Invasive cribriform carcinoma with extensive microcalcifications in the male breast.
Department of Clinical Laboratory, National Hospital Organization Shikoku Cancer Center, Horinouchi 13, Matsuyama, Ehime 790-0007, Japan.Breast Cancer (Impact Factor: 1.59). 02/2005; 12(2):145-8. DOI: 10.2325/jbcs.12.145
Invasive cribriform carcinoma (ICC) is a rare, unique type of invasive breast carcinoma that exhibits a cribriform pattern in the majority of the invasive component and is associated with an excellent prognosis. Only one male patient with ICC has been previously reported. Mammography studies often suggest that ICC contains microcalcifications, but the histological finding of extensive microcalcification has only been reported in one patient with ICC. Here we report a male patient diagnosed with ICC and exhibiting histologically confirmed extensive microcalcification is reported. The patient was a 64-year-old Japanese man in whom a breast tumor was detected during an annual check up. Mammography demonstrated a circumscribed high-density mass with microcalcifications. Breast-conserving surgery with axillary node dissection was performed. The tumor was located in the subareolar region of his left breast. The excised tumor had a maximum diameter of 1.0 cm, and no signs of invasion to extramammary tissue were observed. Histologically, the tumor cells were arranged in a cribriform pattern with invasive and non-invasive components. High-grade carcinoma or tubular carcinoma components were not observed. Extensive calcification was seen within the cribriform spaces. Immunohistological staining revealed that the cribriform spaces did not contain basement membrane material, and the tumor cells had not differentiated into basaloid cells or lactational mammary epithelium. The patient is presently free from local recurrence or metastasis 7 months after undergoing surgery.
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ABSTRACT: There is increased understanding of the heterogeneity of breast tumors, with greater emphasis now being placed on histological and molecular profiles and, in particular, their implications for prognosis and therapy. This review addresses breast cancers of unusual histological subtype with an approximate incidence ≤1%. Given the rarity of these tumors, the literature contains primarily case reports, small series, and population-based studies. Data are heterogeneous and almost entirely retrospective, frequently gathered over long time periods, in the context of changing pathological techniques and reporting. In addition, our understanding of the disease biology and therapeutic context has also evolved significantly over this time. There is often limited information about the specific therapies used and the rationale for choosing such an approach. Meaningful comparisons of treatment modalities are not feasible and it is not possible to define management guidelines. Instead, this review correlates the available information to give an impression of how each subgroup behaves-of the favored surgical technique, responses to therapy, and prognosis-as well as the emerging molecular data, highlighting new research areas for potential target in clinical trials. Each tumor subtype described represents a small but real cohort of patients with breast cancer, and although inferences may be made from this review, we are mindful of the paucity of data. The management of each patient must be considered in the context of their unique clinical presentation and correlated with the evidence-based principles that apply to more common breast cancer histologies.The Oncologist 07/2012; 17(9):1135-45. DOI:10.1634/theoncologist.2012-0134 · 4.87 Impact Factor
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ABSTRACT: Purpose: We conducted a retrospective analysis to evaluate the management and outcome of invasive male breast cancer treated in a single-institution over a period of 40 years. Materials and methods: We reviewed the clinical and pathological features of 60 male patients affected by breast carcinoma treated at our Radiotherapy Unit between 1971 and 2011. Tumours were classified according to histological type and the updated 2010 TNM classification of malignant tumours. Results: At a median follow-up of 8.9 [range, 0.6-20; standard deviation (SD), 4.98] years, 32 patients (53.3%) were alive and 16 patients died (26.7%) due to disease progression and 12 (20%) due to other causes. At univariate analysis for overall survival, pathological tumour size (p=0.031), histological subtype (p=0.013) and nodal status (p=0.006) emerged as significant predictors of death. At multivariate analysis, independent death predictors were advanced pathological tumour size (p=0.016), positive nodal status (p=0.003) and invasive cribriform histological type (p=0.0003). Conclusions: In consideration of the rarity of the disease, many issues are still being debated, and future collaborative studies are required. However, our experience confirms the prognostic role of greater pathological tumour size and positive nodal status as unfavourable features for survival in male breast cancer.La radiologia medica 08/2012; 118(3). DOI:10.1007/s11547-012-0867-x · 1.34 Impact Factor
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ABSTRACT: Nine cases of infiltrating cribriform carcinoma (ICC) of the breast are reported and the clinicopathological features, particularly the imaging findings, are analyzed in the present study. Sonograms revealed that all masses exhibited a hypoechoic internal echo texture (9/9) and that a number of masses presented with an irregular shape (8/9), obscure boundary (5/9), partially microlobulated (5/9) or well-circumscribed (4/9) margins, and an inhomogeneous echo (8/9). Mammographic imaging revealed increased radiological density masses (6/8), and sand-like calcification was not observed in all patients. In two patients, the tumors were mammographically occult. Magnetic resonance imaging performed on one patient revealed a slightly high signal intensity on fat-saturated T1- and T2-weighted images. Following contrast enhancement, a homogeneous early enhancement was revealed with a quick ascent and quick descent time-density curve. Immunohistochemistry revealed that all ICCs expressed estrogen receptor and progesterone receptor, but that none were positive for human epidermal growth factor receptor 2. The Ki-67 labeling index was 3.75% (range, 2-5%) in the tumor tissue. Four patients were treated with mastectomy and the others with breast-conserving surgery. Six clinically node-negative patients underwent sentinel lymph node biopsy; three then received axillary lymph node dissection. Following surgery, three patients received adjuvant chemotherapy, radiotherapy and hormonal therapy, respectively. With a median follow-up time of 38 months (range, 4-70 months), one patient developed local recurrence following breast-conserving surgery; axillary lymph nodes and distant metastases were not observed. This study confirms that this type of carcinoma has unique biological characteristics and a favorable prognosis, but that it remains possible to experience local recurrence.Oncology letters 02/2015; 9(4). DOI:10.3892/ol.2015.2972 · 1.55 Impact Factor