Invasive ductal carcinoma - Revision history

Mikael Häggström: /* Tubule formation */ 2

2026-04-08T22:26:00Z

Tubule formation: 2

← Older revision		Revision as of 18:26, 8 April 2026
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	==== Tubule formation ====		==== Tubule formation ====
	[[File:Nottingham tubular score.jpg\|thumb\|500px\|Tubule formation score in the Nottingham system:<br>  1. A cribriform pattern also counts as tubules<br>  3. Almost all clear (white) spaces here are entrapped fat cells which do not count as tubules.{{MH}}]]		[[File:Nottingham tubular score.jpg\|thumb\|500px\|Tubule formation score in the Nottingham system:<br>  1. A cribriform pattern also counts as tubules<br>  2. Between 10 and 75% of tumor is tubule forming.<br>  3. Almost all clear (white) spaces here are entrapped fat cells which do not count as tubules.{{MH}}]]
	The overall appearance of the tumor is considered.<ref name="PujaniSharma2014">{{cite journal\|last1=Pujani\|first1=Mukta\|last2=Sharma\|first2=KiranLata\|last3=Srivastava\|first3=AN\|last4=Singh\|first4=US\|last5=Bansal\|first5=Cherry\|title=Grading systems in the cytological diagnosis of breast cancer: A review\|journal=Journal of Cancer Research and Therapeutics\|volume=10\|issue=4\|year=2014\|pages=839\|issn=0973-1482\|doi=10.4103/0973-1482.140979}}</ref>		The overall appearance of the tumor is considered.<ref name="PujaniSharma2014">{{cite journal\|last1=Pujani\|first1=Mukta\|last2=Sharma\|first2=KiranLata\|last3=Srivastava\|first3=AN\|last4=Singh\|first4=US\|last5=Bansal\|first5=Cherry\|title=Grading systems in the cytological diagnosis of breast cancer: A review\|journal=Journal of Cancer Research and Therapeutics\|volume=10\|issue=4\|year=2014\|pages=839\|issn=0973-1482\|doi=10.4103/0973-1482.140979}}</ref>
	* 1 point: tubular formation in more than 75% of the tumor		* 1 point: tubular formation in more than 75% of the tumor

Mikael Häggström: /* Tubule formation */ Higher res

2026-04-08T22:09:51Z

Tubule formation: Higher res

← Older revision		Revision as of 18:09, 8 April 2026
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	==== Tubule formation ====		==== Tubule formation ====
	[[File:~~Tubule formation~~ score ~~in the Nottingham system~~.jpg\|thumb\|500px\|Tubule formation score in the Nottingham system]]		[[File:Nottingham tubular score.jpg\|thumb\|500px\|Tubule formation score in the Nottingham system:<br>  1. A cribriform pattern also counts as tubules<br>  3. Almost all clear (white) spaces here are entrapped fat cells which do not count as tubules.{{MH}}]]
	The overall appearance of the tumor is considered.<ref name="PujaniSharma2014">{{cite journal\|last1=Pujani\|first1=Mukta\|last2=Sharma\|first2=KiranLata\|last3=Srivastava\|first3=AN\|last4=Singh\|first4=US\|last5=Bansal\|first5=Cherry\|title=Grading systems in the cytological diagnosis of breast cancer: A review\|journal=Journal of Cancer Research and Therapeutics\|volume=10\|issue=4\|year=2014\|pages=839\|issn=0973-1482\|doi=10.4103/0973-1482.140979}}</ref>		The overall appearance of the tumor is considered.<ref name="PujaniSharma2014">{{cite journal\|last1=Pujani\|first1=Mukta\|last2=Sharma\|first2=KiranLata\|last3=Srivastava\|first3=AN\|last4=Singh\|first4=US\|last5=Bansal\|first5=Cherry\|title=Grading systems in the cytological diagnosis of breast cancer: A review\|journal=Journal of Cancer Research and Therapeutics\|volume=10\|issue=4\|year=2014\|pages=839\|issn=0973-1482\|doi=10.4103/0973-1482.140979}}</ref>
	* 1 point: tubular formation in more than 75% of the tumor		* 1 point: tubular formation in more than 75% of the tumor

