Histological Classification
IN SITU, NON INVASIVE CANCER
Ductal Carcinoma In Situ (DCIS)
It affects 50% of women aged 60 years and 1/3 of women under 50 years of age. It is presented mammographically, usually in the form of calcifications. It is a carcinoma with cytological characters and a structure similar to that of porogenic carcinoma, but without stroma infiltration. It is usually accompanied by invasive carcinoma while it can coexist with lobular in situ. Microscopically, it presents a wide variety of histological types (eg phagocytic comedo, compact solid, cribriform ethmoid, papillary papillary). Intraductal carcinoma is classified into 3 types: well (Grade I), medium (Grade II) and poorly (Grade III) differentiation. The test that detects DCIS is digital mammography and, less commonly, breast ultrasound or MRI. In the international literature there are more than 10.
NOS (NOS)
Invasive porogenic cancer
It is the most common malignant neoplasm with a rate estimated at 65-80% of breast carcinomas. It can also be combined with other specific types of cancer. Clinically, the tumor presents mammographic findings and may be palpable, while edema, paget, and ulceration are rare. Macroscopically, the tumor appears solid with necrosis. In 55-75% of invasive serous carcinomas of the breast, the neoplastic cells are positive for estrogen receptors.
Invasive lobular cancer
Invasive lobular carcinoma of the breast affects women with an average age of 45-56 years. Its cells resemble the lobular in situ. Its frequency is 10-14%. It can be multifocal or multicentric with a high tendency to develop contemporary or later bilateral carcinoma. It is often positive for hormone receptors.
SPECIAL TYPES OF BREAST CANCER
Tubular carcinoma
Its frequency is approximately 1.5%. They are usually estrogen receptor positive with rare lymph node metastases. The differential diagnosis also includes benign conditions, such as sclerosing adenosis, microglandular adenosis and the radial sclerosing lesion.
Invasive ethmoid carcinoma
It is very rare with a very good prognosis.
Invasive papillary carcinoma
It mainly occurs in postmenopausal women and is usually positive for estrogen and progesterone receptors.
Micropapillary carcinoma
It does not have a very good prognosis.
Mucinous (colloid) carcinoma
It accounts for 1-6% of breast cancers. Affects older women. It usually has a good prognosis.
Medullary carcinoma
It accounts for 5-7% of breast cancers. It has a relatively good prognosis.
Atypical medullary carcinoma
He has an intermediate prognosis.
Rare types
Carcinoma with metaplasia (5%) of high malignancy, apocrine carcinoma, adenocystic carcinoma of low malignancy, secretory or juvenile carcinoma due to its presence in children, liposecretory carcinoma of high malignancy.
CANCER WITH A SPECIAL CLINICAL PRESENTATION
Paget’s disease (of the nipple)
The disease appears with eczematoid lesions of the nipple. In most cases it is combined with porogenic in situ or invasive carcinoma. The prognosis depends on the extent of the cancer.
Inflammatory carcinoma
It is the clinical manifestation of a carcinoma with extensive infiltration of the lymphatic vessels of the skin. It is manifested by redness and swelling of the breast. It has a poor prognosis with lymph node metastases.
Malignant mesenchymal neoplasms (sarcomas)
They are extremely rare at less than 1%. They come from the breast layer. They usually grow rapidly and can even exceed 30 cm. The most common sarcoma is angiosarcoma. This cancer metastasizes hematologically and not lymph nodes, so it does not need an axillary lymph node cleansing.