Practical Atlas of Breast Pathology

✍ Scribed by Simona Stolnicu, Isabel Alvarado-Cabrero

• Publisher: Springer
• Year: 2018
• Tongue: English
• Leaves: 510
• Category: Library

✦ Table of Contents

Foreword
Preface
Acknowledgments
Contents
Contributors
1: Histology of the Normal Breast, Normal Changes, and Abnormalities of Breast Development
1.1 Histology of the Normal Breast and Normal Changes
1.2 Abnormalities of Breast Development
References
2: Radiology of the Normal Breast and Overview of Breast Imaging Reporting and Data System
2.1 Normal Anatomy of the Female Breast
2.2 Normal Mammographic Anatomy
2.3 Normal Ultrasonographic Anatomy
2.4 Magnetic Resonance (MR), Normal Anatomy
2.5 Breast Imaging Reporting and Data System (BI-RADS) Lexicon Fifth Edition (2013)
2.5.1 Density
2.5.2 Assessment
2.5.3 Masses
2.5.4 Calcifications
2.5.5 Architectural Distortion
2.5.6 Asymmetries
2.5.7 Lesion Location
References
3: Core-Needle Biopsy: Radiologic-Pathologic Correlation
3.1 Introduction
3.2 Breast Imaging Modalities
3.3 Mammography [7]
3.3.1 Mammography-Screening
3.3.2 Mammography-Diagnostic
3.4 Ultrasound
3.5 Magnetic Resonance Imaging (MRI)
3.6 Core-Needle Biopsy: Radiologic–Pathologic Correlation
3.7 Sclerosing Adenosis
3.8 Radial Sclerosing Lesions
3.9 Malignant Lesions
3.10 Ductal Carcinoma In Situ
3.11 Invasive Carcinomas
3.12 Breast Core-Needle Biopsy: Specimen Processing
3.13 Specimen Radiograph
3.13.1 Core-Needle Biopsy
3.14 Evaluation of Breast Specimens Removed by Needle Localization Technique
References
4: Fine Needle Aspiration of Breast Cytology
4.1 FNA and NCB of Breast
4.2 Advantages and Limitations of FNA of Breast
4.3 Slide Preparation and Staining Techniques
4.4 Reporting of Breast FNA
4.5 Benign Epithelial Cells
4.6 Non-neoplastic Entities
4.6.1 Cystic Apocrine Metaplasia
4.6.2 Fibroadenoma
4.6.3 Lactational Change
4.6.4 Fat Necrosis
4.7 Atypical Breast Lesions
4.8 Neoplastic Entities
4.8.1 Breast Cancer
4.8.2 Invasive Carcinoma of No Special Type (NST)
4.8.2.1 Tubular Carcinoma
4.8.2.2 Mucinous (Colloid) Carcinoma
4.8.2.3 Micropapillary Carcinoma
4.8.2.4 Apocrine Carcinoma
4.8.2.5 Metaplastic Carcinoma
4.8.2.6 Medullary Carcinoma
4.8.3 Invasive Lobular Carcinoma
4.9 Papillary Lesions/Neoplasms
4.9.1 Intraductal Papilloma
4.9.2 Papillary Carcinoma
4.10 Role of Immunohistochemistry in Breast Carcinoma
4.10.1 Metastatic Breast Carcinoma
4.10.2 Predictive/Prognostic Markers in Breast Carcinoma
4.10.3 Distinguishing Between NST Versus Lobular Carcinoma
4.11 Metastatic Non-mammary Tumors to the Breast
References
5: Inflammatory and Reactive Lesions of the Breast
5.1 Breast Inflammations
5.1.1 Acute Mastitis
5.1.2 Subareolar Abscess
5.1.3 Plasma Cell Mastitis
5.1.4 Lymphocytic Mastopathy
5.1.5 Specific Infections
5.2 Breast Granulomatous Reactions
5.2.1 Idiopathic Granulomatous Lobular Mastitis
5.2.2 Tuberculous Mastitis
5.2.3 Sarcoidosis
5.2.4 Cat Scratch Disease
5.2.5 Suture Granuloma
5.2.6 Silicone Granuloma
5.3 Fat Necrosis
5.4 Mammary Duct Ectasia
5.5 Gouty Tophus
5.6 Amyloidosis
5.7 Breast Infarct
5.8 Inflammatory Pseudotumor
5.9 Vasculitis
References
6: Papillary Tumors of the Breast
6.1 Papilloma
6.2 Intraductal Papillary Carcinoma
6.3 Encapsulated Papillary Carcinoma
6.4 Solid Papillary Carcinoma
6.5 Invasive Papillary Carcinoma