Mikael Häggström: /* Tubule formation */ Not the same

2024-03-29T23:49:30Z

Tubule formation: Not the same

← Older revision		Revision as of 19:49, 29 March 2024
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	[[File:Tubule formation score in the Nottingham system.jpg\|thumb\|500px\|Tubule formation score in the Nottingham system]]		[[File:Tubule formation score in the Nottingham system.jpg\|thumb\|500px\|Tubule formation score in the Nottingham system]]
	The overall appearance of the tumor is considered.<ref name="PujaniSharma2014">{{cite journal\|last1=Pujani\|first1=Mukta\|last2=Sharma\|first2=KiranLata\|last3=Srivastava\|first3=AN\|last4=Singh\|first4=US\|last5=Bansal\|first5=Cherry\|title=Grading systems in the cytological diagnosis of breast cancer: A review\|journal=Journal of Cancer Research and Therapeutics\|volume=10\|issue=4\|year=2014\|pages=839\|issn=0973-1482\|doi=10.4103/0973-1482.140979}}</ref>		The overall appearance of the tumor is considered.<ref name="PujaniSharma2014">{{cite journal\|last1=Pujani\|first1=Mukta\|last2=Sharma\|first2=KiranLata\|last3=Srivastava\|first3=AN\|last4=Singh\|first4=US\|last5=Bansal\|first5=Cherry\|title=Grading systems in the cytological diagnosis of breast cancer: A review\|journal=Journal of Cancer Research and Therapeutics\|volume=10\|issue=4\|year=2014\|pages=839\|issn=0973-1482\|doi=10.4103/0973-1482.140979}}</ref>
	* 1 point: tubular formation in more than 75% of the tumor ~~(it may in addition be termed "majority of tumor")~~		* 1 point: tubular formation in more than 75% of the tumor
	* 2 points: tubular formation in 10 to 75% of the tumor ("moderate")		* 2 points: tubular formation in 10 to 75% of the tumor ("moderate")
	* 3 points: tubular formation in less than 10% of the tumor ("little or none")		* 3 points: tubular formation in less than 10% of the tumor ("little or none")

Mikael Häggström: /* Microscopic evaluation */ + Images

2023-12-10T20:18:58Z

Microscopic evaluation: + Images

← Older revision		Revision as of 16:18, 10 December 2023
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	==Microscopic evaluation==		==Microscopic evaluation==
	~~[[File:Invasive ductal carcinoma, with occasional entrapped normal ducts.jpg\|thumb\|Invasive ductal carcinoma, with occasional entrapped normal ducts (arrow).]]~~

	===Characteristics===		===Characteristics===
	Low power:<ref name=PathologyOutlines>{{cite web\|url=http://www.pathologyoutlines.com/topic/breastmalignantductalNOS.html\|title=Breast - Invasive breast carcinoma of no special type and variants - NST (ductal)\|website=Pathology Outlines\|author=Monika Roychowdhury}} Topic Completed: 1 September 2009. Minor changes: 17 September 2020</ref>		Low power:<ref name=PathologyOutlines>{{cite web\|url=http://www.pathologyoutlines.com/topic/breastmalignantductalNOS.html\|title=Breast - Invasive breast carcinoma of no special type and variants - NST (ductal)\|website=Pathology Outlines\|author=Monika Roychowdhury}} Topic Completed: 1 September 2009. Minor changes: 17 September 2020</ref>
	*Sheets, nests, cords or individual cells		*Sheets, nests, cords or individual cells, but generally ratherplump tumor nests (rather than the single-file linear pattern of [[invasive lobular carcinoma]])
	*Prominent tubular formations in well differentiated tumors, but absent when poorly differentiated		*Prominent tubular formations in well differentiated tumors, but absent when poorly differentiated
	*The stroma is usually desmoplastic		*The stroma is usually desmoplastic
	High power typically shows tumor cells that are more pleomorphic than in lobular carcinoma.<ref name=PathologyOutlines/>		High power typically shows tumor cells that are more pleomorphic than in lobular carcinoma.<ref name=PathologyOutlines/>
			<gallery mode=packed heights=180>
			File:Histopathology of invasive ductal carcinoma, intermediate magnification.jpg\|IDC, intermediate magnification. The presence in adipose tissue strongly favors invasiveness.
			File:Histopathology of adenocarcinoma.png\|High magnification shows non-specific adenocarcinoma features.
			File:Invasive ductal carcinoma, with occasional entrapped normal ducts.jpg\|IDC, with occasional entrapped normal ducts (arrow).
			</gallery>

