Surgical Pathology Criteria

Infiltrating Ductal Carcinoma of the Breast (Carcinoma of No Special Type)

Differential Diagnosis

Infiltrating Ductal Carcinoma Infiltrating Lobular Carcinoma
Infiltration in cords of varying thickness Single file infltration
May form ductal structures No duct formation
E-cadherin positive E-cadherin negative
The utility of E-cadherin in borderline cases is currently uncertain


Infiltrating Ductal Carcinoma Sclerosing Adenosis
Infiltrating Circumscribed, nodular
Myoepithelial cells absent Myoepithelial cells present


Infiltrating Ductal Carcinoma Microglandular Adenosis
Infiltrating Nodular or diffuse
Variable and irregular duct formation Uniformly round ducts
Empty lumens Eosinophilic secretion usually present in lumens
EMA positive EMA negative
Basement membrane absent Basement membrane variable
Both may have rounded non-branching ducts with a single layer of cells, lacking myoepithelial cells


Infiltrating Ductal Carcinoma Radial Scar
Cells may show various levels of atypia Cytologically bland cells
No myoepithelial cells Myoepithelial cells present
Frequent infiltration of fat by naked tubules No bare infiltration of fat
May show various infiltrative patterns Stellate configuration


Tubular Carcinoma Grade I Infiltrating Ductal Carcinoma, NOS
Stellate infiltration Irregular infiltration
90% tubules May have >10% ribbons or cords
Infrequent branching Frequent budding and branching
Single layer of cells May show stratification
Uniform chromatin Slightly irregular chromatin
Nucleoli inconspicuous Nucleoli may be prominent
  • A continuum exists between tubular carcinoma and well differentiated (Grade I) infiltrating ductal carcinoma
  • It is probable that a small (under 2.0 cm) well differentiated infiltrating ductal carcinoma will have a prognosis similar to that of tubular carcinoma so the distinction may not be critical
  • Grade II and III carcinomas are excluded by definition from tubular carcinoma.

    Breast vs. other origin in carcinoma of unknown primary

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