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Clinical history
52-year-old woman with a 22 mm screen-detected mass in the upper outer quadrant of the left breast. Core biopsy performed.
Infiltrating cords and tubules of atypical epithelial cells within a desmoplastic stroma. Moderate nuclear pleomorphism. Mitotic activity moderate. No definite lymphovascular invasion in this sample.
Diagnostic question
What is the most likely diagnosis and what ancillary studies would you request?
Reveal differential diagnosis
Invasive lobular carcinoma
Sclerosing adenosis
Radial scar with entrapped glands
Reveal final diagnosis
Invasive carcinoma of no special type, NHG grade 2
Learning points
Assess tubule formation, nuclear pleomorphism and mitotic count for grading
Request ER, PR, HER2 and Ki-67 on the biopsy
Look carefully for lymphovascular invasion at the periphery
Self-assessment
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All whole-slide images in this library are anonymised and used under appropriate licence. Cases are provided for education only and must not be used for clinical diagnosis.