-
Receptor-positive
- Respond better to hormones, chemo, surgery
- Most common in post-menopausal women
- Progesterone receptor +: better prognosis than estrogen receptor +
- PR/ER + has the best prognosis
-
Male Breast CA
- Usually ductal
- Later presentation = poorer prognosis
- Pectoral muscle involvement
- Risk: steroid use, XRT, Klinefelter's (high estrogen)
- Tx:
- Modified radical mastectomy
-
Ductal CA
- 85%
- Medullary: smooth borders, increased lymphocytes, ductal type cancer with bizarre cells; favorable prognosis
- Tubular: 10% nodes +; favorable prognosis
- Mucinous CA (Colloid): favorable prognosis
- Scirrhotic CA: worse prognosis
- Tx:
- MRM or
- Lumpectomy with ALND or SLND
- Postop XRT
-
Lobular CA
- 10%
- No calcifications
- Infiltrative
- Likely BL, multifocal, multi-centric
- +Signet ring cells: worse prognosis
- Tx:
- MRM or
- Lumpectomy with ALND or SLNB
- Postop XRT
-
Inflammatory CA
- Tx:
- Chemo and XRT first
- Mastectomy
- Very aggressive
- Dermal lymphatic invasion
- Peau d'orange lymphedema
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