Low-grade adenosquamous carcinoma of the breast: a review with focus on imaging and management

Romanucci, Giovanna; Mercogliano, Sara; Carucci, Elisabetta; Lunardi, Maria; Caneva, Andrea; Benassuti, Chiara; Quaglia, Andrea; Fornasa, Francesca

doi:10.1177/20584601211013501

Cited by 7 publications

(17 citation statements)

References 38 publications

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“…No clear benefit was found with adjuvant therapy after an adequate local excision. 21,22 In conclusion, LGASC is a rare but important entity in the differential diagnosis of small glandular proliferations. It has some unique but not entirely specific histopathological features, including squamous differentiation, cuffing desmoplastic stroma and peripheral lymphocytic aggregates.…”

Section: Discussionmentioning

confidence: 92%

“…Routine sentinel node biopsy and axillary dissection may not be necessary in view of the rarity of nodal metastasis in the literature. No clear benefit was found with adjuvant therapy after an adequate local excision 21,22 …”

Section: Discussionmentioning

confidence: 99%

“…Given the indolent behaviour of LGASC, local excision with negative margins is probably sufficient, provided that the lymph nodes are clinically unremarkable. 10,17,21,22 Routine sentinel node biopsy and axillary dissection may not be necessary in view of the rarity of nodal metastasis in the literature. No clear benefit was found with adjuvant therapy after an adequate local excision.…”

Section: Discussionmentioning

confidence: 99%

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Low‐grade adenosquamous carcinoma of the breast: a clinical, morphological and immunohistochemical analysis of 25 patients

et al. 2023

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Aims Due to its rarity and non‐specific clinical and pathological features, low‐grade adenosquamous carcinoma (LGASC) of the breast continues to pose diagnostic challenges. Unlike other triple‐negative breast carcinomas, LGASC tends to have an indolent clinical behaviour. It is essential to recognise this lesion for accurate diagnosis and appropriate management. Methods and results Twenty‐five cases of LGASC were identified in our archives and collaborating institutes. Cases of LGASC with dominant coexisting other type carcinomas were excluded. We studied the clinical presentation, morphological features, patterns of the commonly used immunohistochemical stains and follow‐up. In our cohort, LGASC was commonly located at the outer aspect of the breast and associated with intraductal papilloma. The morphology of LGASC is characterised by infiltrating small glands and nests with variable squamous differentiation. We also found cuffing desmoplastic (fibrolamellar) stromal change in 75% of patients and peripheral lymphocytic aggregates in 87.5% of patients. P63 and smooth muscle myosin (SMM) were the most common myoepithelial markers used to assist in diagnosis. P63 often stained peripheral tumour cells surrounding invasive glands (circumferential staining in 80% of the cases), mimicking myoepithelial cells. It also stained the small nests with squamous differentiation. However, SMM was negative in 63% of the cases. The vast majority of our cases were triple‐negative; only a few had focal and weak expressions of ER and PR. One patient who did not have excision developed lymph node metastasis. Most patients underwent excision or mastectomy with negative margins as surgical treatment; there were no recurrences or metastases in these patients with clinical follow‐ups up to 108 months. Conclusions LGASC has some unique, although not entirely specific, morphological features and immunohistochemical staining patterns. Fibrolamellar stromal change, peripheral lymphocytic aggregates and variable staining of p63 and SMM are valuable features to facilitate the diagnosis.

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Low‐grade adenosquamous carcinoma of the breast: a clinical, morphological and immunohistochemical analysis of 25 patients

et al. 2023

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“…In 1912, Konjentzny first described adenosquamous findings in a breast tumor case. Rosen and Ernsberger first coined the term “LGASC” for breast in 1987 after studying and integrating eleven similar cases [ 2 , 3 ]. The World Health Organization (WHO) breast cancer classification in 2019 classifies ASC as a variant of metaplastic breast carcinoma.…”

Section: Discussionmentioning

confidence: 99%

“…There is currently no proposed optimal treatment for ASC, given its rarity. There is documentation of management ranging from local excision only to excision with 1 cm margins if lymph nodes are unaffected [ 3 ]. Since the current literature mentions local recurrence, it has led to the implementation of aggressive management with wide breast excision.…”

Section: Discussionmentioning

confidence: 99%

Adenosquamous Carcinoma of the Breast: Case Report and Literature Review

Priyadarshini¹,

Ali²,

Kasireddy³

2022

Cureus

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Low-grade adenosquamous breast carcinoma (LGASC) is an atypical variant of metaplastic breast cancer. It differs from metaplastic carcinoma and has an indolent behavior. It usually presents as a palpable lump, unlike in our case, which had an incidental presentation. Because of its rarity, it often creates a clinical and diagnostic challenge. With the risk of local recurrence, the current management is aggressive with excision. Chemoradiation has been used in a few cases, but optimal management is unclear. Our manuscript aims to add to the existing knowledge on LGASC.

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Molecular pathology in breast disease: diagnostic, prognostic, and therapeutic tools

Varga,

Maccio

2023

Virchows Arch

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Molecular testing in breast cancer gained increasing attention and importance as specific molecular results can tailor not only oncological decisions on systemic adjuvant or neoadjuvant or in metastatic setting, but increasingly serve in diagnostic routine histopathological services to differentiate between morphologically overlapping or ambiguous histological pictures. Diagnostic tools involve in most cases a broad spectrum of immunohistochemical panels, followed by entity-specific in situ hybridization probes and in given cases NGS-based sequencing. Workflow of which methodology is applied and in which order depends on the specific entity resp. on the given differential diagnosis in question. Regarding prognostic/predictive molecular testing, the choice of assay and the workflow are based on clinical algorithms and on the evidence of targeted therapies following the molecular alterations. In this review paper, we aim to address the use of molecular technics in [1] the histological diagnostic setting (such as subtyping of invasive carcinomas/malignant spindle cell tumors and sarcomas and some B3 lesions) and [2] in the context of adjuvant or neoadjuvant or other clinical settings with special focus of targeted therapies.

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Low-grade adenosquamous carcinoma of the breast: a review with focus on imaging and management

Cited by 7 publications

References 38 publications

Low‐grade adenosquamous carcinoma of the breast: a clinical, morphological and immunohistochemical analysis of 25 patients

Low‐grade adenosquamous carcinoma of the breast: a clinical, morphological and immunohistochemical analysis of 25 patients

Adenosquamous Carcinoma of the Breast: Case Report and Literature Review

Molecular pathology in breast disease: diagnostic, prognostic, and therapeutic tools

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