Lectures

Types of Non-Invasive Breast Cancer

by Carlo Raj, MD
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    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.

    00:48 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 In fact, remember, you can have multiple hits, multifactorial.

    01:37 Maybe BRCA-1, BRCA-2, maybe p53 might be involved, right? Or you could have your HER-2/neu so on and so forth.

    01:44 And you could have the hyperplasia, what is the most important histologic finding in hyperplasia? What makes you think that your patient’s going into cancer? Atypical.

    01:55 Here we go again.

    01:57 So you have endometrial hyperplasia, that could -- atypical, completely different.

    02:01 Uh-oh.

    02:02 Epithelial hyperplasia, part of your fibrocystic change, atypical.

    02:06 Uh-oh. Cancer.

    02:08 Ductal hyperplasia with atypia.

    02:11 Uh-oh. Cancer.

    02:14 Note here early malignancy without basement membrane rupture.

    02:18 So still intact.

    02:20 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.

    02:29 If you take a look at the histologic picture, you’ll notice that here the middle of it, it’s undergone necrosis.

    02:37 The central portion of your tumor has undergone necrosis, you call this comedocarcinoma.

    02:44 Ductal caseous necrosis.

    02:47 What does caseous mean to you? Yes.

    02:50 Increased enzymatic destruction, a subtype of ductal carcinoma in situ.

    02:55 This one, you definitely want to know.

    02:58 Our topic is non-invasive ductal carcinoma in situ, comedocarcinoma.


    About the Lecture

    The lecture Types of Non-Invasive Breast Cancer by Carlo Raj, MD is from the course Breast Disease.


    Included Quiz Questions

    1. It does not involve the basement membrane.
    2. It describes any dysplatic lesion.
    3. It is an invasive type of cancer.
    4. It always arises from ductal hyperplasia.
    5. It involves liquefactive necrosis.
    1. Caseous necrosis
    2. Liquefactive necrosis
    3. Fibroid necrosis
    4. Fat necrosis
    5. Coagulative necrosis

    Author of lecture Types of Non-Invasive Breast Cancer

     Carlo Raj, MD

    Carlo Raj, MD


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