Rare morphological appearance of breast carcinoma

Clinical question

This is a case of an elderly woman who presented symptomatically and on examination was found to have a multifocal breast cancer. An ultrasound-guided axillary node biopsy was carried out.

Review the high-quality, interactive digital Aperio slide at http://virtualacp.com/JCPCases/jclinpath-2018-205079/ and consider your diagnosis.

What is your diagnosis?

DCIS in axillary breast tissue with dense lymphocytic infiltrate

Metastatic carcinoma of the breast with DCIS-like morphology

Primary carcinoma in axillary tail breast tissue

Primary carcinoma arising in ectopic breast tissue in the axillary node

Primary invasive carcinoma with DCIS and lymphocytic infiltrate

The correct answer is after the discussion.

Discussion

This core biopsy shows nodal tissue with well-circumscribed islands of malignant cells showing central comedo necrosis and focal calcification. The appearances resemble solid ductal carcinoma in situ (DCIS) with luminal calcifications and comedo necrosis. However, careful...

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