[問題] 乳房切片報告請教

作者: luciferwing (殘念)   2024-08-24 15:40:47
從健保快譯通得到的乳房切片報告
看起來確定是乳癌了
想請教是否看得出哪種類型的乳癌/幾期以及是否擴散?
感謝各位
Breast, right, 10 o'clock position/3 cm from nipple, core needle biopsy, ductal carcinoma in situ with invasions (invasive carcinomas and mucinous carcinoma)The specimen submitted consists of five tissue fragments measuring up to 1.7 x 0.1 x 0.1 cm in size, fixed in formalin. Grossly, they are gray and cordlike. All for section.Histologic type of right breast (10'/3) tumor: Mixed invasive carcinomas and mucinous carcinoma, some foci Histologic grade: Grade 1 (provisional in biopsy specimen) Tubule and
gland formation: < 10% (score: 3) Nuclear pleomorphism: Moderate (score: 1) Mitotic count: < 7/10 HPF (score: 1) Total score: 5 Histologic feature: Extensive spreading of ductal carcinoma in situ with some foci of invasions presenting infiltrative nests, strands and cords set in the sclerotic and desmoplastic stroma; presence of mucinous carcinoma Ductal carcinoma in situ (DCIS): Present Microcalcifications: Present in DCIS Peritumoral lymphovascular invasion: Not present in this small biopsy Perineural
invasion: Not present in this small biopsy Immunohistochemical stains (for invasions): p63: Loss of myoepithelial rimming Estrogen receptor (ER): < 1% Progesterone receptor (PR): < 1% HER2/neu protein: Positive, score 3+ Ki67 proliferation index: 5%
作者: aka79019 (阿卡)   2024-08-24 20:27:00
切片報告沒辦法看出是第幾期,腫瘤大小跟是否擴散才是判斷期別的依據,但這個要靠影像檢查才能知道
作者: luciferwing (殘念)   2024-08-25 09:24:00
好的了解 感謝回覆
作者: Euglena (婆娑之洋黑心之島)   2024-08-25 19:50:00
分化度很低的乳癌,或是預後很好的粘液性乳癌;分期從切片看不出來。
作者: fafagood (柯基大神)   2024-08-26 00:48:00
看起來是黏液性的導管癌DCIS,一般來說屬於預後較好的種類,但仍需要進一步檢查,需要注意的是ER/PR受體陰性而HER2陽性反應,需跟主治醫師討論是否需要使用標靶藥物
作者: luciferwing (殘念)   2024-08-26 16:28:00
好的~感謝樓上兩位的回覆
作者: eric15234 (布卡)   2024-09-09 16:23:00
這就是Her2 陽性的類型吧

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