Invasive breast carcinoma - IARC

A
Fig. 2.06 Serous borderline tumour, typical pattern. A The epithelial papillae show hierarchical and complex branching without stromal invasion. B Higher magnification
shows stratification and tufting of the epithelium with moderate atypia.
B
located within empty stromal spaces, but
vascular space invasion occurs in 10% of
cases. In 87% of the 39 re p o rted cases
the invasive cells were of the eosinophilic
cell type {203,2867}. The lymph nodes
w e re rarely assessed as part of staging for
these tumours. Tumour cells, mainly of the
eosinophilic cell type, were found in thre e
nodes (obturator, external iliac, and paraa
o rtic) from two women {203,2867}.
Prognosis and predictive factors
The behaviour of SBTs with micro i n v a s i o n
is similar to that of SBTs without micro i n v a-
sion. In one series long-term follow-up was
available in 11 cases with a 5-year survival
of 100% and a 10-year survival of 86%
{2285}. Unilateral salpingo-oophore c t o m y
is currently acceptable therapy for young
women who wish to preserve fertility.
Serous borderline tumour
Definition
An ovarian tumour of low malignant
potential exhibiting an atypical epithelial
proliferation of serous type cells greater
than that seen in their benign counterp
a rts but without destructive stro m a l
invasion.
Synonyms
Serous tumour of low malignant potential,
serous tumour of borderline malignancy.
The designation "atypical pro l i f e r a t i v e
s e rous tumour" is not re c o m m e n d e d
because it discourages complete surgical
staging {2285} and because long
t e rm follow up indicates that some
patients with typical SBT do not follow a
benign course {3946].
Epidemiology
Patients with SBT are approximately 10-
15 years younger than those with serous
carcinoma (i.e. 45 years vs. 60 years).
About 30-50% of SBTs are bilateral.
Clinical features
Signs and symptoms
The tumour is often asymptomatic but
may rarely present with abdominal
enlargement or pain due to rupture of a
cystic tumour or torsion. In younger
women SBT has been associated with a
high rate of infertility {2894a}.
Macroscopy
The tumour may be cystic with a variable
number of excrescences, form a solid
purely surface papillary growth or have a
combination of these appearances. In
A
Fig. 2.07 Serous borderline tumour with micropapillary pattern. A Note the filigree papillae with non-hierarchical processes. B Peritoneal cytology shows a threedimensional
papillary-like tumour cell formation with low grade nuclear atypia mixed with mesothelial and inflammatory cells.
B
Surface epithelial-stromal tumours 121