Adenocarcinoma of the breast
Breast adenocarcinoma can almost be thought of as an over-arching term for ‘breast cancer‘. An adenocarcinoma refers to a type of carcinoma that begins in glandular tissue (cells with a secretory function), such as the ducts and lobules of the breast. So, breast cancers which begin in the ducts or lobules are sometimes called adenocarcinomas, though the term can be applied to cancers of glandular tissue anywhere in the body.
This page is still great for research, however, we have created a newer & more up-to-date page on Adenocarcinoma, though. You should check it out.
Each breast typically has about 15 to 20 sections called ‘lobes‘ and many smaller sections called ‘lobules‘.The lobules produce the milk, which is secreted into the ducts, and carried towards the nipple. Most breast cancers will start in either the breast ducts or the breast lobules, and because of the glandular tissue which comprises much of the ducts and lobules, these breast cancers are referred to as adenocarcinomas. The two main types of adenomacarcinoma are therefore infiltrating or invasive ductal carcinoma, and infiltrating or invasive lobular carcinoma. Lobular adenocarcinoma is actually much less common and tends to have a much better prognosis than ductal carcinoma. Invasive lobular carcinomas account for about 10-15% of breast cancers.
Around 80% of breast cancers are the infiltrating ductal carcinoma variety of adenocarcinoma, but there are also a number or rarer, specialized forms of adenocarcinoma, none of which account for more than 6% of breast cancers. Inflammatory breast cancer accounts for between 1% and 6% of breast carcinomas, while medullary breast carcinoma is estimated at 3%-5% of breast cancers. Mucinous breast carcinoma accounts for about 3%, tubular breast carcinoma for 1%-2%, and cribriform breast carcinoma for 5%-6%. Finally, there is papillary breast carcinoma which is estimated at between 1% to 2% of all breast cancers. (Some would include invasive lobular carcinoma within this specialized group). There are of course many other subtle variations and hybrid presentations of this core group of specialized adenocarcinomas.
Certain immunochemical stains can determine if a suspected breast cancer is adenocarcinoma
Part of the histological evaluation of breast biopsy specimens usually involves the staining of a cytological sample for microscopic evidence of various proteins or hormones. Analysis of this staining process can help determine the feasibility of adjuvant chemotherapy, but prior to that, the process can greatly assist in the differential diagnosis of breast cancers. For examples, approximately 72% of breast adenocarcinomas over express the H19 gene as compared to healthy tissues. (Normal breast tissue does not express H19 RNA in the mammagry glands, except during puberty and pregnancy). Hormonal receptors for estrogen (ER) and progesterone (PR), the Wilms tumor susceptibility gene 1 (WT1) and gross cystic disease fluid protein (GCDFP) are also useful for diagnosing breast adenocarcinomas.
Below are some handy Q&A…
- What are the treatments for invasive adenocarcinoma of the breast? Breast cancer surgery, chemotherapy, or radiation treatment.
- What are the two main types of adenocarcinoma? Ductal carcinomas and lobular carcinomas are the two most common types.
- Where does adenocarcinoma start? It starts in the ducts or lobules of the breast.
- What are the symptoms of invasive ductal carcinoma? Lump in the breast, thickening of the breast skin, rash or redness of the breast, swelling in a breast, new pain in the other breast, dimpling around the nipple or on the breast skin, nipple pain or the nipple turning inward, nipple discharge, lumps in the underarm area, changes in the appearance of the nipple or breast that are different from the normal monthly changes a women experiences.
- What treats ductal carcinoma? Lumpectomy, mastectomy, sentinel node biopsy, axillary node dissection, breast reconstruction, radiation, chemotherapy, hormonal therapy, or biologic targeted therapy.
- What are the symptoms of lobular carcinoma? In the earliest stages, lobular carcinoma may cause no signs nor sympsoms. As it grows larger though, it may cause an area of thickening in part of the breast, a new area of fullness or swelling in the breast, a change in the texture or appearance of the skin over the breast (such as dimpling or thickening), and an inverted nipple. Lobular carcinoma is less likely than other forms to cause a firm breast lump.
- What treats lobular carcinoma? Lumpectomy or mastecomy, depending on the size and location of the tumor. Chemotherapy and/or radiation, hormonal therapy or biologic targeted therapy may be recommended as well. To be sure the cancer has been removed, the surgeon must clear the cancer from the tissue all the way around the tumor, including any growth that may not be evident on imaging. In some cases, re-excision is necessary.
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- Bassioukas K, Nakuci M, Dimou S, Kanellopoulou M, Alexis I . Zosteriform cutaneous metastases from breast adenocarcinoma. Journal of the European Academy of Dermatology and Venereology (2005), 19(5):593-6