Invasive breast carcinoma - IARC

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CHAPTER 2 Tumours of the Ovary and Peritoneum Tumours of the ovary represent about 30% of all cancers of the female genital system. Age-adjusted incidence rates are highest in the economically advanced countries where they are almost as common as cancers of the corpus uteri and invasive cancer of the cervix. Carcinomas of surface epithelial-stromal origin account for 90% of these cancers in North America and Western Europe. In some Asian countries, including Japan, germ cell tumours account for a significant proportion (20%) of ovarian malignancies. High parity and the use of oral contraceptives are consistently associated with a reduced risk of developing surface epithelial-stromal tumours while long-term estrogen replacement therapy appears to increase the risk in postmenopausal women.
WHO histological classification of tumours of the ovary Surface epithelial-stromal tumours Serous tumours Malignant Adenocarcinoma 8441 / 3 1 Surface papillary adenocarcinoma 8461/3 Adenocarcinofibroma (malignant adenofibroma) 9014/3 Borderline tumour 8442/1 Papillary cystic tumour 8462/1 Surface papillary tumour 8463/1 Adenofibroma, cystadenofibroma 9014/1 Benign Cystadenoma 8441/0 Papillary cystadenoma 8460/0 Surface papilloma 8461/0 Adenofibroma and cystadenofibroma 9014/0 Mucinous tumours Malignant Adenocarcinoma 8480/3 Adenocarcinofibroma (malignant adenofibroma) 9015/3 Borderline tumour 8472/1 Intestinal type Endocervical-like Benign Cystadenoma 8470/0 Adenofibroma and cystadenofibroma 9015/0 Mucinous cystic tumour with mural nodules Mucinous cystic tumour with pseudomyxoma peritonei 8480/3 Endometrioid tumours including variants with squamous differentiation Malignant Adenocarcinoma, not otherwise specified 8380/3 Adenocarcinofibroma (malignant adenofibroma) 8381/3 Malignant müllerian mixed tumour 8950/3 (carcinosarcoma) Adenosarcoma 8933/3 Endometrioid stromal sarcoma (low grade) 8931/3 Undifferentiated ovarian sarcoma 8805/3 Borderline tumour Cystic tumour 8380/1 Adenofibroma and cystadenofibroma 8381/1 Benign Cystadenoma 8380/0 Adenofibroma and cystadenofibroma 8381/0 Clear cell tumours Malignant Adenocarcinoma 8310/3 Adenocarcinofibroma (malignant adenofibroma) 8313/3 Borderline tumour Cystic tumour 8310/1 Adenofibroma and cystadenofibroma 8313/1 Benign Cystadenoma 8310/0 Adenofibroma and cystadenofibroma 8313/0 Transitional cell tumours Malignant Transitional cell carcinoma (non-Brenner type) 8120/3 Malignant Brenner tumour 9000/3 Borderline Borderline Brenner tumour 9000/1 Proliferating variant 9000/1 Benign Brenner tumour 9000/0 Metaplastic variant 9000/0 Squamous cell tumours Squamous cell carcinoma 8070/3 Epidermoid cyst Mixed epithelial tumours (specify components) Malignant 8323/3 Borderline 8323/1 Benign 8323/0 Undifferentiated and unclassified tumours Undifferentiated carcinoma 8020/3 Adenocarcinoma, not otherwise specified 8140/3 Sex cord-stromal tumours Granulosa-stromal cell tumours Granulosa cell tumour group Adult granulosa cell tumour 8620/1 Juvenile granulosa cell tumour 8622/1 Thecoma-fibroma group Thecoma, not otherwise specified 8600/0 Typical 8600/0 Luteinized 8601/0 Fibroma 8810/0 Cellular fibroma 8810/1 Fibrosarcoma 8810/3 Stromal tumour with minor sex cord elements 8593/1 Sclerosing stromal tumour 8602/0 Signet-ring stromal tumour Unclassified (fibrothecoma) Sertoli-stromal cell tumours Sertoli-Leydig cell tumour group (androblastomas) Well differentiated 8631/0 Of intermediate differentiation 8631/1 Variant with heterologous elements (specify type) 8634/1 Poorly differentiated (sarcomatoid) 8631/3 Variant with heterologous elements (specify type) 8634/3 Retiform 8633/1 Variant with heterologous elements (specify type) 8634/1 Sertoli cell tumour 8640/1 Stromal-Leydig cell tumour Sex cord-stromal tumours of mixed or unclassified cell types Sex cord tumour with annular tubules 8623/1 Gynandroblastoma (specify components) 8632/1 Sex cord-stromal tumour, unclassified 8590/1 Steroid cell tumours Stromal luteoma 8610/0 Leydig cell tumour group Hilus cell tumour 8660/0 Leydig cell tumour, non-hilar type 8650/1 Leydig cell tumour, not otherwise specified 8650/1 Steroid cell tumour, not otherwise specified 8670/0 Well differentiated 8670/0 Malignant 8670/3 Germ cell tumours Primitive germ cell tumours Dysgerminoma 9060/3 Yolk sac tumour 9071/3 Polyvesicular vitelline tumour Glandular variant Hepatoid variant Embryonal carcinoma 9070/3 114 Tumours of the ovary and peritoneum
