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*'''Triple negative''': If the breast cancer cells don’t have estrogen or progesterone receptors and don’t have too much HER2
*'''Triple negative''': If the breast cancer cells don’t have estrogen or progesterone receptors and don’t have too much HER2


==Classification Based on Gene Expression==<ref name="pmid28331693">Eliyatkın N, Yalçın E, Zengel B, Aktaş S, Vardar E (2015) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=28331693 Molecular Classification of Breast Carcinoma: From Traditional, Old-Fashioned Way to A New Age, and A New Way.] ''J Breast Health'' 11 (2):59-66. [http://dx.doi.org/10.5152/tjbh.2015.1669 DOI:10.5152/tjbh.2015.1669] PMID: [https://pubmed.gov/28331693 28331693]</ref>
==Classification Based on Gene Expression==
*'''Luminal type''': are estrogen receptor (ER)–positive
*'''Luminal type''': are estrogen receptor (ER)–positive
:*'''Luminal A''':  
:*'''Luminal A''':  
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::*No response to endocrine therapy or trastuzumab
::*No response to endocrine therapy or trastuzumab
::*Sensitive to platinum group chemotherapy and PARP inhibitors
::*Sensitive to platinum group chemotherapy and PARP inhibitors
::*Not all, but usually worse prognosis
::*Not all, but usually worse prognosis<ref name="pmid28331693">Eliyatkın N, Yalçın E, Zengel B, Aktaş S, Vardar E (2015) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=28331693 Molecular Classification of Breast Carcinoma: From Traditional, Old-Fashioned Way to A New Age, and A New Way.] ''J Breast Health'' 11 (2):59-66. [http://dx.doi.org/10.5152/tjbh.2015.1669 DOI:10.5152/tjbh.2015.1669] PMID: [https://pubmed.gov/28331693 28331693]</ref>
==References==
==References==
{{reflist|2}}
{{reflist|2}}

Revision as of 17:45, 1 March 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Mirdula Sharma, MBBS [2] Soroush Seifirad, M.D.[3]

Overview

Breast cancer may be classified according to anatomy into 4 subtypes: ductal, lobular, sarcoma, and lymphoma.

Classification Based on Histopathology

Malignant Tumors

Type Subtype

Ductal

  • Comedo type: ~60%
  • Non-comedo type: ~40%
  • Papillary
  • Micropapillary
  • Cribriform
  • Solid
  • Intracystic papillary carcinoma in situ
  • Invasive ductal carcinoma
  • Invasive ductal carcinoma not otherwise specified (NOS): ~65%
  • Tubular carcinoma of breast: ~7-8%
  • Tubulolobular carcinoma of breast
  • Medullary carcinoma of breast: ~2%
  • Mucinous (colloid) carcinoma: ~2%
  • Malignant papillary lesions of the breast
  • Papillary carcinoma of breast: 1-2% 1

Lobular

Other malignant breast tumors

Sarcoma

Lymphoma

Metastases to the breast

The most common extra-mammary cancers that metastasise to breast are:

Benign Tumors

  • Phyllodes tumor[1]
  • Mammary fibromatosis: 0.2% of all breast tumors 5
  • Benign papillary lesions of the breast
  • Intraductal papilloma
  • Solitary papilloma of breast
  • Central solitary papilloma of breast
  • Peripheral solitary papilloma of breast
  • Multiple papillomata of breast
  • Juvenile papillomatosis of breast
  • Granular cell tumor of the breast

Classification Based on Hormone Receptors Present

  • Hormone receptor positive: either estrogen or progesterone receptors are present
  • Hormone receptor negative: breast cancer cells don’t have either estrogen or progesterone receptors
  • HER2 positive: If excess copies of HER2 gene
  • HER2 negative: If excess copies of HER2 gene are not present
  • Triple positive: cancers that are ER-positive, PR-positive, and have too much HER2
  • Triple negative: If the breast cancer cells don’t have estrogen or progesterone receptors and don’t have too much HER2

Classification Based on Gene Expression

  • Luminal type: are estrogen receptor (ER)–positive
  • Luminal A:
  • Expression of luminal (low molecular weight) cytokeratins, high expression of hormone receptors and related genes
  • 50% of invasive bresat cancer, ER/PR positive, HER2/neu negative
  • Tubular carcinoma, Cribriform carcinoma, Low grade invasive ductal carcinoma, NOS, Classic lobular carcinoma
  • Response to endocrine therapy
  • Variable response to chemotherapy
  • Low grade,
  • Grows slowly,
  • Good prognosis (the best prognosis)
  • Luminal B :
  • Expression of luminal (low molecular weight) cytokeratins, moderate-low expression of hormone receptors and related genes
  • 20% of invasive breast cancer, ER/PR positive, HER2/neu expression variable, higher proliferation than Luminal A, higher histologic grade than Luminal A
  • Invasive ductal carcinoma, NOS Micropapillary carcinoma
  • Response to endocrine therapy (tamoxifene and aromatase inhibitors) not as good as Luminal A
  • Variable response to chemotherapy (better than Luminal A)
  • Prognosis not as good as Luminal A
  • Grows faster
  • HER2/neu
  • High expression of HER2/neu, low expression of ER and related genes
  • 15% of invasive breast cancer, ER/PR negative, HER2/neu positive, high proliferation, diffuse TP53 mutation, high histologic grade and nodal positivity
  • High grade invasive ductal carcinoma, NOS
  • Response to trastuzumab (Herceptin)
  • Response to chemotherapy with antracyclins
  • Usually unfavorable prognosis
  • Basal like
  • High expression of basal epithelial genes and basal cytokeratins, low expression of ER and related genes, low expression of HER2/neu
  • ~15% of invasive breast cancer, most ER/PR/HER2/neu negative (triple negative), high proliferation, diffuse TP53 mutation, BRCA1 dysfunction (germline, sporadi
  • High grade invasive ductal carcinoma, NOS Metaplastic carcinoma, Medullary carcinoma
  • No response to endocrine therapy or trastuzumab
  • Sensitive to platinum group chemotherapy and PARP inhibitors
  • Not all, but usually worse prognosis[2]

References

  1. 1.0 1.1 Breast Neoplasm. Radiopedia. (2015) http://radiopaedia.org/articles/breast-neoplasms Accessed on March 1, 2019
  2. Eliyatkın N, Yalçın E, Zengel B, Aktaş S, Vardar E (2015) Molecular Classification of Breast Carcinoma: From Traditional, Old-Fashioned Way to A New Age, and A New Way. J Breast Health 11 (2):59-66. DOI:10.5152/tjbh.2015.1669 PMID: 28331693

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