Piernicola Machin

Anatomia PatologicaP.O. De Gironcoli

ConeglianoResp. dott.ssa Lucia Bittesini

L.D., 50 anni,microcalcificazioni QIE dx

EE 10xEE 10x

EE 10x

EE 20x

EE 40x

EE 20x

EE 40x

B2B3

B5

B2B3

B5

DIAGNOSI.

Parenchima mammario con focolai di iperplasia dutto-lobulare a fisionomia apocrina con lieve atipia e necrosi intraduttale,

associata a calcificazioni grossolane. Focale, puntiforme e irregolarepositività per proteina p63, proteina 100 e actina 1A4.

DIN1b/DIN1c (IDA/DCIS BG)

QUADRANTECTOMIA

+

LINFONODO SENTINELLA

+SVUOTAMENTO LINFONODALE

EE 5x

EE 10x

EE 40x

EE 40x

DIAGNOSI su QUAD

Condizione post-mammotome con reazione cicatrizialein fase di consolidamento...associata alla presenza di focolaio

di neoplasia duttale intraepiteliale ben differenziata.La neoplasia si associa a numerosi cluster di calcificazioni

di tipo displasico.pTisN0(sn), G1

DIN1c (DCIS BG)

Follow-up

PatologoRadiologo

ChirurgoOncologo

GRAZIE

B2 B3

Although follow-up excision cannot be strongly recommended in ALH and FEA, it should be considered since the upgrade risk is not negligibleAlthough follow-up excision cannot be strongly recommended in ALH and FEA, it should be considered since the upgrade risk is not negligible

ADH lesions with significant cytologic atypia and/or necrosis are most likely to be associated with carcinoma and should be excised. ADH without these features, regardless of extent of involvement, and with [95% removal of the targeted calcifications, is associated with a minimal risk (\3%) of carcinoma and may undergo mammographic follow-up only.

ADH lesions with significant cytologic atypia and/or necrosis are most likely to be associated with carcinoma and should be excised. ADH without these features, regardless of extent of involvement, and with [95% removal of the targeted calcifications, is associated with a minimal risk (\3%) of carcinoma and may undergo mammographic follow-up only.

Ann Surg Oncol. 2010 Oct 23.

122 biopsie(B3)

91 sintomatiche 31 screening

1845 biopsie in 3 anni

FEA 18%

ADH

90%B 10%M

90%B90%BESCISSIONE

Current management of FEA is best achieved through a multidisciplinary review considering various factors to determine if surgical excision is warranted. Further

studies are required to elucidate the malignant potential of this columnar cell lesion.

The American Journal of Surgery