Breast cancer classification: Difference between revisions
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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== | ==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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Breast Cancer Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Breast cancer classification On the Web |
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American Roentgen Ray Society Images of Breast cancer classification |
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Risk calculators and risk factors for Breast cancer classification |
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 |
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Ductal |
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Lobular |
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Other malignant breast tumors |
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Sarcoma |
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Lymphoma |
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Metastases to the breast |
The most common extra-mammary cancers that metastasise to breast are:
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Benign Tumors
- Phyllodes tumor[1]
- Mammary fibromatosis: 0.2% of all breast tumors 5
- Benign papillary lesions of the breast
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- 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
- ↑ 1.0 1.1 Breast Neoplasm. Radiopedia. (2015) http://radiopaedia.org/articles/breast-neoplasms Accessed on March 1, 2019
- ↑ 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