Gruppo regionale veneto dei patologi dello screening
mammografico
Confronto interistituzionale in
patologia mammaria da screening
Rovigo, 19 maggio 2009
Carcinoma
midollare della
mammella
1) Growth in “syncytial” pattern comprising over
75% of the total neoplastic area
2)Complete microscopic circumscription
3) Moderate
to
marked
stromal
lymphoplasmacytic infiltrate
4)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: 1365-85
Rosen 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 ISTOLOGICO
8- carcinoma duttale infiltrante
1- carcinoma midollare
GRADING
1- grado 1
8- 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
infiltration
2) Mononuclear infiltrate, mild or at the margins
of the tumour
3) Low grade nuclei
4)Presence of microglandular features
Carcinoma duttale
infiltrante con aspetti
midollari
Caso 5
TIPO ISTOLOGICO:
8) carcinoma duttale infiltrante
1) carcinoma midollare atipico
1) carcinoma apocrino
GRADING:
1) grado 2
9) grado 3
Caso 10
TIPO ISTOLOGICO:
10) carcinoma duttale infiltrante
1) carcinoma midollare atipico
GRADING:
11) grado 3
Carcinoma non
midollare
“Syncytial” architecture <75% and/or presence of 3 or more other atypical
features
Caso 18
TIPO ISTOLOGICO:
9) carcinoma duttale infiltrante
2) carcinoma midollare
GRADO:
11) grado 3
Typical
Syncytial > 75% with all the characteristics below
Atypical
Syncytial < 75% and associated with 2 or 3 of characteristics
below
Non medullary
Syncytial >75% and associsted with only one of the below
Syncytial <75% or absent and any of the characteristics below:
1)Complete histologic circumscription
2)Mononuclesr cell infiltration, moderate, marked and diffuse
3)Nuclear pleomorphism, moderate or marked
4)Absence of microglandular structure
Rapin V et al. Medullary breast carcinoma. A reevaluation of 95 cases of breast cancer with
inflammatory stroma. Cancer 1988, 61: 2503-2510
Rakha EA et al: The prognostic significance of inflammation and medullary histological type in
invasive carcinoma of the breast. European Journal of Cancer 2009