Rosen's Breast Pathology-5판

PAPILLOMA
Clinical Presentation
Imaging Studies
Gross Pathology
Microscopic Pathology
Cytology
Correlation of Findings of Needle Core Biopsy and Excision Specimens
Immunohistochemistry
Genetic Studies
Treatment and Prognosis
RADIAL SCLEROSING LESION
Clinical Presentation
Imaging Studies
Gross Pathology
Microscopic Pathology
Cytology
Correlation of Findings in Core Biopsy and Excision Specimens
Immunohistochemistry
Genetic Studies
Treatment and Prognosis
SUBAREOLAR SCLEROSING DUCT HYPERPLASIA
Clinical Presentation
Gross Pathology
Microscopic Pathology
Treatment and Prognosis
CYSTIC AND PAPILLARY APOCRINE METAPLASIA
Clinical Presentation
Imaging Studies
Gross Pathology
Microscopic Pathology
Immunohistochemistry
Genetic Studies
Treatment and Prognosis
FLORID PAPILLOMATOSIS OF THE NIPPLE
Clinical Presentation
Imaging Studies
Gross Pathology
Microscopic Pathology
Cytology
Immunohistochemistry
Other Studies
Treatment and Prognosis
SYRINGOMATOUS ADENOMA OF THE NIPPLE
Clinical Presentation
Imaging Studies
Gross Pathology
Microscopic Pathology
Cytology
Immunohistochemistry
Treatment and Prognosis
COLLAGENOUS SPHERULOSIS
Clinical Presentation
Imaging Studies
Gross Pathology
Microscopic Pathology
Cytology
Immunohistochemistry
Treatment and Prognosis

6 Myoepithelial Neoplasms
THE MYOEPITHELIAL CELL
Morphology
Immunohistochemistry
Myoepithelial Cells in Breast Lesions and Possible Differential Diagnoses
ADENOMYOEPITHELIOMA
Clinical Presentation
Gross Pathology
Microscopic Pathology
Core Biopsy Diagnosis
Cytology
Immunohistochemistry
Electron Microscopy
Genetics and Molecular Alterations
Treatment and Prognosis
MYOEPITHELIOMA AND MYOEPITHELIAL CARCINOMA
Myoepithelioma
Myoepithelial Carcinoma

7 Adenosis and Microglandular Adenosis
ADENOSIS
Clinical Presentation
Imaging Studies
Gross Pathology
Microscopic Pathology
Differential Diagnosis
Cytology
Electron Microscopy
Genetic and Molecular Studies
Treatment and Prognosis
MICROGLANDULAR ADENOSIS
Clinical Presentation
Imaging Studies
Macroscopic Pathology
Microscopic Pathology
Differential Diagnosis
Cytology
Immunohistochemistry
Electron Microscopy
Genetics and Molecular Studies
Treatment and Prognosis

8 Fibroepithelial Neoplasms
SCLEROSING LOBULAR HYPERPLASIA (ALSO KNOWN AS FIBROADENOMATOID MASTOPATHY OR FIBROADENOMATOID CHANGE)
Clinical Presentation
Gross Pathology
Microscopic Pathology
FIBROADENOMA
Risk Factors
Clinical Presentation
Gross Pathology
Microscopic Pathology
Cytology
Immunohistochemistry
Genetics and Molecular Studies
Core-Needle Biopsy
Treatment and Prognosis
PHYLLODES TUMOR
Clinical Presentation
Incidence, Ethnicity, and Genetic Predisposition
Gross Pathology
Microscopic Pathology
Morphology of Recurrent Phyllodes Tumor, Including Distant Metastases
Cytology
Immunohistochemistry
Electron Microscopy
Genetics and Molecular Studies
Treatment and Prognosis
Core Biopsy Diagnosis of Fibroepithelial Lesions

9 Ductal Hyperplasia: Usual and Atypical
DEFINING DUCTAL HYPERPLASIA
MOLECULAR CORRELATES OF DUCTAL HYPERPLASIA
CLINICAL PRESENTATION OF DUCTAL HYPERPLASIA
GROSS PATHOLOGY OF DUCTAL HYPERPLASIA
HISTOPATHOLOGY OF USUAL DUCTAL HYPERPLASIA
Distribution of Usual Ductal Hyperplasia
Cytopathology of Usual Ductal Hyperplasia
Qualitative and Quantitative Aspects of Usual Ductal Hyperplasia
GYNECOMASTOID HYPERPLASIA
HISTOPATHOLOGY OF ATYPICAL DUCTAL HYPERPLASIA
Quantitative Aspects of Atypical Ductal Hyperplasia
Qualitative Aspects of Atypical Ductal Hyperplasia
COLUMNAR CELL LESIONS AS A FORM OF DUCTAL HYPERPLASIA
Clinical Presentation of Columnar Cell Lesions
Histopathology of Columnar Cell Change and Columnar Cell Hyperplasia
Calcifications in Columnar Cell Lesions
MANAGEMENT OF NONATYPICAL COLUMNAR CELL LESIONS
HISTOPATHOLOGY OF ATYPICAL COLUMNAR CELL HYPERPLASIA/FLAT EPITHELIAL ATYPIA
REGARDING THE ENTITY OF “FLAT EPITHELIAL ATYPIA”
MANAGEMENT OF ATYPICAL COLUMNAR CELL HYPERPLASIA/FLAT EPITHELIAL ATYPIA
IMMUNOHISTOCHEMISTRY OF COLUMNAR CELL LESIONS
DIAGNOSTIC WORKUP OF ATYPICAL DUCTAL HYPERPLASIA
TRULY “BORDERLINE” LESIONS
“UPGRADE” AFTER DIAGNOSIS OF ATYPICAL DUCTAL HYPERPLASIA ON NEEDLE-CORE BIOPSY
“OBSERVATION ALONE” OF CASES DIAGNOSED WITH ATYPICAL DUCTAL HYPERPLASIA ON NEEDLE-CORE BIOPSY
Immunohistochemistry in Usual Ductal Hyperplasia, Atypical Ductal Hyperplasia, and Low-Grade Ductal Carcinoma In Situ
LONG-TERM MANAGEMENT OF USUAL DUCTAL HYPERPLASIA AND ATYPICAL DUCTAL HYPERPLASIA

