Infiltrating ductal carcinoma of breast presenting as areolar dermal lesion. Analysis of sonographic features for the differentiation of benign and malignant breast tumors of different sizes. Unusual breast cancers: useful clues to expanding the differential diagnosis. NPI >5.4 = poor: 44% cancer-specific 10-year survival NPI >3.4 and ≤5.4 = moderate: 78% cancer-specific 10-year survival NPI >2.4 and ≤3.4 = good: 93% cancer-specific 10-year survival NPI ≤2.4 = excellent: 96% cancer-specific 10-year survival The Nottingham prognostic index (NPI) is used to determine the prognosis for invasive breast carcinoma after surgery 7. Wash-out or plateau kinetic curves (76-91%) Ring enhancement with centripetal progression, or non-mass enhancement (NME)Įarly wash-in: higher initial enhancement ratio (IER) This feature correlates with the tumor grade 5. Posterior acoustic shadowing: 71% in grade 1ĭuctal extension may be seen: represents extension of the mass into the surrounding parenchymaĮlastography depicts increased stiffness of the mass and the surrounding tissue.
Microcalcifications: 34% in grade 1 and 37% in grade 3 5 Spiculated and hyperdense: 41% in grade 1 and 26% in grade 3Ĭircumscribed: more commonly grade 3 (36%)
Irregular mass with or without calcifications This grading system is based on the following criteria 6:ġ point: >75% of the tumor (majority of tumor)ģ-5 points: grade 1 or well-differentiated tumorĦ-7 points: grade 2 or moderately-differentiated tumorĨ-9 points: grade 3 or poorly-differentiated tumor The Nottingham combined histologic grade system, also called the modified Scarff-Bloom-Richardson grading system, is recommended by the College of American Pathologists. Often presents as a large palpable, immobile mass. The Black population has a higher predisposition to grade 3 cancer and also a higher mortality rate. The peak age of presentation is about 50-60 years. "Invasive ductal carcinoma" or "ductal NOS" remain acceptable and commonly used terms.
The rationale is that the term "ductal" relies on unproven histogenetic assumptions for this heterogeneous group of cancers. The 4 th edition (2012) of the WHO classification of tumors of the breast changed the preferred terminology from "invasive ductal carcinoma (IDC), not otherwise specified (NOS)" to "invasive breast carcinoma (IBC) of no special type (NST)" 4.
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