Gruppo regionale veneto dei patologi dello screening mammografico

Rovigo, 19 maggio 2009

Confronto interistituzionale inpatologia mammaria da

screening

Carcinoma midollare della mammella

1)Growth in “syncytial” pattern comprising over 75% of the total neoplastic area

2)Complete microscopic circumscription3)Moderate to marked stromal

lymphoplasmacytic infiltrate4)Neoplastic cells with indistinct

cytoplasmic borders and high nuclear grade

5)High mitotic rate

Ridolfi RL et al. Medullary carcinoma of the breast. A clinicopathologic study with 10 year follow up. Cancer 1977; 40: 1365-85Rosen PP. Rosen’s Breast Pathology. Eusebi V et al. Rare new entities of the breast and medullary carcinoma. Pathology 2009; 41: 1, 48-56

TIPO ISTOLOGICO8- carcinoma duttale infiltrante1- carcinoma midollare

GRADING1- grado 18- grado 3

Carcinoma midollare atipico della mammella

75% of “syncytial pattern” &No more than two of the following

features:1)Tumour margins showing focal or

prominent infiltration2) Mononuclear infiltrate, mild or at the

margins of the tumour3)Low grade nuclei4)Presence of microglandular features

Carcinoma duttale infiltrante con aspetti midollari

Caso Caso 55

TIPO ISTOLOGICO:8) carcinoma duttale infiltrante1) carcinoma midollare atipico1) carcinoma apocrino

GRADING:1) grado 29) grado 3

Caso 10Caso 10

TIPO ISTOLOGICO:10) carcinoma duttale infiltrante1) carcinoma midollare atipico

GRADING:11) grado 3

“Syncytial” architecture <75% and/or presence of 3 or more other atypical features

Carcinoma non midollare

Caso 18Caso 18

TIPO ISTOLOGICO:

9) carcinoma duttale infiltrante

2) carcinoma midollare

GRADO:

11) grado 3

Typical Syncytial > 75% with all the characteristics belowAtypical Syncytial < 75% and associated with 2 or 3 of characteristics belowNon medullary Syncytial >75% and associsted with only one of the below Syncytial <75% or absent and any of the characteristics below:1)Complete histologic circumscription2)Mononuclesr cell infiltration, moderate, marked and diffuse3)Nuclear pleomorphism, moderate or marked4)Absence of microglandular structure

Rakha EA et al: The prognostic significance of inflammation and medullary histological type in invasive carcinoma of the breast. European Journal of Cancer 2009

Rapin V et al. Medullary breast carcinoma. A reevaluation of 95 cases of breast cancer with inflammatory stroma. Cancer 1988, 61: 2503-2510