Special Types of Breast Cancer

Most cancers of the breast are invasive carcinoma,benign finding called mucocele-like tumor. These
NST (no special type), frequently called invasivecancers are almost always estrogen and
ductal carcinoma, which accounts for most cancers.progesterone receptor positive and negative for
The remaining cancers are referred to as "specialHER-2 over-expression.
type." The most common among the special types is- Adenoid cystic: This special type of breast cancer
invasive lobular carcinoma which is the second mostcan be found arising in other parts of the body,
common type after invasive carcinoma, NST. Theparticularly the head and neck area where they have
remaining invasive cancers in the special typea poor prognosis. However, in the breast, they tend
category are much less common and include theto behave more favorably. These cancers are almost
following (this list is not all-inclusive):always negative for estrogen and progesterone
- Invasive lobular (ILC): This type of breast cancerreceptors and negative for HER-2 over-expression.
accounts for approximately 10-15% of all invasive- Invasive cribriform: This is another rare type of
carcinomas in the breast. Most of these cancers arebreast cancer that can sometimes be confused with
Nottingham grade I or II. An exception is so-calledductal carcinoma in situ. Special studies or consultation
pleomorphic invasive lobular carcinoma. The cells ofwith a breast pathologist can help with this distinction.
typical ILC grow in a characteristic pattern whichThese cancers are usually estrogen and progesterone
distinguishes it from invasive carcinoma, NST. Thisreceptor positive and negative for HER-2
growth pattern often makes it difficult to determineover-expression.
the actual size of the cancer by clinical exam or by- Invasive papillary: This is a special type of breast
radiology. These cancers are almost always estrogencancer where the cells grow in a characteristic form
and progesterone receptor positive and negative forsimilar to papillary carcinomas that can be found in
HER-2 over-expression.other organs, such as the ovaries and thyroid. Most
- Tubular: These are low grade breast cancersof these rare cancers are estrogen and progesterone
(Nottingham grade I) that are composed almostreceptor positive and negative for HER-2
entirely of invasive duct-like structures that resembleover-expression.
normal breast ducts. It can sometimes be difficult for- Invasive micropapillary: This rare variant of breast
the pathologist to distinguish this type of cancer fromcancer usually has a poor prognosis. The
benign lesions such as sclerosing adenosis or radialcharacteristic appearance of the cancer is the cells
scar. Special studies or consultation with a breastinvading the breast tissue surrounded by "clear
pathologist can help with this distinction. Thesespaces". This type of breast cancer frequently
cancers are almost always estrogen andspreads into the lymphatic spaces of the breast.
progesterone receptor positive and negative forMost of these cancers are positive for estrogen and
HER-2 over-expression.progesterone receptors and approximately half or
- Medullary: This is a rare type of breast cancer thatmore are positive for HER-2 over-expression.
has a very characteristic appearance under the- Secretory: This very rare type of breast cancer
microscope. These tumors are not graded using thetends to occur in younger women. These tumors
Nottingham system as they are a unique cancer.tend to be circumscribed and the cells have a classic
There are very strict criteria that a pathologist mustappearance under the microscope with abundant
adhere to in making this particular diagnosis. Thesesecretory material which helps distinguish this type of
cancers are almost always negative for estrogen andcarcinoma from other types. The cancers are
progesterone receptors and negative for HER-2generally negative for estrogen and progesterone
over-expression.receptors and negative for HER-2 over-expression.
- Mucinous: This is another breast cancer that has aFor more information on breast cancer and breast
very characteristic appearance--the cancer cellspathology, visit SBPC.
invade the breast tissue associated with abundant© 2010 Seattle Breast Pathology Consultants,
mucin. They can sometimes be confused with aLLC. All rights reserved.