4.2
PATHOLOGY
The
lesion is an adenocarcinoma and
the cell of origin is the
epithelial lining
of the lactiferous ducts and lobules
of the
breast.
In most cases it originates from
the duct
epithelium.
The classification used by most pathologists
is:
1.In Intraduct and
Intralobular Non-infiltrating carcinoma
(Carcinoma in situ)
DCIS: Cell morphology
shows
hyperchromatic nuclei and mitotic figures with no invasion
of basement membrane.
Those showing papillary overgrowth are called
papillary
carcinoma.
2.Infiltrating Adenocarcinoma
constitutes 75% of cases seen
in practice.
There is intense fibrosis (Scirrhus)
On microscopic examination
it shows all
degrees of
differentiation from anaplastic
to well differentiated
tumours.
The fibrosis can
also be of different grades
mild to
moderate or severe (atrophic scirrhus)
3.Medullary carcinoma a
type of carcinoma
with minimal
fibrosis cells arranged in
anastomosing large islands and
the scanty fibrosis shows lymphocytic infiltration.
It is a slow growing carcinoma.
4.Inflammatory carcinoma usually
occurs in younger women in
pregnancy or post-partum period,
acute in onset and there
is redness and pain.
Microscopic examination shows undifferentiated tumor cells,
lymphatics and veins are involved by tumour cells.
5.Paget's disease of
nipple: The disease presents
as a
weeping eczema of the nipple.
The areola and surrounding skin
may be involved. There is
always an underlying carcinoma of the breast.
Microscopically a biopsy of the
involved eczematoid area
will show:
*
Large vacuolated clear Paget's cells
* Round cell infiltration
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