6.6 Fine-Needle Aspiration Cytology of Papillary Lesions
6.7 Papillary Lesions on Core-Needle Biopsy
6.8 Epithelial Displacement
References
7: Benign Lesions (Proliferations) and Tumors of the Breast
7.1 Fibrocystic Changes
7.2 Radial Scar
7.3 Adenosis
7.3.1 Simple Adenosis
7.3.2 Sclerosing Adenosis
7.3.3 Microglandular Adenosis
7.3.4 Adenomyoepithelial Adenosis
7.4 Pregnancy-Like Changes
7.5 Epithelial Metaplasia
7.5.1 Apocrine Metaplasia
7.5.2 Clear Cell Metaplasia
7.5.3 Squamous Metaplasia
7.5.4 Mucinous Metaplasia
7.6 Microcalcifications
7.7 Hypersecretory Cystic Hyperplasia
7.8 Mucocele-Like Tumor
7.9 Benign Tumors of the Breast
7.9.1 Tubular Adenoma
7.9.2 Lactating Adenoma
7.9.3 Apocrine Adenoma
7.9.4 Pleomorphic Adenoma
7.9.5 Ductal Adenoma
7.9.6 Other Types of Benign Tumors
References
8: Myoepithelial Lesions and Tumors of the Breast
8.1 Myoid and Squamous Metaplasia
8.2 Myoepithelial Hyperplasia
8.3 Sclerosing Adenosis
8.4 Collagenous Spherulosis
8.5 Adenomyoepithelioma
8.6 Malignant Adenomyoepithelioma
8.7 Myoepithelial Carcinoma
References
9: Fibroepithelial Lesions of the Breast
9.1 Fibroadenoma
9.2 Phyllodes Tumor
9.3 Immunohistochemistry in the Diagnosing of Fibroepithelial Lesions
References
10: Diagnostic Evaluation of Usual Ductal Hyperplasia and Atypical Ductal Hyperplasia
10.1 Usual Ductal Hyperplasia
10.1.1 Clinical Features
10.1.2 Cytologic Features
10.1.3 Architectural Features
10.1.4 Variant Features
10.1.5 Immunohistochemistry
10.1.6 Clinical Management
10.2 Atypical Ductal Hyperplasia
10.2.1 Clinical Features
10.2.2 Cytologic Features
10.2.3 Architectural Features
10.2.4 Immunohistochemistry
10.2.5 Clinical Management
10.3 Differential Diagnosis
10.3.1 Atypical vs. Non-atypical Intraductal Proliferations
10.3.2 Atypical Ductal Hyperplasia vs. Ductal Carcinoma In Situ
References
11: Ductal Carcinoma In Situ
11.1 Histologic Parameters
11.2 Low-Grade Ductal Carcinoma In Situ
11.3 High-Grade Ductal Carcinoma In Situ
11.4 Intermediate-Grade Ductal Carcinoma In Situ
11.5 Rare Variants of Ductal Carcinoma In Situ
11.6 Immunohistochemistry
References
12: Microinvasive Carcinoma
References
13: Atypical Lobular Hyperplasia and Lobular Carcinoma In Situ
13.1 Variants of Lobular Carcinoma In Situ
References
14: Infiltrating Carcinoma of No Special Type
14.1 NST Infiltrating Carcinoma
14.2 Mixed Carcinoma
14.3 Pleomorphic Carcinoma
14.4 Carcinoma with Osteoclast-Like Stromal Giant Cells
14.5 Carcinoma with Choriocarcinomatous Features
14.6 Carcinoma with Melanotic Features
References
15: Special Types of Invasive Breast Carcinoma
15.1 Invasive Lobular Carcinoma
15.2 Tubular Carcinoma
15.3 Mucinous Carcinoma
15.4 Micropapillary Carcinoma
15.5 Mucinous Micropapillary Carcinoma
15.6 Carcinoma with Medullary Features
15.7 Apocrine Carcinoma
15.8 Metaplastic Breast Carcinoma
15.9 Adenoid Cystic Carcinoma
15.10 Secretory Carcinoma
15.11 Solid Papillary Breast Carcinoma Resembling the Tall Cell Variant of Papillary Thyroid Neoplasms/Solid Papillary Carcinoma with Reverse Polarity
15.12 Inflammatory Breast Cancer
References
16: Hematopoietic Lesions of the Breast
16.1 Introduction
16.2 Diffuse Large B-Cell Lymphoma (DLBCL)
16.3 Extranodal Marginal Zone B-Cell Lymphoma (MALT Lymphoma)
16.4 Follicular Lymphoma
16.5 Burkitt Lymphoma
16.6 Hodgkin Lymphoma