10 Precarcinomatous Breast Disease: Epidemiologic, Pathologic, and Clinical Considerations
GENERAL RISK FACTORS FOR BREAST CARCINOMA
GENETIC PREDISPOSITION TO BREAST CARCINOMA
BRCA1 and BRCA2
Pathology of BRCA1 and BRCA2 Breast Carcinomas
Prognosis of BRCA-Associated Breast Carcinomas
Surgery for BRCA1- and BRCA2-Associated Breast Carcinoma
Nonsurgical Management of BRCA1- and BRCA2-Associated Breast Carcinoma
Overview of Chemoprevention for Breast Carcinoma
Chemoprevention in BRCA1 and BRCA2 Mutation Carriers
Future Directions in Management of BRCA1 and BRCA2
Other Genes Associated with Breast Carcinoma
Risk Assessment
The Multistep Process of Mammary Carcinogenesis
Spectrum of Risk Lesions in Breast Pathology
Flat Epithelial Atypia as a Precursor Lesion
Progression of DCIS to Invasive Carcinoma
PROLIFERATIVE BREAST CHANGES

11 Ductal Carcinoma In Situ
HISTORICAL BACKGROUND
CLINICAL PRESENTATION
RISK FACTORS
MAMMOGRAPHY
ULTRASONOGRAPHY
MAGNETIC RESONANCE IMAGING
PALPABLE DUCTAL CARCINOMA IN SITU
FROZEN SECTION EVALUATION
AGE AT DIAGNOSIS
BILATERALITY
GROSS PATHOLOGY
SAMPLING OF EXCISIONAL BIOPSIES
MICROSCOPIC PATHOLOGY
General Histopathologic Features
Myoepithelium in Ductal Carcinoma In Situ
Cell Types in Ductal Carcinoma In Situ
Architectural Classification
Neuroendocrine Differentiation in Ductal Carcinoma In Situ
Paget Disease
Grading
Classification Systems for Ductal Carcinoma In Situ
Interobserver Variability in Grading
ANGIOGENESIS
ANCILLARY STUDIES
Estrogen Receptor and Progesterone Receptor
HER2
p53
nm23 and EGFR
E-cadherin
Ploidy and Proliferative Rate
CYTOGENETICS AND MOLECULAR GENETICS
NEEDLE CORE BIOPSY
CYTOLOGIC DIAGNOSIS
EXTENT OF DUCTAL CARCINOMA IN SITU
MULTICENTRICITY AND MULTIFOCALITY
MICROINVASIVE CARCINOMA
Clinical Significance of Microinvasion
Sentinel Lymph Node Biopsy
MARGINS OF EXCISION
TUMOR-INFILTRATING LYMPHOCYTES
TREATMENT AND PROGNOSIS
Mastectomy
Nipple-Sparing Mastectomy
Breast-Conserving Therapy
Oncotype DX for Ductal Carcinoma In Situ
Breast-Conserving Surgery with Radiotherapy
MSKCC NOMOGRAM
Breast Conservation for Mammographically Detected Ductal Carcinoma In Situ
Accelerated Partial Breast Irradiation
Concurrent Lobular Carcinoma In Situ, Atypical Proliferative Lesions, and Breast Conservation
META-ANALYSIS OF TREATMENT
SELECTIVE ESTROGEN RECEPTOR MODULATORS IN DUCTAL CARCINOMA IN SITU
CLINICAL TRIALS
SUMMARY OF TREATMENT RECOMMENDATIONS
CONCLUSIONS
THE PATHOLOGY REPORT OF DUCTAL CARCINOMA IN SITU

12 Invasive Ductal Carcinoma: Assessment of Prognosis with Morphologic and Biologic Markers
INVASIVE DUCTAL CARCINOMA WITH MIXED HISTOLOGIC FEATURES
DUCTAL CARCINOMA IN SITU IN INVASIVE DUCTAL CARCINOMA
THE COMPLEXITY OF ASSESSING PROGNOSIS
Prognostic and Predictive Factors
Race
Heterogeneity
Genetic Factors
Bilaterality
METHOD OF TUMOR DETECTION AND SCREENING
RECURRENT CARCINOMA
LOCAL RADIOTHERAPY
LOCAL RECURRENCE IN CONSERVED BREAST OR CHEST WALL
EARLY DETECTION OF RECURRENCE
TIME DEPENDENCY OF PROGNOSTIC VARIABLES
UNIVARIATE AND MULTIVARIATE ANALYSES
IMPACT OF THERAPY ON PROGNOSIS
CHANGING INCIDENCE AND MORTALITY
GROSS APPEARANCE
TUMOR SIZE
Impact of Tumor Size and Nodal Status on Prognosis
Measuring the Size of a Unifocal Invasive Ductal Carcinoma
“T” on Needle-Core Biopsies
Measuring the Size of Multifocal or Multicentric Invasive Ductal Carcinoma
TUMOR CONFIGURATION OR SHAPE
HISTOPATHOLOGIC PROGNOSTIC FACTORS
GRADING
Histologic Grading of Needle-Core Biopsy Specimens
Reproducibility of Grading
Grading and Prognosis
Incorporation of Grading into Staging
NECROSIS
APOPTOSIS, BCL-2, TELOMERASE, AND NECROSIS
TUMOR-INFILTRATING LYMPHOCYTES
PD-L1
Atezolizumab Plus Nab-Paclitaxel
LYMPHOVASCULAR INVOLVEMENT
Detection of Lymphovascular Tumor Emboli with Immunostains
Prognostic Significance of Lymphovascular Tumor Emboli
Staging and Lymphovascular Involvement
Blood Vessel Invasion
Quantitation of Lymphovascular Involvement
ANGIOGENESIS
Measurement of Angiogenesis
Angiogenesis and Prognosis
Angiogenic Proteins and Prognosis
Antiangiogenic Therapy
PERINEURAL INVASION
STROMAL CHARACTERISTICS
EXTENSIVE INTRADUCTAL COMPONENT AS A PROGNOSTIC MARKER
OTHER HISTOLOGIC VARIABLES
TUMOR GROWTH RATE
Clinical Assessment of Tumor Growth Rate
Determination of S-phase Fraction and Ploidy by Flow Cytometry
Immunohistochemical versus Molecular Assessment of Prognosis
5-Bromodeoxyuridine
Ki-67
MIB-1
PCNA
NUCLEAR MORPHOMETRY
BASAL-LIKE/TRIPLE-NEGATIVE PHENOTYPE
ER AND PR TESTING
American Society of Clinical Oncology/College of American Pathologists Guideline for Hormone-Receptor Testing
Quantitation of ER and PR
“Low-Positive” ER
Hormone-Receptor Testing in Ductal Carcinoma In Situ
ER and PR in Recurrent or Metastatic Carcinoma
Other Tests for ER
Histology of Hormone-Receptor–Positive Cancers
HER2
HER2 Testing
HER2 Heterogeneity
Other HER2 Testing Algorithms and Testing Methodologies
HER2 Status in Recurrent and Metastatic Carcinomas
Histology of HER2 (+) Invasive Carcinomas
TECHNICAL CONSIDERATIONS IN ER, PR, AND HER2 TESTING
AMERICAN JOINT COMMITTEE ON CANCER PROGNOSTIC STAGING

