Invasive non-specific (NST) carcinoma also known as invasive ductal carcinoma or ductal NOS and formerly known as invasive ductal carcinoma, not another mentioned (NOS) is a group of breast cancer that does not have a "specific distinguishing feature". Those who have these features belong to other types.
In this group were: pleomorphic carcinoma, carcinoma with osteoclast-like stromal giant cells, carcinoma with choriocarcinomatous features, and carcinoma with melanotic features. This is a diagnosis of exclusion, which means that for diagnosis should be made all other specific types should be ruled out.
Video Invasive carcinoma of no special type
Classification
Invasive non-specific carcinoma (NST) is the most common form of invasive breast cancer. It accounts for 55% of breast cancer incidents after diagnosis, according to statistics from the United States in 2004. In mammograms, it is usually visualized as a mass with fine spines radiating from the edges. On physical examination, this lump usually feels much harder or firmer than a benign breast lesion such as fibroadenoma. On microscopic examination, cancer cells attack and replace the surrounding normal tissue. IDC is divided into several histologic subtypes.
Maps Invasive carcinoma of no special type
Signs and symptoms
In many cases, ductal carcinoma has no symptoms, and is detected as an abnormal result in mammography. When symptoms appear, the non-painful and enlarged masses that do not fluctuate with the menstrual period can be felt. Clamping the skin on it can also be seen. Certain subtypes, such as inflammatory carcinomas, can cause breast to swell, dilate, and soften. All variants of the cancer, if there is spread of metastasis, can cause enlarged lymph nodes and affect other organs.
Cause
Cancer can form from a pre-cancerous lesion called ductal carcinoma in situ.
Diagnosis
Size of tumor
Tumors below 1 cm in diameter are not possible to spread systemically. Tumors are staged by size.
Lymph node involvement
The absence of cancer cells in the lymph nodes is a good indication that the cancer has not spread systemically. The presence of cancer in the lymph nodes suggests the cancer may have spread. In the study, some women had cancer presence in lymph nodes, were not treated with chemotherapy, and still had no systemic spread. Therefore, lymph node involvement is not a positive predictor of the spread.
Clinical staging
Staging the size of the tumor and the categorization of nodal involvement can be combined into a single clinical staging number.
Histological appearance
The emergence of cancer cells under a microscope is another predictor of systemic spread. The more different cancer cells than normal duct cells, the greater the risk of systemic spread. There are three characteristics that differentiate cancer cells from normal cells.
- Tendency to form a tubular structure
- Size, shape, and intensity of nuclear staining
- Mitotic rate - Cell division value
The histologic appearance of cancer cells can be assessed on these three parameters on a scale from one to three. The sum of these values ​​is a number between 3 and 9. This score is called Bloom Richardson Grade (BR) and is declared [number of values]/9. For example, cells rated on the 3 parameters will result in a BR score of 6/9.
Skor 5 dan di bawah dianggap Rendah. 6 hingga 7 dianggap Menengah. 8 hingga 9 dianggap Tinggi.
Invasi vaskular
The presence of cancer cells in small blood vessels is called vascular invasion. The presence of vascular invasion increases the likelihood of systemic spread.
DNA analysis
DNA analysis shows the amount of DNA in cancer cells and how quickly the cancer develops.
Cells with normal DNA counts are called diploids. A cell with too much or too little DNA is called aneuploid. Aneuploid cells are more likely to spread than diploid cells.
DNA testing shows the rate of growth by determining the number of cells in a synthetic phase (S Phase). S Phase & gt; 10% means the possibility of higher spread.
DNA testing results are considered a less reliable predictor of spread than size, histology, and lymph node involvement.
Prognosis
According to the NIH Consensus Conference, if DCIS is left untreated, nature or nature history travels vary according to DCIS values. Unless treated, about 60 percent of low-grade DCIS lesions will become invasive in 40 years of follow-up. High levels of unresectable DCIS lesions and no radiotherapy have a 50% risk of invasive breast cancer within seven years. About half of the lower class DCIS detected at screening will represent overdiagnosis, but high-grade DCIS overdiagnosis is rare. The natural history of DCIS mid-level is difficult to predict. About one-third of the malignant calcification clusters detected in mammography screening have an invasive focus.
The prognosis of IDC depends, in part, on its histologic subtype. Mucosal, papillary, cribiform, and tubular carcinomas have longer survival, and lower recurrence rates. The most common prognosis of IDC forms, called "IDC Not Otherwise Specified", is an intermediary. Finally, some forms of rare breast cancer (eg, sarcomatoid carcinoma, inflammatory carcinoma) have a poor prognosis. Regardless of histologic subtype, IDC's prognosis also depends on tumor size, presence of lymph node cancer, histologic level, presence of small vessel (vascular invasion), hormonal and oncogene receptor expression such as HER2/neu.
These parameters can be incorporated into models that provide a statistical probability of systemic deployment. The probability of systemic spread is a key factor in determining whether radiation and chemotherapy are beneficial. Individual parameters are also important because they can predict how well the cancer will respond to a particular chemotherapy agent.
Overall, the 5-year survival rate of invasive ductal carcinoma was approximately 85% in 2003.
Treatment
Treatment of invasive carcinoma without a special type (NST) depends on the size of the mass (measured tumor size in the longest direction):
- & lt; 4 cm mass: surgery to remove the mass of the main tumor and to take lymph node samples in the axilla. The tumor stage is confirmed after this first surgery. Adjuvant therapy (ie, postoperative care) may include a combination of chemotherapy, radiotherapy, hormonal therapy (eg, tamoxifen) and/or targeted therapy (eg, trastuzumab). Other surgery is sometimes necessary to complete the removal of the initial tumor or to remove recurrences.
- 4 cm or larger mass: modification (less aggressive radical mastectomy) radical mastectomy (due to malignant masses exceeding 4 cm in size exceeding lumpectomy criteria) along with lymph node sampling in the axilla.
The treatment options offered to a patient are determined by the shape, stage and location of the cancer, and also by age, previous disease history and general health of the patient. Not all patients are treated in the same way.
See also
- Atypical ductal hyperplasia
- Spherulosis collagen
References
External links
- Breastfeeding Ductal Carcinoma
Source of the article : Wikipedia
0 Comments