This article has a correction
Please see: ABC of breast diseases: Breast cancer
- J R C Sainsbury,
- T J Anderson,
- D A L Morgan
Breast cancers are derived from the epithelial cells that line the terminal duct lobular unit. Cancer cells that remain within the basement membrane of the elements of the terminal duct lobular unit and the draining duct are classified as in situ or non-invasive. An invasive breast cancer is one in which there is dissemination of cancer cells outside the basement membrane of the ducts and lobules into the surrounding adjacent normal tissue. Both in situ and invasive cancers have characteristic patterns by which they can be classified.
Carcinoma in situ affecting a breast lobule
Classification of invasive breast cancers
The most commonly used classification of invasive breast cancers divides them into ductal and lobular types. This classification was based on the belief that ductal carcinomas arose from ducts and lobular carcinomas from lobules. We now know that invasive ductal and lobular breast cancers both arise from the terminal duct lobular unit, and this terminology is no longer appropriate. Some tumours show distinct patterns of growth and cellular morphology, and on this basis certain types of breast cancer can be identified. Those with specific features are called invasive carcinomas of special type, while the remainder are considered to be of no special type. This classification has clinical relevance in that certain special type tumours have a much better prognosis than tumours that are of no special type.
Classification of invasive breast cancers
Special types
• Tubular • Cribriform • Medullary
• Mucoid • Papillary • Classic lobular
No special type
• Commonly known as NST or NOS (not otherwise specified)
• Useful prognostic information can be gained by grading such cancers
Invasive carcinomas showing diffuse infiltration through breast tissue: grade I (left), grade II (centre), and grade III (right)
Tumour differentiation
Among the cancers of no special type, prognostic information can be gained by grading the degree of differentiation of the tumour. Degrees of glandular formation, nuclear pleomorphism, …
Sign in
Personal subscribers, sign in here:
Article access
Article access for 1 day
Purchase this article for £20 $30 €32*
The PDF version can be downloaded as your personal record
CiteULike
Connotea
Del.icio.us
Digg
Facebook
Reddit
Technorati
Twitter
Stumbleupon
Rapid responses
Latest Responses
Evidence Based Medicine-Boondoggle?
Published 8 February 2012
Wills and wishes in organ donation
Published 8 February 2012
Re: Lessons from America
Published 8 February 2012
Boosting the role of low-molecular-weight heparins in primary PCI
Published 8 February 2012
Re: Should UK membership exams be held overseas? Yes
Published 8 February 2012
Most responses
Does anyone understand the government’s plan for the NHS? (17 responses)
Published 17 Jan 2012
Bad medicine: medical nutrition (15 responses)
Published 18 Jan 2012
Wakefield sues BMJ over MMR articles (5 responses)
Published 10 Jan 2012
Search for evidence goes on (5 responses)
Published 17 Jan 2012
How much of a social media profile can doctors have? (5 responses)
Published 23 Jan 2012