13 Tubular Carcinoma
CLINICAL PRESENTATION
Incidence and Presenting Symptoms
Imaging
Age
Ethnicity
Family History
MACROSCOPIC EXAMINATION
Size
MICROSCOPIC PATHOLOGY
Precursor Lesions Associated with Tubular Carcinoma
Multifocal Tubular Carcinoma and Contralateral Carcinoma
DIFFERENTIAL DIAGNOSIS
Microglandular Adenosis
Sclerosing Adenosis and Radial Sclerosing Lesions
Well-Differentiated Invasive Ductal Carcinoma
TUBULOLOBULAR CARCINOMA
DIAGNOSIS OF TUBULAR CARCINOMA IN NEEDLE CORE BIOPSY MATERIAL
IMMUNOHISTOCHEMISTRY
ELECTRON MICROSCOPY
CYTOLOGY
GENOMIC ANALYSIS AND MOLECULAR STUDIES
LYMPH NODE METASTASES
Pathology of Lymph Node Metastases
TREATMENT AND PROGNOSIS

14 Papillary Carcinoma
CLINICAL PRESENTATION
IMAGING STUDIES
GROSS PATHOLOGY
MICROSCOPIC PATHOLOGY
Noninvasive Papillary Carcinoma
Papilloma with Superimposed Atypical Epithelial Proliferations
Invasive Papillary Carcinoma
CYTOLOGY
IMMUNOHISTOCHEMISTRY
GENETIC STUDIES
VARIANT PATTERNS OF PAPILLARY CARCINOMA
Intracystic Papillary Carcinoma
Encapsulated Papillary Carcinoma
Solid Papillary Carcinoma with Endocrine Features
Tall Cell Carcinoma with Reversed Polarity
TREATMENT AND PROGNOSIS

15 Medullary Carcinoma
CLINICAL PRESENTATION
IMAGING STUDIES
GROSS PATHOLOGY
MICROSCOPIC PATHOLOGY
Lymphoplasmacytic Infiltrate
Microscopic Circumscription
Syncytial Growth
Nuclear Grade and Mitoses
Ductal Carcinoma In Situ
Metaplasia
Necrosis
CYTOLOGY
IMMUNOHISTOCHEMISTRY
HLA-DR
Cytokeratins
Vimentin
Other Cellular Markers
Hormone and Growth Factor Receptors
Basal Cell–Associated Proteins
p53
Growth Rate
Lymphoplasmacytic Infiltrate
Epstein–Barr Virus
GENETIC STUDIES
TREATMENT AND PROGNOSIS

16 Carcinoma with Metaplasia
CARCINOMA WITH METAPLASIA
Benign Metaplasia
Malignant Metaplasia
Terminology
Clinical Presentation
Fibromatosis-Like Metaplastic (Spindle Cell) Carcinoma
Metaplastic Spindle Cell Carcinoma (Intermediate or High Nuclear Grade)
Differential Diagnosis of Metaplastic Spindle Cell Carcinoma and Fibromatosis-Like Spindle Cell Carcinoma
Metaplastic Carcinoma with Heterologous Mesenchymal Differentiation
Mixed Metaplastic Carcinomas
Metastases of Metaplastic Breast Carcinoma
Cytology
Immunohistochemistry
Electron Microscopy
Genetics and Molecular Studies
Treatment
Prognosis
LOW-GRADE ADENOSQUAMOUS CARCINOMA
Clinical Presentation
Macroscopic Pathology
Microscopic Pathology
Cytology
Immunohistochemistry
Genetics and Molecular Alterations
Treatment and Prognosis

17 Squamous Cell Carcinoma
ORIGIN OF MAMMARY SQUAMOUS CELL CARCINOMA
CLINICAL PRESENTATION
RADIOLOGIC FINDINGS
GROSS PATHOLOGY
HISTOPATHOLOGY
CYTOPATHOLOGY
IMMUNOHISTOCHEMISTRY
ELECTRON MICROSCOPY
GENETICS AND MOLECULAR STUDIES
TREATMENT
PROGNOSIS

18 Mucinous Carcinoma
CLINICAL PRESENTATION
Incidence
Age
Genetic Predisposition
Ethnicity
Clinical Presentation
GROSS PATHOLOGY
Size
MICROSCOPIC PATHOLOGY
Type A, Type B, and Type AB Mucinous Carcinomas
Mucinous Carcinoma Associated with Solid and Papillary Carcinoma
Pure Mucinous Carcinomas with Foci of Micropapillary Morphology
Mucinous Carcinoma with Signet Ring Cells
DUCTAL CARCINOMA IN SITU
MUCOCELE-LIKE LESIONS
Clinical Presentation
Imaging Findings
Macroscopic Findings
Microscopic Findings
Core Biopsy of Mucocele-Like Lesion and Upgrade at Excision
Long-Term Follow-Up of Patients with Mucocele-Like Lesions
Differential Diagnosis of Mucinous Lesions
CYTOLOGY
IMMUNOHISTOCHEMISTRY
Mucins
Hormone Receptors, HER2, and Ki67
Neuroendocrine Differentiation and Other Markers
ELECTRON MICROSCOPY
GENETICS AND MOLECULAR STUDIES
TREATMENT
PROGNOSIS
CYSTIC PAPILLARY MUCINOUS CARCINOMA (MUCINOUS CYSTADENOCARCINOMA)
IMMUNOHISTOCHEMISTRY
TREATMENT AND PROGNOSIS

19 Apocrine Carcinoma
CLINICAL PRESENTATION
Incidence
Age
Genetic Predisposition
Symptoms and Imaging
MACROSCOPIC PATHOLOGY
MICROSCOPIC PATHOLOGY
Malignant Apocrine Histology
Invasive Apocrine Carcinoma
Apocrine Ductal Carcinoma In Situ
Atypical Apocrine Lesions
Apocrine Metaplasia
CYTOLOGY
ELECTRON MICROSCOPY
IMMUNOHISTOCHEMISTRY
Antigens Associated with Apocrine Differentiation
Nonapocrine Antigens
DIFFERENTIAL DIAGNOSIS OF APOCRINE LESIONS
GENETIC ALTERATIONS
TREATMENT AND PROGNOSIS
Atypical Apocrine Lesions
Apocrine Ductal Carcinoma In Situ
Invasive Apocrine Carcinoma