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Previous volumes in this series Kle
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World Health Organization Classific
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Published by IARC Press, Internatio
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CHAPTER 1 Tumours of the Breast Can
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TNM classification of carcinomas of
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Invasive breast carcinoma I.O. Elli
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Rapid growth and greater adult heig
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tives, administrative and clerical
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Grade 1 - well differentiated: 3-5
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ent and this is occasionally extens
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Most melanotic tumours of the breas
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A Fig. 1.22 A Classic invasive lobu
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yet others at 90% {97,2147}. For pr
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Fig. 1.27 Medullary carcinoma. The
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myoepithelial cells in fibro a d e
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A Fig. 1.33 Neuroendocrine carcinom
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Macroscopy Fisher et al. reported t
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Fig. 1.39 Apocrine carcinoma. Note
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cells contain intracytoplasmic lume
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A Fig. 1.50 Carcinosarcoma. A Two a
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A B C Fig. 1.75 Lobular neoplasia.
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Intraductal proliferative lesions F
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A B absence of either microcalcific
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Fig. 1.83 Atypical ductal hyperplas
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A B Fig. 1.88 Large excision biopsy
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unusual variants as well. Using thi
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esemble those identified in invasiv
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A B Fig. 1.97 Microinvasive carcino
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A Papilloma may be subject to morph
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A B C Fig. 1.103 Papillary intraduc
Page 64 and 65: colour measuring from 0.5 to 12 cm.
Page 66 and 67: Immunoprofile The cases studied by
Page 68 and 69: Glycogen-rich, clear cell carcinoma
Page 70 and 71: Differential diagnosis There may be
Page 72 and 73: quality metaphase spreads from an i
Page 74 and 75: Fig. 1.67 Lobular carcinoma of brea
Page 76 and 77: detectable distant metastasis displ
Page 78 and 79: detected at a late stage as small t
Page 80 and 81: Extent of ductal carcinoma in situ
Page 82 and 83: Benign epithelial proliferations G.
Page 84 and 85: Fig. 1.112 Microglandular adenosis.
Page 86 and 87: A Apocrine adenoma ICD-O code 8401/
Page 88 and 89: A B Fig. 1.128 Adenomyoepithelioma,
Page 90 and 91: Mesenchymal tumours M. Drijkoningen
Page 92 and 93: 1113,1275}. There is a complex patt
Page 94 and 95: A B Fig. 1.137 A Lipoma. Intraparen
Page 96 and 97: Fig. 1.141 Angiosarcoma after breas
Page 98 and 99: A Fig. 1.144 Mammary osteosarcoma.
