Track 1: Breast Pathology:-
Meaning Of Breast Pathology:-
The core needle breast biopsies, incisional and excisional biopsies, lumpectomy or partial and total mastectomy specimens, sentinel lymph nodes, axillary dissections, prophylactic and oncoplastic reduction mammoplasty, as well as neoadjuvant breast cases are all examined and interpreted in the Breast Pathology programme.
In situations when a cancer diagnosis has been made, it is highlighted that additional ancillary examinations for receptors have turnaround times of two to three days. To guarantee that our patients obtain reliable, precise statistics that are crucial to patient care, we work closely with our clinical team.
The significance of breast pathology:-
Breast cancer is typically diagnosed after a change is found during a breast check or mammography. The following step is usually a breast core biopsy, which involves taking a small sample of breast tissue and giving it to a pathologist. A pathologist is a doctor who specialises in identifying cancer and other diseases using tissue samples and a microscope.
However, pathologists are crucial to the care of cancer patients. They describe the many types of breast cancer, their severity, and their defects.
Numerous illnesses that thousands of breast cancer patients are dealing with, in our opinion, are degrading their quality of life.
These issues were discovered by a thorough examination of the literature and consultations with subject-matter authorities. Practitioners of breast pathology, radiography, surgery, cancer, and related fields who are employed in cooperative, academic, and community contexts.
The Male Breast Cancer Pathology:-
The variability of male breast disease is comparable to that found in females. Despite the fact that the terminal lobular unit is often lacking in males, lobular carcinomas have been seen in both in situ and invasive forms in various studies. 16,100,101 Almost all histologic conditions documented in women have also been observed in men. Men with a range of histologic subtypes, the most prevalent of which is invasive papillary carcinoma, exhibit a comparable but more apparent prevalence of ductal pathology. There were divergent patterns of p21, p53, pRb, Ki-67, and DNA ploidy expression in a study of 50 consecutive male and 50 consecutive female breast cancer patients, suggesting separate paths of tumour formation. The most common sites for metastatic behaviour seem to be the lung, adrenal, and bone, and they resemble those of female patients.
Cancer Committee Staging System:-
The American Joint Committee on Cancer (AJCC) staging system uses the same criteria for both men and women, with lymph node involvement and tumour size being significant predictors of outcome. Breast cancer in men tends to present with larger tumours, a higher frequency of node-positive disease (37 percent vs. 22 percent), more frequent multinodal involvement (62.5 percent vs. 20.7 percent), and a larger median size of nodal metastases, according to a comparison of male and female patients from 1999 to 2005. (10 vs. 3 mm). Even while males are more likely to have chest wall fixation than women are, this does not seem to have the same negative effects on the prognosis. The relative frequency of this observation in males is explained by the breast’s typical anatomical closeness to the skin and muscle.
Although ductal carcinomas are the most prevalent kind, males have a different distribution due to in situ illness, which is seldom identified. Up to 40% of all mammographically diagnosed tumours in women under the age of 50 may be DCIS. In comparison, DCIS may make up as little as 5% of all male breast malignancies. According to reports, in situ malignancies are diagnosed at ages 85 and 104, respectively, earlier and later than invasive tumours. Metastases to lymph nodes are uncommon, however, they have been documented. 104 None of the 31 males with DCIS who were reviewed showed lymph node involvement. In comparison to women, who seldom show nipple discharge due to DCIS, 35% of males with pure DCIS come with nipple discharge as one of their presenting symptoms. The majority of tumours are low- and intermediate-grade, although high-grade DCIS is more frequently linked to invasive malignancy. According to Cutuli and colleagues, papillary subtypes are more prevalent, with comedo carcinoma representing just 10% of male DCIS cases.
Mammography Screening:-
The relative rarity of DCIS in men may be due to the lack of screening mammography as a method of detection. However, an analysis of 84 males with pure DCIS found that 38% had microcalcifications that were identified histologically. This finding suggests that screening mammography may offer a method for early diagnosis in this small population of individuals. It is believed that the widespread use of mammography is responsible for the sharp rise in DCIS in female patients. The frequency of in situ illness in males without mammographic screening is comparable to previous data reported in women with the palpable disease. Younger age at diagnosis (57 years) is linked to the coexistence of in situ and invasive illness, indicating that DCIS may be a precursor to the more prevalent invasive ductal variant. Theoretically, equal numbers of in situ cancers may be seen in men and women if screening mammography were consistently introduced in males.
Less than 2% of males get contralateral breast cancer.
This reflects a somewhat lower but comparable incidence when compared to women. Men have been reported to have inflammatory breast cancer, notwithstanding its rarity. The superficial dermal lymphatics are invaded, just like in women, which causes edoema and vascular congestion. It causes hyperemia and peau d’orange, which results in inflammatory clinical signs. In addition to nipple ulceration, bleeding, and crust development, Paget’s disease of the nipple frequently exhibits an accompanying tumour and palpable adenopathy. The treatment for invasive ductal carcinoma in males is similar.