20 Mammary Carcinomas with Endocrine Features
CARCINOMAS WITH NEUROENDOCRINE MORPHOLOGY AND/OR DIFFERENTIATION
CLINICAL PRESENTATION
Incidence
Age
Clinical Findings
Imaging Studies
MACROSCOPIC PATHOLOGY
MICROSCOPIC PATHOLOGY
Neuroendocrine Breast Carcinomas and Invasive Carcinomas with NE Features
(Neuro)Endocrine (Ductal) Carcinoma In Situ
CYTOLOGY
HISTOCHEMISTRY
IMMUNOHISTOCHEMISTRY
DIFFERENTIAL DIAGNOSIS WITH NON-MAMMARY NEUROENDOCRINE TUMORS
ELECTRON MICROSCOPY
GENETICS AND MOLECULAR STUDIES
PROGNOSIS AND TREATMENT

21 Small Cell Carcinoma
CLINICAL PRESENTATION
IMAGING STUDIES
GROSS PATHOLOGY
MICROSCOPIC PATHOLOGY
Differential Diagnosis
CYTOLOGY
IMMUNOHISTOCHEMISTRY
GENETIC STUDIES
TREATMENT AND PROGNOSIS

22 Secretory Carcinoma
CLINICAL PRESENTATION
IMAGING STUDIES
GROSS PATHOLOGY
MICROSCOPIC PATHOLOGY
Differential Diagnosis
CYTOLOGY
IMMUNOHISTOCHEMISTRY
MOLECULAR STUDIES
Chromosomal Abnormalities
TREATMENT
PROGNOSIS

23 Mammary Carcinoma with Osteoclast-Like Giant Cells
CLINICAL PRESENTATION
IMAGING STUDIES
GROSS PATHOLOGY
MICROSCOPIC PATHOLOGY
Differential Diagnosis
CYTOLOGY
IMMUNOHISTOCHEMISTRY
TREATMENT AND PROGNOSIS

24 Cystic Hypersecretory Carcinoma and Cystic Hypersecretory Hyperplasia
INCIDENCE AND PRESENTATION
IMAGING
MACROSCOPIC PATHOLOGY
MICROSCOPIC PATHOLOGY
INTRADUCTAL CYSTIC HYPERSECRETORY CARCINOMA
CYSTIC HYPERSECRETORY CHANGE AND HYPERPLASIA
ASSOCIATED INVASIVE CARCINOMA
ASSOCIATED BENIGN EPITHELIAL LESIONS
ELECTRON MICROSCOPY
CYTOLOGY
IMMUNOHISTOCHEMISTRY
NEEDLE CORE BIOPSY
TREATMENT AND PROGNOSIS

25 Adenoid Cystic Carcinoma
INCIDENCE
AGE, GENDER, AND ETHNICITY
CLINICAL PRESENTATION
IMAGING STUDIES
GROSS PATHOLOGY
MICROSCOPIC PATHOLOGY
Solid Pattern and Basaloid Morphology
Metaplastic Patterns in Adenoid Cystic Carcinoma
CARCINOMA IN SITU
Associated Carcinomas
CYTOLOGY
IMMUNOHISTOCHEMISTRY
ELECTRON MICROSCOPY
DIFFERENTIAL DIAGNOSIS OF ADCC
NEEDLE CORE BIOPSY
GENETIC ALTERATIONS
TREATMENT
PROGNOSIS

26 Invasive Cribriform Carcinoma
CLINICAL PRESENTATION
IMAGING STUDIES
GROSS PATHOLOGY
MICROSCOPIC PATHOLOGY
IMMUNOHISTOCHEMISTRY
TREATMENT AND PROGNOSIS

27 Lipid-Rich Carcinoma
CLINICAL PRESENTATION
IMAGING STUDIES
GROSS PATHOLOGY
MICROSCOPIC PATHOLOGY
Differential Diagnosis
Unusual Patterns
CYTOLOGY
IMMUNOHISTOCHEMISTRY
TREATMENT AND PROGNOSIS

28 Glycogen-Rich Carcinoma
CLINICAL PRESENTATION
IMAGING STUDIES
GROSS PATHOLOGY
MICROSCOPIC PATHOLOGY
Differential Diagnosis
CYTOLOGY
IMMUNOHISTOCHEMISTRY
TREATMENT AND PROGNOSIS

29 Invasive Micropapillary Carcinoma
INCIDENCE
AGE AND GENDER
CLINICAL PRESENTATION
IMAGING STUDIES
SIZE
MACROSCOPIC PATHOLOGY
MICROSCOPIC PATHOLOGY
PRECURSOR LESIONS
IMMUNOHISTOCHEMISTRY
CYTOLOGY
DIFFERENTIAL DIAGNOSIS
CORE BIOPSY
ELECTRON MICROSCOPY
GENETICS AND MOLECULAR STUDIES
TREATMENT AND PROGNOSIS

30 Paget Disease of the Nipple
CLINICAL PRESENTATION
Frequency
Gender
Age
Risk Factors
Signs and Symptoms
Lesions That Clinically Mimic Paget Disease
Unusual Presentations
Recurrent Carcinoma as Paget Disease
Pigmented Paget Disease
IMAGING STUDIES
GROSS PATHOLOGY
MICROSCOPIC PATHOLOGY
Paget Cells
Coexisting Carcinomas
Secondary Paget Disease
Invasive Paget Disease
Biopsy Diagnosis
Differential Diagnosis
CYTOLOGY
IMMUNOHISTOCHEMISTRY
GENETIC STUDIES
TREATMENT
The Breast
The Axilla
PROGNOSIS

