Case of the month - July 2006
A tricky core biopsy - discussion
History - 50 year old female - clinically suspicious area left breast, FNA C4 - core biopsies
Arrows on insert show subtle groups of infiltrating carcinoma cells
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CK pan reveals large numbers of malignant cells not evident on the H&E.
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Discussion points
- Diagnosis: Invasive carcinoma of no special type Grade 2
- This could have been missed very easily
- The availability of suspicious cytology and radiology (R5/U5) encouraged very close scrutiny of the cores for a focus of carcinoma
- Subtle infiltration such as this is more commonly seen with lobular carcinomas - note this is E cad positive
- CK pan is very helpful in picking out infiltrating carcinoma
- A CK 5/6 was also carried out (and was negative) thus excluding a biopsy from the edge of a sclerosing lesion
