V

Figure 17.22. Invasive lobular carcinoma, with 'Indian filing' (x125).

Figure 17.23. Tubular carcinoma (x150). Tubular carcinoma

Tubular carcinomas are usually small and well-differentiated tumours. Histologically, they are characterised by the tumour cells being arranged into well-differentiated tubular structures.

The tumour cells have a low mitotic rate and there is little nuclear pleomorphism. The stromal tissue is also very dense and can be found within the tubular structures (Fig. 17.23). Patients with this type of tumour generally have an excellent prognosis as it usually remains confined to the breast and rarely metastasises, either regionally or more distally.

Figure 17.23. Tubular carcinoma (x150). Tubular carcinoma

Tubular carcinomas are usually small and well-differentiated tumours. Histologically, they are characterised by the tumour cells being arranged into well-differentiated tubular structures.

The tumour cells have a low mitotic rate and there is little nuclear pleomorphism. The stromal tissue is also very dense and can be found within the tubular structures (Fig. 17.23). Patients with this type of tumour generally have an excellent prognosis as it usually remains confined to the breast and rarely metastasises, either regionally or more distally.

Medullary carcinoma

Medullary carcinomas constitute less than 5% of all breast cancers. They have a well-defined margin and are soft. Histologically, they are characterised by a marked lymphocytic infiltration, high cellularity and have less fibrous tissue than is seen in other histological types of breast cancer. They are less commonly associated with axillary gland metastases than are invasive ductal cancers. Even if the axillary lymph glands do contain tumour the prognosis is still better than for the invasive ductal tumour type.

Mucinous carcinoma

Mucinous tumours comprise less than 5% of all breast cancers. They tend to occur in the older population and are believed to be more slowly growing than other types, rarely metastasising to the regional lymph nodes. Histologically, there are large areas of mucin in the tumour. The tumour cells themselves can be seen to lie within pools of mucin forming small islands of cells or gland-like structures. This type of tumour is also associated with a good prognosis.

Inflammatory breast cancer

Inflammatory breast cancer occurs in approximately 2-5% of patients with malignant lesions in the breast. It is recognised clinically by redness of the skin and signs of inflammation of the breast, often with peau d'orange of the skin. The histo-logical findings may be non-specific, but the characteristic feature is invasion of the dermal lymphatics by malignant cells and tissue oedema, and a variable degree of infiltration of the breast by inflammatory cells. It is biologically more aggressive than the other tumour types and is associated with a worse prognosis.

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