31 Lobular Carcinoma In Situ and Atypical Lobular Hyperplasia
LOBULAR CARCINOMA IN SITU
Definition and Types
Lobular Carcinoma In Situ in the AJCC Cancer Staging System
“Lobular Neoplasia”
Epidemiology of Lobular Carcinoma In Situ
Clinical Presentation of Lobular Carcinoma In Situ
Age of Patients with Lobular Carcinoma In Situ
Role of Exogenous Estrogens
Bilaterality of Lobular Carcinoma In Situ
Multicentricity of Lobular Carcinoma In Situ
Gross Pathology of Lobular Carcinoma In Situ
Distribution of Lobular Carcinoma In Situ
Lobular Involvement of Lobular Carcinoma In Situ
Minimal Involvement of Lobules in Lobular Carcinoma In Situ
Absence of Lobular Lumens
Cytologic Features of Lobular Carcinoma In Situ Cells
Coexisting Lobular Carcinoma In Situ and Ductal Carcinoma In Situ in a Single Duct
The Low-Grade Mammary Neoplasia Family
Lobular Carcinoma In Situ Involving Benign Proliferative Lesions
Microinvasive Lobular Carcinoma
Cytology of Lobular Carcinoma In Situ
Molecular Pathology of Lobular Carcinoma In Situ
E-Cadherin and p120 Immunohistochemistry in Lobular Carcinoma In Situ
Biomarkers in Lobular Carcinoma In Situ
Ultrastructure of Lobular Carcinoma In Situ
Atypical Lobular Hyperplasia
Histopathology of Atypical Lobular Hyperplasia
E-Cadherin in Atypical Lobular Hyperplasia
Prognosis of Atypical Lobular Hyperplasia
Clinical Significance of Lobular Carcinoma In Situ
Pathologic Predictors of Increased Risk Due to Lobular Carcinoma In Situ
Classic Lobular Carcinoma In Situ, Florid Lobular Carcinoma In Situ, and Pleomorphic Lobular Carcinoma In Situ:
Precursor Lesions or Markers of Invasive Carcinoma?
Not All Lobular Carcinoma In Situ is Classic Lobular Carcinoma In Situ
Surgical Management of Lobular Carcinoma In Situ in Needle Core Biopsy Specimens
Current Recommendations
Atypical Lobular Hyperplasia in Needle Core Biopsy Specimen
Radiologic Follow-Up of Patients with Atypical Lobular Hyperplasia and Lobular Carcinoma In Situ
Treatment Options for Atypical Lobular Hyperplasia and Lobular Carcinoma In Situ. Clinical Follow-Up and Use of
Selective Estrogen Receptor Modulators and Aromatase Inhibitors
Radiation Therapy
Mastectomy and Biopsy of the Contralateral Breast
Significance of Lobular Carcinoma In Situ in Breast Conservation Therapy for DCIS and Invasive Carcinoma
Margin Assessment for Lobular Carcinoma In Situ and Invasive Lobular Carcinoma
Influence of Lobular Carcinoma In Situ on Recurrence of Ductal Carcinoma In Situ in a Single Duct
Influence of Lobular Carcinoma In Situ on Recurrence of Invasive Carcinoma
SUMMARY

32 Invasive Lobular Carcinoma
INCIDENCE
CLINICAL PRESENTATION
Age and Gender
Symptoms and Signs
Mammography
Ultrasonography
Magnetic Resonance Imaging
Breast-Specific Gamma Imaging
Digital Tomosynthesis
Preoperative Assessment of Size of ILC
Assessment of Lumpectomy Margins by Imaging
BILATERALITY
GROSS PATHOLOGY
Estimation of Size
HISTOPATHOLOGY
Classic Form of ILC
Variant Forms of ILC
CYTOLOGY
PERINEURAL AND LYMPHOVASCULAR INVOLVEMENT
ANGIOGENESIS
IMMUNOHISTOCHEMISTRY
Estrogen and Progesterone Receptors
HER2
Carcinoembryonic Antigen, α-Lactalbumin, and Casein
Gross Cystic Disease Fluid Protein-15
Cyclin-D1
Epidermal Growth Factor Receptor
p53
Stromal Proteins
Cytokeratin 5/6
Topoisomerase-11
E-Cadherin
HISTOCHEMISTRY
TELOMERE LENGTHS
PLOIDY
MOLECULAR GENETICS
ULTRASTRUCTURE
ASPIRATION CYTOLOGY
LYMPH NODE INVOLVEMENT
NONNODAL METASTASES
GENOMIC TESTING
PROGNOSIS
Prognosis of C-ILC
Prognosis of P-ILC
Summary of Prognosis for C-ILC and P-ILC
MANAGEMENT
Mastectomy and Breast-Conserving Surgery
Summary of Surgical Treatment for ILC
Neoadjuvant Chemotherapy and Endocrine Therapy
Adjuvant Chemotherapy or Endocrine Therapy
CDH1 MUTATION CARRIERS

33 Unusual Clinical Presentation of Carcinoma
CARCINOMA IN PREGNANCY AND LACTATION
Clinical Presentation
Clinical Diagnosis
Pathology
Biomarkers
Treatment
Prognosis
BREAST CARCINOMA IN “YOUNGER” AND “OLDER” WOMEN
Patients Younger Than 40 Years
Patients 40 to 49 Years of Age
Pathology
Biomarkers in Invasive Carcinoma
Breast Conservation Therapy
Carcinoma in Elderly Women
Genetic Considerations
Fertility Preservation in “Younger” Women with Breast Carcinoma
CARCINOMA ARISING IN FIBROEPITHELIAL NEOPLASMS
Clinical Presentation
Gross Pathology
Microscopic Pathology
Molecular Analysis
Treatment and Prognosis
OCCULT CARCINOMA PRESENTING WITH AXILLARY NODAL METASTASES
Clinical Presentation
Clinical Evaluation
Gross Pathology
Axillary Lymph Nodes
Pathology of the Occult Primary Breast Carcinoma
Treatment
Prognosis
CARCINOMA IN ECTOPIC BREAST TISSUE
Clinical Presentation
Microscopic Pathology
Treatment
Cytology
INFLAMMATORY CARCINOMA
Clinical Features
Biomarkers and Special Studies
Noninflammatory Cutaneous Involvement by Breast Carcinoma
Secondary Inflammatory Carcinoma
Gross Pathology
Microscopic Pathology
Treatment
Response to Treatment
Prognosis
REDUCTION MAMMOPLASTY SPECIMENS
RECURRENT CARCINOMA IN TRAM FLAP