	===Differential diagnosis===		===Differential diagnosis===

Mikael Häggström: Updated template

2023-12-08T19:31:41Z

Updated template

← Older revision		Revision as of 15:31, 8 December 2023
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	File:Histopathology of fibroadenoma with small cell clusters.jpg\|'''[[Fibroadenoma]]''' may have small cell clusters, but lacks the cellular atypia of invasive ductal carcinoma.		File:Histopathology of fibroadenoma with small cell clusters.jpg\|'''[[Fibroadenoma]]''' may have small cell clusters, but lacks the cellular atypia of invasive ductal carcinoma.
	</gallery>		</gallery>

	In case of both invasive and in situ carcinoma, separately describe the in situ component. Report as "'''extensive intraductal component'''" (EIC) if DCIS is occupying 25% or more of the area encompassed by the invasive tumor and DCIS present in grossly normal adjacent breast tissue.<ref name=Hurd1997>{{cite journal\| author=Hurd TC, Sneige N, Allen PK, Strom EA, McNeese MD, Babiera GV \| display-authors=etal\| title=Impact of extensive intraductal component on recurrence and survival in patients with stage I or II breast cancer treated with breast conservation therapy. \| journal=Ann Surg Oncol \| year= 1997 \| volume= 4 \| issue= 2 \| pages= 119-24 \| pmid=9084847 \| doi=10.1007/BF02303793 \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9084847 }} </ref>		In case of both invasive and in situ carcinoma, separately describe the in situ component. Report as "'''extensive intraductal component'''" (EIC) if DCIS is occupying 25% or more of the area encompassed by the invasive tumor and DCIS present in grossly normal adjacent breast tissue.<ref name=Hurd1997>{{cite journal\| author=Hurd TC, Sneige N, Allen PK, Strom EA, McNeese MD, Babiera GV \| display-authors=etal\| title=Impact of extensive intraductal component on recurrence and survival in patients with stage I or II breast cancer treated with breast conservation therapy. \| journal=Ann Surg Oncol \| year= 1997 \| volume= 4 \| issue= 2 \| pages= 119-24 \| pmid=9084847 \| doi=10.1007/BF02303793 \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9084847 }} </ref>

Mikael Häggström: +Microcalcifications

2023-12-08T19:22:46Z

+Microcalcifications

← Older revision		Revision as of 15:22, 8 December 2023
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	* 6-7 '''Grade 2''' tumor ('''moderately differentiated'''). Medium prognosis.		* 6-7 '''Grade 2''' tumor ('''moderately differentiated'''). Medium prognosis.
	* 8-9 '''Grade 3''' tumor ('''poorly differentiated'''). Worst prognosis.		* 8-9 '''Grade 3''' tumor ('''poorly differentiated'''). Worst prognosis.
			[[File:Histopathology of a calcification in an invasive ductal carcinoma.png\|thumb\|200px\|A conventional calcification in invasive ductal carcinoma.]]
			{{Microcalcifications in breast cancer}}
	{{Immunohistochemistry evaluation of invasive breast cancer}}		{{Immunohistochemistry evaluation of invasive breast cancer}}
	====Estrogen and progesterone receptors====		====Estrogen and progesterone receptors====

Mikael Häggström: /* Invasive versus in situ */ EIC

2023-10-29T18:18:59Z

Invasive versus in situ: EIC

← Older revision		Revision as of 14:18, 29 October 2023
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	File:Histopathology of fibroadenoma with small cell clusters.jpg\|'''[[Fibroadenoma]]''' may have small cell clusters, but lacks the cellular atypia of invasive ductal carcinoma.		File:Histopathology of fibroadenoma with small cell clusters.jpg\|'''[[Fibroadenoma]]''' may have small cell clusters, but lacks the cellular atypia of invasive ductal carcinoma.
	</gallery>		</gallery>

			In case of both invasive and in situ carcinoma, separately describe the in situ component. Report as "'''extensive intraductal component'''" (EIC) if DCIS is occupying 25% or more of the area encompassed by the invasive tumor and DCIS present in grossly normal adjacent breast tissue.<ref name=Hurd1997>{{cite journal\| author=Hurd TC, Sneige N, Allen PK, Strom EA, McNeese MD, Babiera GV \| display-authors=etal\| title=Impact of extensive intraductal component on recurrence and survival in patients with stage I or II breast cancer treated with breast conservation therapy. \| journal=Ann Surg Oncol \| year= 1997 \| volume= 4 \| issue= 2 \| pages= 119-24 \| pmid=9084847 \| doi=10.1007/BF02303793 \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9084847 }} </ref>

