System : Breast
Introduction
Breast cancer is one of the leading causes of death by cancer in the world. This has led to the development of breast screening programs and biopsies of difficult borderline breast lesions.
Breast pathologists are confronted with different problems when analyzing a breast core biopsy or surgical specimen :
- Typing and grading of breast in situ or invasive carcinomas
- Recognizing rare breast carcinomas
- Typing of borderline breast intraepithelial lesions: flat epithelial atypia, atypical ductal hyperplasia, atypical lobular hyperplasia, lobular carcinoma in situ, ductal carcinoma in situ
- Typing of breast papillary lesions
- Differentiating fibroadenomas from phyllodes tumors
- Grading phyllodes tumors
- Recognizing breast sarcomas and differentiating them from metaplastic carcinomas.
Why refer cases for a second opinion ?
A second opinion is often necessary when the referring pathologist is uncertain of his or her diagnosis or if the patient or her doctor wants a second opinion.
This diagnosis can have important consequences for the patient concerning her breast pathology : is it cancer or not ? is it associated with metastatic risk and how important is this risk ? does she need surgical excision ? surgical reexcision ? mastectomy? radiotherapy? adjuvant therapy (chemotherapy, hormone therapy) ?