34 Metastases in the Breast from Nonmammary Malignant Neoplasms
HISTORICAL PERSPECTIVE
CLINICAL FINDINGS
IMAGING FEATURES
HISTOPATHOLOGIC FINDINGS
IMMUNOHISTOCHEMICAL FINDINGS
Skin Adnexal Carcinoma
SPECIFIC TYPES OF METASTATIC NEOPLASMS IN THE BREAST
Malignant Melanoma
Lung Carcinoma and Mesothelioma
Carcinoid (Neuroendocrine) Tumor
Small Blue Round Cell Neoplasm
Gynecologic Carcinoma
Gastrointestinal Carcinoma
Thyroid Carcinoma
Salivary Gland Tumor
Renal Carcinoma
Sarcoma
Prostatic Adenocarcinoma
AXILLARY LYMPH NODE METASTASES FROM NONMAMMARY CARCINOMAS
“IMPLANTATION METASTASES” IN THE BREAST
MANAGEMENT AND PROGNOSIS OF METASTASES IN BREAST
FUTURE DIRECTIONS
SUMMARY

35 Benign Proliferative Lesions of the Male Breast
PAPILLARY LESIONS
FLORID PAPILLOMATOSIS OF THE NIPPLE
FIBROEPITHELIAL TUMORS
DUCT ECTASIA
VARIOUS FIBROCYSTIC CHANGES
GYNECOMASTIA
Clinical Presentation
Radiology
Etiology
Macroscopic Pathology
Microscopic Pathology
Additional Epithelial Changes
Atypical Ductal Hyperplasia in Gynecomastia
Gynecomastia-Like Hyperplasia in Women
Fine-Needle Aspiration Cytology and Needle Core Biopsy
Immunohistochemistry
Electron Microscopy
Treatment and Prognosis

36 Carcinoma of the Male Breast
EPIDEMIOLOGY
Incidence
Race
Predisposing Factors
CLINICAL PRESENTATION
Symptoms
Age
LOCATION
IMAGING
GROSS PATHOLOGY
MICROSCOPIC PATHOLOGY
Invasive Carcinoma
Invasive Lobular Carcinoma and Lobular Carcinoma In Situ
Other Special Subtypes of Invasive Carcinoma
Encapsulated Papillary Carcinoma
Ductal Carcinoma In Situ
Metastases to the Breast
CYTOLOGY
IMMUNOHISTOCHEMISTRY
Hormone Receptors
HER2
Combined ER, PR, and HER2 Profiles
Other Antigens
ELECTRON MICROSCOPY
GENETICS AND MOLECULAR STUDIES
TREATMENT
PROGNOSIS

37 Breast Tumors in Children and Young Adults
INCIDENCE
IMAGING
RISK OF SUBSEQUENT CARCINOMA
JUVENILE PAPILLOMATOSIS
Clinical Presentation
Family History of Breast Carcinoma
Genetic Alterations
Macroscopic Pathology
Microscopic Pathology
Differential Diagnosis
Breast Carcinomas Associated with Juvenile Papillomatosis
Risk of Subsequent Breast Carcinoma
Treatment and Prognosis
PAPILLOMA AND PAPILLARY DUCT HYPERPLASIA IN CHILDREN AND YOUNG WOMEN
Clinical Presentation
Macroscopic Pathology
Microscopic Pathology
Treatment and Prognosis
“JUVENILE” ATYPICAL DUCTAL HYPERPLASIA
GYNECOMASTIA
Age
Presenting Symptoms
Treatment
Gynecomastia and ADH or Carcinoma
Gynecomastia and Neurofibromatosis
FIBROEPITHELIAL LESIONS
Age and Ethnicity
Fibroadenoma
Phyllodes Tumors
PSEUDOANGIOMATOUS STROMAL HYPERPLASIA
Fibroepithelial Lesions and Juvenile Papillomatosis
CARCINOMA IN CHILDREN AND ADOLESCENTS
Predisposing Factors
Age and Presenting Symptoms
Microscopic Findings
OTHER TUMORS

38 Benign Mesenchymal Lesions
FIBROMATOSIS
Clinical Presentation
Predisposing Factors
Imaging Studies
Gross Pathology
Microscopic Pathology
Differential Diagnosis
Cytology
Immunohistochemistry
Molecular Studies
Treatment and Prognosis
NODULAR FASCIITIS
Clinical Presentation
Imaging Studies
Gross Pathology
Microscopic Pathology
Differential Diagnosis
Cytology
Immunohistochemistry
Genetic Studies
Treatment and Prognosis
FIBROUS TUMOR
Clinical Presentation
PSEUDOANGIOMATOUS HYPERPLASIA OF MAMMARY STROMA
Clinical Presentation
Imaging Studies
Gross Pathology
Microscopic Pathology
Differential Diagnosis
Atypical Pseudoangiomatous Stromal Hyperplasia
Cytology
Immunohistochemistry
Treatment and Prognosis
MYOFIBROBLASTOMA
Clinical Presentation
Imaging Studies
Gross Pathology
Microscopic Pathology
Variant Forms
Differential Diagnosis
Cytology
Immunohistochemistry
Molecular Studies
Treatment and Prognosis
TUMORS WITH PERIVASCULAR MYOID DIFFERENTIATION
GIANT CELL FIBROBLASTOMA
GRANULAR CELL TUMOR
Clinical Presentation
Imaging Studies
Gross Pathology
Microscopic Pathology
Differential Diagnosis
Cytology
Immunohistochemistry
Treatment and Prognosis
SCHWANNOMA
NEUROFIBROMA
LEIOMYOMA
Clinical Presentation
Imaging Studies
Gross Pathology
Microscopic Pathology
Treatment and Prognosis
MYOID “HAMARTOMA”
MYXOMA
Clinical Presentation
Gross Pathology
Microscopic Pathology
Treatment and Prognosis
NODULAR MUCINOSIS
Clinical Presentation
Gross Pathology
Microscopic Pathology
Treatment and Prognosis
LIPOMA
Clinical Presentation
Imaging Studies
Gross Pathology
Microscopic Pathology
Treatment and Prognosis
PERILOBULAR HEMANGIOMA
Clinical Presentation
Gross and Microscopic Pathology
Treatment and Prognosis
HEMANGIOMA
Clinical Presentation
Imaging Studies
Gross Pathology
Microscopic Pathology
Differential Diagnosis
Immunohistochemistry
Treatment and Prognosis
ANGIOMATOSIS
Clinical Presentation
Imaging Studies
Gross Pathology
Microscopic Pathology
Differential Diagnosis
Immunohistochemistry
Treatment and Prognosis
LYMPHANGIOMA
Clinical Presentation
Imaging Studies
Gross Pathology
Microscopic Pathology
Treatment and Prognosis
VENOUS HEMANGIOMA
Clinical Presentation
Gross Pathology
Microscopic Pathology
Treatment and Prognosis
ANEURYSM
HEMANGIOMA
Clinical Presentation
Gross and Microscopic Pathology
Treatment and Prognosis
ANGIOLIPOMA
Clinical Presentation
Gross and Microscopic Pathology
Treatment and Prognosis
PAPILLARY ENDOTHELIAL HYPERPLASIA
Clinical Presentation
Gross and Microscopic Pathology
Treatment and Prognosis

