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What is Breast Cancer which involves both breasts is: and explain in detail?
Ans. (a) Lobular carcinomaRef: Sabiston 19th ed./842, Bailey 26th ed. / 809LOBULAR CARCINOMA BREAST SALIENT FEATURES* Mostly Multi-centric and bilateral* Histological hallmark: Indian file pattern due to the tendency of tumor cells to invade in linear strand.* Presenting feature-Breast mass with ill-defined margins* Cellular feature- cytoplasmic mucoid globule* Neighbourhood calcification-calcification in LCIS typically occurs in adjacent tissues. It is a unique feature and adds to diagnosis.BREAST CA- AT A GLANCEMC cancer in women (Worldwide)MC cancer in women in urban area (India)* MC arise from TDLU (terminal duct lobular unit)* MC type- invasive ductal* MC malignant type- inflammatory breast CA* MC Site- upper outer quadrant* MC Site of metastasis is bone (osteolytic) lumbar vertebra>femur>thoracic vertebrae.* MC Cause of death- metastatic disease i.e malignant pleural effusion* 2nd Most common cause of cancer death in women (1st is lung in both sexes)Evaluation/ Diagnosis by triple assessment-* Clinical* Imaging (Mammography/USG)* Histopathology# 1st initial Investigation is FNAC# Best /gold standard test- HPE after biopsy# USG- for young patient# MRI- Patient with breast implant condition# PET scan- For recurrence# Mammography- For older patient# Mammography: IOC for micro-calcificationBIRADSBreast imaging reporting and data system0- incomplete assessment1- Negative2- Benign3- Probably benign4- Suspicious5- Highly suggestive of malignancy6- Malignant