Page 100 and 101: Fibroepithelial tumours J.P. Belloc
Page 102 and 103: aged women (average age of presenta
Page 104 and 105: lished data suggests a 21% rate of
Page 106 and 107: A Fig. 1.157 Syringomatous adenoma
Page 108 and 109: Malignant lymphoma and metastatic t
Page 110 and 111: used. Inflammatory conditions in th
Page 112 and 113: male population both in the USA and
Page 116 and 117: Polyembryoma 9072/3 Non-gestational
Page 118 and 119: Surface epithelial-stromal tumours
Page 120 and 121: A Fig. 2.04 A Serous borderline tum
Page 122 and 123: A Fig. 2.06 Serous borderline tumou
Page 124 and 125: A Fig. 2.10 Invasive peritoneal imp
Page 126 and 127: Fig. 2.15 Mucinous carcinoma with i
Page 128 and 129: Fig. 2.20 Mucinous endocervical-lik
Page 130 and 131: A Fig. 2.28 Mucinous cystic tumour
Page 132 and 133: early secretory endometrium {2605}.
Page 134 and 135: IV, 6% {2233}. Patients with grade
Page 136 and 137: A Fig. 2.37 A This polypoid intracy
Page 138 and 139: Fig. 2.40 Endometrioid cyst with at
Page 140 and 141: 1 tumours are extremely rare. Almos
Page 142 and 143: Fig. 2.50 Borderline Brenner tumour
Page 144 and 145: express thrombomodulin and have bee
Page 146 and 147: serous and transitional cell carcin
Page 148 and 149: is yellow to tan with a variable ad
Page 150 and 151: Genetic susceptibility JGCTs may pr
Page 152 and 153: Clinical features F i b romas may b
Page 154 and 155: distinguishes this tumour from the
Page 156 and 157: A Fig. 2.77 A Retiform Sertoli-Leyd
Page 158 and 159: Mean ages of 21 and 38 years and me
Page 160 and 161: Tumours unassociated with PJS form
Page 162 and 163: mal origin without crystals of Rein
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Germ cell tumours F. Nogales A. Tal
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cases, anisokaryosis has no prognos
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ation may coexist in the same neopl
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Table 2.06 Grading of ovarian immat
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A B Fig. 2.102 A Mature cystic tera
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Diagnostic procedures Elevated urin
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associated with mature teratomas sh
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atives intimately admixed. The germ
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Fig. 2.113 Mixed germ cell-sex cord
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A Fig. 2.116 A Adenomatous hyperpla
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Fig. 2.117 Small cell carcinoma, hy
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Clinical features Adenoid cystic-li
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Histopathology This epithelial tumo
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sis. Corpus luteum of pregnancy has
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Lymphomas and leukaemias L.M. Roth
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Secondary tumours of the ovary J. P
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Occasionally, the colonic adenocarc
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Peritoneal tumours S.C. Mok J.O. Sc
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A B Fig. 2.140 Cystic adenomatoid m
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whelmingly poor {1038,1547,2310}. H
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CHAPTER 3 Tumours of the Fallopian
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TNM and FIGO classification of carc
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Endometrioid adenocarcinoma Endomet
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Two examples of adenofibroma of bor
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A Fig. 3.11 Adenomatoid tumour. A T
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Clinical features Patients range in
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Fig. 3.16 Uterus-like mass. The cys
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CHAPTER 4 Tumours of the Uterine Co
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TNM and FIGO classification of non-
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Epithelial tumours and related lesi
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endometrioid adenocarcinoma fro m a
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fers from the prototypical type I e
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the ovary and bladder. Unlike prima
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schema {1535,2602}. Although this c
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Table 4.03 Altered gene function in
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Mesenchymal tumours and related les
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areas are limited to less than 30%
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A B C Fig. 4.30 Leiomyosarcoma. A T
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e used sparingly and is reserved fo
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A B Fig. 4.38 Leiomyoma with perino
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cytological atypia, tumour cell nec
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Mixed epithelial and mesenchymal tu
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Prognosis and predictive factors Th
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tumours may superficially invade th
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A Fig. 4.46 A Gestational choriocar
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A Fig. 4.49 A Classic complete hyda
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Sex cord-like, neuroectodermal and
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Secondary tumours of the uterine co
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WHO histological classification of
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Epithelial tumours M. Wells J.M. Ne
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Fig. 5.04 Mechanisms of human papil
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Fig. 5.08 Keratinizing squamous cel
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in their Asian population {2957}. I
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have a strong association with high
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e red by squamous epithelium {380}.