39 Sarcoma
GENERAL CONSIDERATIONS
Incidence
Predisposing Factors
Clinical Presentation
Macroscopic Appearance
Differential Diagnosis
Treatment
Prognosis
STROMAL SARCOMA
LEIOMYOSARCOMA
Clinical Presentation
Imaging Studies
Gross and Microscopic Pathology
Cytology
Immunohistochemistry
Genetic Studies
Treatment and Prognosis
LIPOSARCOMA
Clinical Presentation
Imaging Studies
Gross and Microscopic Pathology
Cytology
Immunohistochemistry
Treatment and Prognosis
OSTEOSARCOMA AND CHONDROSARCOMA
Clinical Presentation
Imaging Studies
Gross and Microscopic Pathology
Cytology
Immunohistochemistry
Treatment and Prognosis
UNDIFFERENTIATED PLEOMORPHIC SARCOMA AND FIBROSARCOMA
Undifferentiated Pleomorphic Sarcoma
Clinical Presentation
Imaging Studies
Gross and Microscopic Pathology
Cytology
Immunohistochemistry
Treatment and Prognosis
Fibrosarcoma
RHABDOMYOSARCOMA
Primary Rhabdomyosarcoma
Clinical Presentation
Imaging Studies
Gross and Microscopic Pathology
Cytology
Immunohistochemistry
Treatment and Prognosis
Metastatic Rhabdomyosarcoma
SOLITARY FIBROUS TUMOR (HEMANGIOPERICYTOMA)
Clinical Presentation
Imaging Studies
Gross Pathology
Microscopic Pathology
Cytology
Immunohistochemistry and Genetic Studies
Treatment and Prognosis
DERMATOFIBROSARCOMA PROTUBERANS
Clinical Presentation
Imaging Studies
Gross Pathology
Microscopic Pathology
Cytology
Immunohistochemistry and Genetic Analysis
Treatment and Prognosis
SARCOMAS OF PERIPHERAL NERVES
EWING SARCOMA (PRIMITIVE NEUROECTODERMAL TUMOR)
MYOFIBROBLASTIC SARCOMA (MYOFIBROSARCOMA)
OTHER SARCOMAS
ANGIOSARCOMA
SPORADIC ANGIOSARCOMA
Clinical Presentation
Imaging Studies
Gross Pathology
Microscopic Pathology
Cytology
Immunohistochemistry
Genetic Studies
Treatment
Prognosis
POSTIRRADIATION ANGIOSARCOMA AND CUTANEOUS ATYPICAL VASCULAR LESION
Angiosarcoma Following Breast Conservation Therapy
Clinical Presentation
Imaging Studies
Gross Pathology
Microscopic Pathology
Differential Diagnosis
Cytology
Immunohistochemistry
Genetic Studies
Treatment
Prognosis
Cutaneous Atypical Vascular Lesion
Clinical Presentation
Microscopic Pathology
Immunohistochemistry
Treatment and Prognosis
ANGIOSARCOMA ARISING IN CHRONIC EDEMA (STEWART–TREVES SYNDROME)
Clinical Presentation
Imaging Studies
Gross Pathology
Microscopic Pathology
Cytology
Immunohistochemistry
Genetic Studies
Treatment and Prognosis

40 Lymphoid and Hematopoietic Neoplasms of the Breast
LYMPHOMAS OF THE BREAST
Primary Lymphoma of the Breast
Secondary Lymphomas of the Breast
PLASMA CELL NEOPLASMS
Clinical Presentation
Gross Pathology
Microscopic Pathology
Differential Diagnosis
Treatment and Prognosis
MYELOID SARCOMA OF THE BREAST
Clinical Presentation
Pathology
Differential Diagnosis
EXTRAMEDULLARY HEMATOPOIESIS
Differential Diagnosis
HISTIOCYTIC PROLIFERATIONS OF THE BREAST
Rosai–Dorfman Disease of the Breast
Erdheim–Chester Disease
Langerhans Cell Histiocytosis
Differential Diagnosis of Histiocytic Proliferations in the Breast

41 Pathologic Effects of Therapy
IRRADIATION
Irradiation as Treatment for Hodgkin Lymphoma
Irradiation as Conservation Treatment for Breast Carcinoma
NEOADJUVANT CHEMOTHERAPY
ABLATION METHODS
Interstitial Laser Therapy
Radiofrequency Ablation
Microwave Ablation
High-Intensity Focused Ultrasound Ablation
Cryoablation
Electroporation
Use of Ablation Techniques

42 Cutaneous Lesions
MELANOCYTIC LESIONS OF MAMMARY SKIN AND PARENCHYMA
Cutaneous Nevus
Melanosis of the Areola
Cutaneous Melanoma
Nevi of the Mammary Parenchyma
Melanoma of the Mammary Parenchyma
Metastatic Melanoma in the Mammary Parenchyma
Melanin-Producing Carcinoma of the Mammary Parenchyma
NONMELANOCYTIC CUTANEOUS MAMMARY LESIONS
Benign Cutaneous Tumors
Cutaneous Carcinomas
LESIONS OF THE NIPPLE
Hyperkeratosis
Nevoid Hyperkeratosis
Adenoma
Basal Cell Carcinoma
Squamous Carcinoma
Melanoma
Other Carcinomas of the Skin of the Nipple

43 The Pathology of Axillary and Intramammary Lymph Nodes
HETEROTOPIC EPITHELIAL INCLUSIONS
Types of Inclusions
Histogenesis of Epithelial Inclusions
Clinical Presentation
Gross Pathology
Microscopic Pathology
NEVUS CELL AGGREGATES
Etiology
Frequency
Clinical Presentation
Gross Pathology
Microscopic Pathology
Intradermal Nevus Type of Nevus Cell Aggregate
Blue Nevus Type of Nevus Cell Aggregates
Differential Diagnosis
Electron Microscopy
Prognosis
SINUS HISTIOCYTOSIS
ROSAI–DORFMAN DISEASE
SILICONE LYMPHADENITIS
Clinical Presentation
Gross Pathology
Microscopic Pathology
INVOLVEMENT BY IMPLANT-ASSOCIATED LYMPHOMA
PIGMENT DEPOSITS
VASCULAR LESIONS
Hemangiomas
Kaposi Sarcoma
Vascular Transformation of Sinuses (and Nodal Angiomatosis)
INTRAMAMMARY LYMPH NODES
Imaging Studies
Cytology and Needle Core Biopsy
Clinical Studies and Pathology
Metastatic Carcinoma in Intramammary Lymph Nodes
Intramammary Sentinel Lymph Nodes
Summary of Data on Intramammary Lymph Nodes
EXTRAMEDULLARY HEMATOPOIESIS

