A 45-year-old woman undergoes a mammogram, which reveals a suspicious lesion in her breast. A biopsy is performed, and the pathology report indicates a noninvasive malignancy. The medical team discusses the diagnosis with her and plans the next steps for her treatment.
Which of the following breast lesions are considered noninvasive malignancies?
A. Intraductal carcinoma of the comedo type
B. Tubular carcinoma and mucinous carcinoma
C. Infiltrating ductal carcinoma and lobular carcinoma
D. Medullary carcinoma, including atypical medullary lesions
Answer:
The Correct Answer is: A. Intraductal carcinoma of the comedo type
Explanation:
Intraductal carcinoma of the comedo type (A):
– Also known as ductal carcinoma in situ (DCIS), this is a noninvasive malignancy where the cancer cells are confined within the ductal system of the breast and have not invaded surrounding tissues.
– The comedo type of DCIS is characterized by high-grade cells that can produce necrosis. Despite its aggressive appearance under the microscope, it remains noninvasive and has a good prognosis when treated appropriately.
Explanation of Incorrect Options:
Tubular carcinoma and mucinous carcinoma (B):
– Both tubular carcinoma and mucinous carcinoma are types of invasive breast cancer. Tubular carcinoma is a subtype of invasive ductal carcinoma with a good prognosis, while mucinous carcinoma is characterized by the production of mucin and also has a relatively favorable outcome.
– Neither of these is classified as a noninvasive malignancy.
Infiltrating ductal carcinoma and lobular carcinoma (C):
– Infiltrating (or invasive) ductal carcinoma and invasive lobular carcinoma are both types of invasive breast cancer. They involve the spread of cancer cells beyond the ductal or lobular structures into the surrounding breast tissue.
– These are considered invasive malignancies.
Medullary carcinoma, including atypical medullary lesions (D):
– Medullary carcinoma is an invasive form of breast cancer that is characterized by well-defined boundaries and a lymphocyte-rich stroma. While it can have a good prognosis compared to other types of invasive breast cancer, it is still classified as an invasive malignancy.
– Atypical medullary lesions also fall under the category of invasive cancers.
In conclusion, intraductal carcinoma of the comedo type is a noninvasive malignancy, making option A the correct answer.