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endometrioid adenocarcinoma of the
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metrial epithelium. In some cases t
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with distinct cell borders and a gr
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Mesenchymal tumours M.L. Carcangiu
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{781}, liposarcoma {2840,3016}, ost
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Mixed epithelial and mesenchymal tu
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Fig. 5.44 Wilms tumour. The tumour
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A Fig. 5.47 Implant of endometrial
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CHAPTER 6 Tumours of the Vagina Alt
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Epithelial tumours E.S. Andersen A.
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Aetiology The fact that both VAIN a
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Fig. 6.10 Fibroepithelial polyp.A m
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er of mitoses varies but is usually
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ICD-O codes Adenosquamous carcinoma
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A C Fig. 6.17 Sarcoma botryoides. A
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1-11 cm. They may arise anywhere in
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elsewhere in the female genital tra
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A Fig. 6.24 Yolk sac tumour. A The
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g rowing in sheets. Some may have s
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WHO histological classification of
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Epithelial tumours E.J. Wilkinson M
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even with additional sectioning, it
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type) is a highly diff e rentiated
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Clinical features Bartholin gland c
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glandular elements surrounded by fi
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Mesenchymal tumours R.L. Kempson M.
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Table 7.03 Differential diagnosis o
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Prognosis and predictive factors A
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Table 7.04 Clark levels of cutaneou
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A Fig. 7.23 Vulvar peripheral primi
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Familial aggregation of cancers of
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BRCA1 syndrome Definition Inherited
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dispose individuals to the developm
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Fig. 8.05 To assess whether wild-ty
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Fig. 8.07 Factors that modify risk
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BRCA2 syndrome R. Eeles S. Piver S.
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tubal or ovarian carcinomas. Howeve
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in typical nuclear foci that may re
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Breast tumours Frequency Breast can
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Fig. 8.14 Codon distribution of som
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Breast tumours Age distribution and
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Hereditary non-polyposis colon canc
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essary in the evaluation of the pat
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Age distribution and penetrance Mos
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Contributors Dr Vera M. ABELER** De
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Dr Carlo LA VECCHIA Laboratory of E
Page 366 and 367:
Dr Manuel TEIXEIRA Department of Ge
Page 368 and 369:
02.100 Dr. A. Ostor 02.101 Dr. F.A.
Page 370 and 371:
52. Akhtar M, Robinson C, Ashraf Al
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180. Bapat K, Brustein S (1989). Ut
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307. Bolis GB, Maccio T (2000). Cle
Page 376 and 377:
436. Chang J, Sharpe JC, A'Hern RP,
Page 378 and 379:
562. Costa MJ, Ames PF, Walls J, Ro
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689. Di Domenico A, Stangl F, Benni
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820. Falck J, Petrini JH, Williams
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943. Gad A, Azzopardi JG (1975). Lo
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1067. Grimes MM (1992). Cystosarcom
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1197. Herod JJ, Shafi MI, Rollason
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1323. Jacques SM, Qureshi F, Ramire
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1449. Khalifa MA, Mannel RS, Harawa
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1564. Lagios MD (1977). Multicentri
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1687. Loman N, Johannsson O, Kristo
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1807. McCluggage G, McBride H, Maxw
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1937. Mukai M, Torikata C, Iri H (1
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2056. Norris HJ, Taylor HB (1967).
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2180. Park JS, Jones RW, McLean MR,
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2304. Puls LE, Hamous J, Morrow MS,
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2 4 3 4 . Rosen PP, Groshen S, Saig
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2559. Schlesinger C, Silverberg SG
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2686. Silverberg SG (1999). Protoco
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2806. Stutz JA, Evans AJ, Pinder S,
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2942. Tornos C, Silva EG, Ordonez N
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3061. Wargotz ES, Norris HJ (1990).
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3189. Yoshioka T, Tanaka T (2000).
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References 425
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Biphasic teratomas, 168 BLM, 341, 3
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G GADD45, 343, 353 GCDFP-15, 25, 33
Page 428 and 429:
MPNST, see Malignant peripheral ner
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Small cell / oat cell carcinoma, 32
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