	====Ductal versus lobular====		====Ductal versus lobular====

Mikael Häggström:

2022-12-02T23:45:51Z

← Older revision		Revision as of 19:45, 2 December 2022
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	{{Top		<noinclude>{{Top
	\|author1=[[User:Mikael Häggström\|Mikael Häggström]]		\|author1=[[User:Mikael Häggström\|Mikael Häggström]]
	\|author2=		\|author2=
	}}		}}
	{{Comprehensiveness}}		{{Comprehensiveness}}</noinclude>
	==Gross examination==		==Gross examination==
	[[File:Breast cancer gross appearance.jpg\|thumb\|Gross appearance of invasive ductal carcinoma.]]		[[File:Breast cancer gross appearance.jpg\|thumb\|Gross appearance of invasive ductal carcinoma.]]
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	{{Evaluation of tumors}}		{{Evaluation of tumors}}
	{{Reporting of invasive breast cancer}}		{{Reporting of invasive breast cancer}}
	{{Bottom}}		<noinclude>{{Bottom}}</noinclude>

Mikael Häggström: Mitoses

2022-11-06T22:28:53Z

Mitoses

← Older revision		Revision as of 18:28, 6 November 2022
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	==== Mitotic count ====		==== Mitotic count ====
	~~[[File:Mitosis appearances in breast cancer.jpg\|thumb\|Mitosis appearances~~ in breast cancer]]		{{Mitotic count in invasive breast cancer}}
	~~Mitotic figures are counted only at the periphery of the tumor, and counting should begin in the most mitotically active areas, and in at least 10 high-power fields (HPFs):~~
	*'''1 point''': ≤3 mitoses per mm<sup>2</sup> (such as ≤6 mitoses when counting 10 HPFs in a microscope where each HPF is 0.2 mm<sup>2</sup>) {{further\|Evaluation#Counts per mm2}}
	*'''2 points''': 4-7 mitoses per mm<sup>2</sup> (7 to 14 mitoses per 10 HPFs of 0.2 mm<sup>2</sup>/HPF)
	*'''3 points''': ≥8 mitoses per mm<sup>2</sup>

	==== Overall grade ====		==== Overall grade ====
	The scores for each of these three criteria are added together to give a final overall score and a corresponding grade as follows:		The scores for each of these three criteria are added together to give a final overall score and a corresponding grade as follows:

Mikael Häggström: Size

2022-07-01T19:28:53Z

Size

← Older revision		Revision as of 15:28, 1 July 2022
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	Note: The cancer areas having cells with the greatest atypia should be evaluated.		Note: The cancer areas having cells with the greatest atypia should be evaluated.
	* '''1 point''': Nuclei are small or mildly increased in size compared to normal breast epithelial cells. They have uniform nuclear chromatin and only mild pleomorphism.		* '''1 point''': Nuclei are small or mildly increased in size compared to normal breast epithelial cells. They have uniform nuclear chromatin and only mild pleomorphism.
	* '''2 points''': nuclei with moderate variation in size and shape. Cells are larger than normal, display open vesicular nuclei, have visible nucleoli.		* '''2 points''': nuclei with moderate variation in size and shape. Cells are larger than normal (usually 1.5 - 2 times larger)<ref name="pmid34196797">{{cite journal\| author=van Dooijeweert C, van Diest PJ, Ellis IO\| title=Grading of invasive breast carcinoma: the way forward. \| journal=Virchows Arch \| year= 2022 \| volume= 480 \| issue= 1 \| pages= 33-43 \| pmid=34196797 \| doi=10.1007/s00428-021-03141-2 \| pmc=8983621 \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=34196797 }} </ref>, display open vesicular nuclei, have visible nucleoli.
	* '''3 points''': nuclei with marked variation in size and shape. Cells display vesicular nuclei, often prominent nucleoli. Often very large and bizarre cells.		* '''3 points''': nuclei with marked variation in size and shape. Cells display vesicular nuclei, often prominent nucleoli. Often very large and bizarre cells.