00:01
Breast cancer, the way that
we will organize this for you
and at this point, I’m going
to give you an organization
that is very much
relevant to your boards.
00:10
Understand that real life clinical
practice just keeps changing.
00:15
At this point, you’re not
going into pathology
and you’re not going into
OB-GYN specifically, right?
But let’s make sure that
you know the basics.
00:26
We’ll begin with
non-invasive breast cancer.
00:29
This is malignancy.
00:32
Our topic is in situs.
00:35
"Dr. Raj, I thought in situ
meant that it was dysplasia?"
No.
00:39
In situ means membrane intact.
00:41
That’s why we call
it non-invasive.
00:44
Start again,
breast cancer, non-invasive.
00:47
These are in situs.
00:50
After we discuss common in
situs that you need to know,
we’re then going to
move into invasive.
00:57
What does that mean?
What’s been invaded?
Good.
01:01
The basement membrane.
01:05
Non-invasive number one,
ductal carcinoma in situ.
01:09
So when you say ductal,
what does that mean to you?
You’re going from the nipple and
you go into the lactiferous sinus
and then you move
through the major duct,
the terminal duct
and then lobule.
01:20
You put all the ducts together
and then the duct
here, unfortunately,
your female has developed
breast cancer.
01:26
Malignancy.
01:27
It fills the duct lumen, arises
from ductal hyperplasia.
01:33
Note here
early malignancy without
basement membrane rupture.
01:38
So still intact.
01:40
The most important or the
one that you want to know
as far as your ductal carcinoma
in situ is a subtype known as
comedocarcinoma.
01:49
If you take a look at
the histologic picture,
you’ll notice that
here the middle of it,
it’s undergone necrosis.
01:56
The central portion of your
tumor has undergone necrosis,
you call this comedocarcinoma.