16.7 T-Cell Lymphoma
16.8 Breast Implant-Associated Anaplastic Large T-Cell Lymphoma
16.9 Differential Diagnosis of Mammary Lymphoma
16.10 Other Hematopoietic Lesions
16.11 Histiocytic Proliferations
References
17: The Role of Immunohistochemistry in Breast Pathology
17.1 Usual Ductal Hyperplasia, Atypical Ductal Hyperplasia and Ductal Carcinoma In Situ
17.2 Lobular Versus Ductal Differentiation of Epithelial Lesions
17.3 Papillary Neoplasms
17.4 Sclerosing Lesions
17.5 Paget Disease of Nipple
17.6 Assessment of Invasion
17.7 Spindle Cell Lesions
17.8 Lymphovascular Channel Involvement
17.9 Sentinel Lymph Node
17.10 Metastatic Malignancies
17.11 Hormone Receptors and HER2
17.12 Surrogate Markers for Molecular Classification
References
18: Prognostic and Predictive Factors in Breast Carcinoma
18.1 Clinical Prognostic Factors
18.1.1 Age
18.1.2 Pregnancy
18.1.3 Bilaterality
18.1.4 Multicentricity
18.1.5 Stage
18.2 Pathological Prognostic Factors
18.2.1 Tumor Size
18.2.2 Microscopic Type
18.2.3 Microscopic Grade
18.2.4 Vascular Invasion
18.2.5 Tumor Necrosis
18.2.6 Tumor-Infiltrating Lymphocytes
18.2.7 An Extensive In Situ Component
18.2.8 Status of Surgical Margins
18.2.9 Lymph Node Metastases
18.2.10 Nottingham Prognostic Index
18.3 Molecular and Genetic Prognostic Factors
18.3.1 Hormonal Receptor
18.3.2 Oncogene c-ErbB2
18.3.3 Proliferation Markers
18.3.4 Other Markers
References
19: Basic Molecular Pathology in Breast Carcinoma
19.1 Introduction
19.2 Identification of Breast Cancer Subtypes
19.3 Clinical Practice
19.3.1 Phenotypical Variations of Predictive Biomarkers
19.3.1.1 Hormone Receptors
19.3.1.2 HER Receptor Family
19.4 Cancer Predisposition
19.5 Circulating Tumor Cells
19.6 Exosomes: Does the Future Lie There?
References
20: Morphologic Changes Induced by the Oncologic Treatment for Breast Carcinoma (Chemotherapy, Radiotherapy, Hormonal Therapy)
20.1 Radiological and Macroscopic/ Gross Changes
20.1.1 Radiologic Changes
20.1.2 Gross/Macroscopic Changes
20.2 Histological Changes
20.2.1 Tumor Bed: Characteristics
20.2.2 Tumor Cytopathic Changes at the Cellular and Stromal Level
20.2.3 Normal/Native Epithelial Changes
20.2.4 Lymph Nodes’ Treatment Changes
20.3 Biomarkers’ Changes: Hormonal Receptors, HER2 and Ki-67
20.4 Residual Cancer Burden
References
21: Evaluation of Residual Tumor After Neoadjuvant Treatment
21.1 Assessment of Different Variables for Evaluating Pathologic Tumor Response
21.2 Predictors of Response to Neoadjuvant Chemotherapy
21.3 Procedures Required Before Starting Neoadjuvant Chemotherapy
21.4 Evaluation of Response to Neoadjuvant Chemotherapy
21.5 The Components of a Pathology Report
21.6 Different Classification Systems and Nomograms for Estimating Residual Tumor Burden After Neoadjuvant Chemotherapy
References
22: Sentinel Lymph Node: Clinicopathologic Features
22.1 Introduction
22.2 Patterns of Regional Nodal Drainage
22.3 Indications and Contraindications for Sentinel Lymph Node
22.4 Surgical Techniques
22.5 Pathological Axillary Lymph Node Staging
22.6 Occult Metastatic Disease
22.7 Intraoperative Evaluation
22.7.1 Pathologic Evaluation
22.7.2 Gross Evaluation
22.7.3 Histologic Evaluation
22.8 Extracapsular Extension
22.9 Sentinel Lymph Node Biopsy After Neoadjuvant Chemotherapy
22.10 Immunohistochemistry