44 Pathologic Examination of Breast and Axillary Lymph Nodes
NEEDLE-CORE AND INCISIONAL BIOPSIES
EXCISIONAL BIOPSY
Gross Examination of an Excisional Biopsy
Intraoperative Evaluation, Including Frozen-Section Examination
Sampling of the Excisional Biopsy (Lumpectomy) Specimen
Handling of Specimens After Neoadjuvant Chemotherapy
Gross Description of an Excisional Biopsy
Assessing Lumpectomy Margins
Margins in Invasive Carcinoma: SSO-ASTRO Guidelines
Margins in Ductal Carcinoma In Situ: SSO-ASTRO-ASCO Guidelines
Changes in Practice Following Adoption of SSO-ASTRO Margin Guidelines
Post–Neoadjuvant Chemotherapy Assessment of Margins
Cavity Shave Margins
Use of In Vivo Emerging Technologies for Margin Assessment
Challenges in Assessing Margins
Reporting of Margins
Additional Considerations Regarding Margins
Clinical Significance of Margin Assessment
Prognostic Significance of Local Breast Recurrence
Clinical Follow-Up after Breast-Conserving Surgery
Reexcision of Biopsy Site
Extensive Ductal Carcinoma In Situ Component of an Invasive Carcinoma
“T” Staging
Lymphovascular Involvement by Tumor Cells and Recurrence after Breast Conservation
Specimen Imaging
PATHOLOGY OF MAMMARY CALCIFICATIONS
Calcium Phosphate Calcifications
Calcium Oxalate Calcifications
Locating Calcifications in Tissue Blocks
American College of Radiology’s Breast Imaging Reporting and Data System Classification
Relationships of Calcifications to Primary and Recurrent Carcinoma
Changes in Calcifications in Mammograms and Specimen Radiographs
Calcifications and Systemic Diseases
Noncalcified Crystalloids
Needle-Core Biopsy as an Initial Diagnostic Procedure
Pathologic Changes Attributable to Needle-Core Biopsies
Cautery (Thermal) Effect
MASTECTOMY SPECIMEN
EXAMINATION OF THE AXILLA
Clinical Staging of the Axilla
Nonsurgical Imaging Methods for Staging of the Axilla
Surgical Staging of Axilla by Endoscopic Axillary Dissection
Axillary Staging Based on Clinicopathologic Factors
Gross Pathologic Examination of Axillary Lymph Nodes
Axillary Lymph Node Ratios
Sentinel Lymph Node Biopsy
Extra-Axillary Sentinel Lymph Nodes
Success Rate for Detecting Sentinel Lymph Nodes
Sentinel Lymph Nodes and the Type of Preoperative Biopsy Procedure
Sentinel Lymph Nodes and Ductal Carcinoma In Situ
Sentinel Lymph Nodes and Microinvasive Carcinoma
Sentinel Lymph Nodes and Multifocal and Multicentric Invasive Carcinoma
Sentinel Lymph Nodes and Neoadjuvant Therapy
Sentinel Lymph Node Biopsy and Other Special Circumstances
Radiation Exposure during Sentinel Lymph Node Biopsy
Pathology of Sentinel Lymph Nodes
Relationship between Sentinel Lymph Nodes and Nonsentinel Lymph Nodes
Measuring Metastatic Carcinoma in Sentinel Lymph Nodes
Distribution of Metastatic Carcinoma in Sentinel Lymph Node
Structural Changes in Sentinel Lymph Node with Micrometastases
Comparative Histology of Primary Carcinoma and Metastatic Carcinoma in Sentinel Lymph Node
Confounding Lesions in the Diagnosis of Sentinel Lymph Node
Molecular Studies of Sentinel Lymph Nodes to Detect Micrometastases
Axillary Lymph Node Micrometastases Prior to the Era of Sentinel Lymph Node
Sentinel Lymph Node Biopsy: Changes in Clinical Practice
Reduced Frequency of Axillary Lymph Node Dissection
Extranodal Extension of Metastases
Pathologic Changes in Axillary Lymph Nodes that Mimic Metastatic Carcinoma Signet-Ring Histiocytes
Hematologic Disorders
Detection of Micrometastases in Bone Marrow
CIRCULATING TUMOR CELLS IN BREAST CARCINOMA
EXAMINATION OF PROSTHETIC BREAST IMPLANTS
OTHER FOREIGN BODIES
EXAMINATION OF REDUCTION MAMMOPLASTY SPECIMENS
PATHOLOGY OF “CLIPS” (BIOPSY-SITE MARKERS)

45 Molecular Classification and Testing of Breast Carcinoma
MOLECULAR TARGETS IN BREAST CARCINOMAS
Hormonal Signaling Pathway
Cell Surface (Transmembrane) Receptors (HER2, TRK, and CDH1)
PI3K Signaling Pathway
Cell Cycle and DNA Repair Pathway
MOLECULAR CLASSIFICATION OF BREAST CARCINOMA
Intrinsic Molecular Classification
Intrinsic Molecular Subtype 50-Gene Classifier (Prediction Analysis of Microarray)
Molecular Classification of Triple-Negative Breast Carcinoma
Other Molecular Classifiers
Clinical Significance of Molecular Classifications
PROGNOSTIC AND PREDICTIVE MOLECULAR TESTS IN BREAST CARCINOMA
70-Gene Prognostic Signature (MammaPrint)
76-Gene Prognostic Signature
Genomic Grade Index
Oncotype DX
Breast Carcinoma Index (HOXB13:IL17R/Five-Gene Molecular Grade Index)
EndoPredict (EP)/EPclin
Sensitivity to Endocrine Therapy Index
CLINICAL TRIALS AND PERSONALIZED THERAPY FOR BREAST CARCINOMAS
CHALLENGES AND FUTURE DIRECTIONS
List of Abbreviations

Index