostly multifocal and bilateral
► Bilateral risk for development of invasive cancer
► Considered primarily a marker for invasion

7. Paget’s Disease of the Breast
► In situ carcinoma of lactiferous ducts with extension to
epidermis
► Involving the nipple and areola
► May present with
► Nipple discharge
► Crusting
► Excoriation of nipple surface

8. Invasive Ductal Carcinoma
► An infiltrative malignant epithelial process
► Most common breast carcinoma
► Classified according to histologic appearance as:
 Carcinoma not otherwise specified : majority(50-70%)
 Special good prognosis subtype
 medullary carcinoma,
 colloid (mucinous) carcinoma,
 tubular carcinoma
 Poor prognosis :
 inflammatory carcinoma

9. Invasive lobular carcinoma
► Accounts for 5-10% of all breast cancers
► Tend to be bilateral (20%) far more frequently than other subtypes
► Multicentric within same breast
► Have diffusely invasive pattern
► which make both primary and metastasis difficult to detect
► either by physical examination or by radiologic studies
► More frequently metastasize to CSF, serosal surfaces, ovary,
uterus and bone marrow than other subtypes

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