References
23: Mesenchymal Tumors of the Breast
23.1 Introduction
23.2 Benign Mesenchymal Tumors and Reactive Lesions
23.2.1 Reactive Spindle Cell Nodules
23.2.2 Fat Necrosis and Histiocytic Reactions
23.2.3 Pseudoangiomatous Stromal Hyperplasia
23.2.4 Nodular Fasciitis
23.2.5 Inflammatory Myofibroblastic Tumor
23.2.6 Myofibroblastoma
23.2.7 Fibromatosis
23.2.8 Lipoma
23.2.9 Hamartoma
23.2.10 Granular Cell Tumor
23.2.11 Benign Vascular Lesions
23.2.11.1 Hemangioma
23.2.11.2 Angiomatosis
23.2.11.3 Atypical Vascular Lesions
23.3 Malignant Mesenchymal Breast Tumors
23.3.1 Angiosarcomas
23.3.2 Other Primary Sarcomas of the Breast
23.3.2.1 Liposarcoma
23.3.2.2 Osteosarcomas
References
24: Breast Lesions/Neoplasms in Men
24.1 Benign Proliferative Lesions of the Male Breast
24.1.1 Male Breast: Normal Histology
24.1.2 Papilloma
24.1.3 Fibroepithelial Tumors
24.1.4 Duct Ectasia
24.1.5 Fibrocystic Changes
24.1.6 Myoepithelial Tumors
24.1.7 Mesenchymal Neoplasms
24.1.8 Gynecomastia
24.2 Malignant Lesions of the Male Breast
24.2.1 Ductal Carcinoma In Situ
24.2.2 Paget Disease of the Nipple
24.2.3 Lobular Carcinoma
24.2.4 Invasive Carcinoma
References
25: Lesions of the Nipple
25.1 Nipple Duct Adenoma
25.2 Syringomatous Adenoma of the Nipple
25.3 Paget’s Disease of the Nipple
25.4 Other Nipple Lesions
References
26: Metastatic Tumors to the Breast
26.1 Introduction
26.2 Clinical Presentation
26.3 Imaging
26.4 Histopathology
26.5 Malignant Melanoma
26.6 Primary Lung Cancer
26.7 Gastrointestinal Tumors
26.8 Neoplasias of Gynecological Organs
26.9 Genitourinary Tract Tumors
26.10 Sarcomas
References
27: Sampling and Evaluation of the Breast Surgical Specimens
27.1 Grossing Breast Specimens
27.2 Core-Needle Biopsies
27.2.1 Specimen Processing
27.3 Incisional Biopsy
27.3.1 Specimen Processing
27.4 Excisional Biopsies
27.4.1 Mastectomy Specimen
27.4.1.1 Specimen Processing
27.4.2 Breast-Conserving Surgery
27.4.2.1 Specimen Processing
27.4.3 Re-excisions
27.4.3.1 Specimen Processing
27.4.4 Duct Dissections
27.4.4.1 Specimen Processing
References
28: Dermatologic Diseases of the Breast and Nipple
28.1 Dermatitis
28.1.1 Nipple Dermatitis (Nipple Eczema)
28.1.2 Allergic Contact Dermatitis
28.1.3 Irritant Contact Dermatitis
28.2 Psoriasis
28.2.1 Inframammary Psoriasis (Inverse Psoriasis)
28.2.2 Plaque-Psoriasis (Psoriasis Vulgaris)
28.3 Vitiligo
28.4 Hyperkeratosis of the Nipple
28.5 Bacterial, Fungal and Viral Infections of the Breast
28.5.1 Bacterial Infections
28.5.1.1 Folliculitis
28.5.1.2 Impetigo
28.5.2 Fungal Diseases
28.5.2.1 Superficial Dermatophytic Infections
28.5.2.2 Candidiasis
Nipple Candidiasis
Candida Intertrigo
28.5.3 Viral Infections
28.5.3.1 Herpes Simplex Infection
28.5.3.2 Herpes Zoster
28.5.3.3 Pityriasis Rosea
28.6 Morphea and Lichen Sclerosus et Atrophicus
28.6.1 Morphea
28.6.2 Lichen Sclerosus et Atrophicus
28.7 Factitial Disease (Dermatitis Artefacta, Patomimia)
28.8 Lyme Disease (Cutaneous Borreliosis)
28.8.1 Erythema Migrans
28.8.2 Borrelia Lymphocytoma
28.9 Vascular Malformations and Steroid Purpura
28.9.1 Vascular Malformations
28.9.2 Steroid Purpura
28.10 Cutaneous Erythematous Lupus
28.11 Autoimmune Blistering Disorders
28.11.1 Intra-Epidermal Blistering (Pemphigus Group)
28.11.2 Subepidermal Blistering (Pemphigoid Group)
References
Index