Invasive breast disease
Most primary breast cancers have invaded into the stroma of the breast at the time of diagnosis. The great majority of these present as breast lumps, although, a small proportion will have eroded through the skin of the breast by the time they are first seen, presenting as fungating tumors. Lesser degrees of skin involvement lead to dimpling or tethering of the skin and peau d’orange – where skin infiltration leads to local lymphatic obstruction.
Invasive (infiltrating), ductal carcinoma is the most common cell type, comprising 70–80% of all cases of breast cancer. The tumors occur throughout the age range of breast carcinoma, being most common in women in their middle to late 50s. It is characterized by its solid core, which is usually hard and firm on palpation. An associated ductal carcinoma in-situ is frequently present and comedo necrosis may occur in both invasive areas and areas of intraductal carcinoma.
Invasive ductal carcinoma commonly spreads to the regional lymph nodes and carries the poorest prognosis among various ductal types
Invasive, lobular carcinoma is relatively uncommon, comprising only 5–10% of breast tumors. Invasive lobular carcinomas are characterized by greater proportion of multicentricity in the same or the opposite breast. The lesions tend to have ill-defined margins, and occasionally the only evidence is subtle thickening or induration.
Patients with infiltrating lobular carcinoma are especially prone to have bilateral carcinoma. Stage by stage, invasive lobular carcinoma has a similar prognosis to infiltrating ductal carcinoma.
Tubular carcinoma typically presents as a well-differentiated carcinoma. The frequency of axillary lymph node metastases is approximately 10%, lower than that of ductal carcinoma. The prognosis for tubular carcinoma is considerably better than for invasive ductal carcinoma.
Medullary carcinoma typically has a prominent lymphocyte infiltrate. Patients with medullary carcinoma tend to be younger than those with other types of breast cancer. The prognosis is generally better than for invasive ductal cancer.
Inflammatory breast carcinoma is characterized by diffuse skin edema, skin and breast redness, and firmness of the underlying tissue without a palpable mass. The clinical manifestation is primarily due to the tumor forming emboli in the dermal lymph channels, with associated engorgement of superficial capillaries. Inflammatory breast cancer carries a poor prognosis.
Paget's disease of the nipple is a rare form of breast cancer that is characterized clinically by eczematous changes of the nipple. It is believed to arise from the migration of malignant cells from adjacent mammary ducts in the nipple. The prognosis for patients with Paget's disease appears to be similar to that of women with other types of breast carcinoma, stage for stage.
Invasive (infiltrating), ductal carcinoma is the most common cell type, comprising 70–80% of all cases of breast cancer. The tumors occur throughout the age range of breast carcinoma, being most common in women in their middle to late 50s. It is characterized by its solid core, which is usually hard and firm on palpation. An associated ductal carcinoma in-situ is frequently present and comedo necrosis may occur in both invasive areas and areas of intraductal carcinoma.
Invasive ductal carcinoma commonly spreads to the regional lymph nodes and carries the poorest prognosis among various ductal types
Invasive, lobular carcinoma is relatively uncommon, comprising only 5–10% of breast tumors. Invasive lobular carcinomas are characterized by greater proportion of multicentricity in the same or the opposite breast. The lesions tend to have ill-defined margins, and occasionally the only evidence is subtle thickening or induration.
Patients with infiltrating lobular carcinoma are especially prone to have bilateral carcinoma. Stage by stage, invasive lobular carcinoma has a similar prognosis to infiltrating ductal carcinoma.
Tubular carcinoma typically presents as a well-differentiated carcinoma. The frequency of axillary lymph node metastases is approximately 10%, lower than that of ductal carcinoma. The prognosis for tubular carcinoma is considerably better than for invasive ductal carcinoma.
Medullary carcinoma typically has a prominent lymphocyte infiltrate. Patients with medullary carcinoma tend to be younger than those with other types of breast cancer. The prognosis is generally better than for invasive ductal cancer.
Inflammatory breast carcinoma is characterized by diffuse skin edema, skin and breast redness, and firmness of the underlying tissue without a palpable mass. The clinical manifestation is primarily due to the tumor forming emboli in the dermal lymph channels, with associated engorgement of superficial capillaries. Inflammatory breast cancer carries a poor prognosis.
Paget's disease of the nipple is a rare form of breast cancer that is characterized clinically by eczematous changes of the nipple. It is believed to arise from the migration of malignant cells from adjacent mammary ducts in the nipple. The prognosis for patients with Paget's disease appears to be similar to that of women with other types of breast carcinoma, stage for stage.
