Original ContributionsAtypical ductal hyperplasia and ductal carcinoma in situ of the breast associated with perineural invasion*,**
Section snippets
Material and methods
Ten thousand consecutive breast biopsy specimens from the files of the Breast Pathology Consultation Service at Vanderbilt University Medical Center (Nashville, TN) were reviewed, and all cases with a diagnosis of perineural invasion by epithelial glands were selected. Invasive mammary carcinomas were excluded. Histologic evaluation was performed by using hematoxylin and eosin–stained sections, and the associated underlying breast lesions were classified by using published diagnostic criteria.14
Results
Fourteen cases of perineural invasion were found and associated with the following diagnoses: ADH (5), DCIS (3), FH without atypia (5), and ductal adenoma (1). Nine cases developed within a background of CSL/RS (Fig 1), 4 cases in SA, and 1 case in a previous biopsy site of ductal adenoma (Table 1).
Discussion
In the current series, 14 cases of perineural invasion by epithelial glands associated with DCIS, ADH, or FH are described. Perineural invasion is a phenomenon previously described in benign breast lesions such as SA, fibrocystic change,8, 9, 10 syringomatous adenoma of the nipple,11, 12 and nerve sheath myxoma.19 To our knowledge, there is only one report of perineural invasion associated with DCIS13 and no published articles on this histologic feature associated with ADH. Thirteen of 14 cases
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2021, Journal of Bone OncologyCitation Excerpt :However, disease-free survival of PNI-positive breast cancer patients was not different from that of PNI-negative breast cancer patients. Further, in the breast, benign lesions such as atypical ductal hyperplasia and ductal carcinoma in situ are also associated with PNI [76]. Thus, prognostic importance of PNI in breast cancer remains to be determined.
Perineural spread of cancer
2020, Neuro-Oncology for the Clinical NeurologistClinical impact of celiac ganglia metastasis upon pancreatic ductal adenocarcinoma: Celiac Ganglia Metastases
2020, PancreatologyCitation Excerpt :EPNI may also occur early in the disease course [8,9]. Perineural invasion is most closely linked to PDAC and melanoma, but has also been reported in many other cancer types [10–17]. In patients with PDAC, surgical pathology and autopsy specimens commonly demonstrate microscopic cancer cell infiltration surrounding individual nerve fibers, with CG metastasis rarely reported (5).
Perineural and intraneural involvement in ductal carcinoma in-situ of breast: Case report
2019, Pathology Research and PracticeCitation Excerpt :Subsequent reports further confirmed this finding in the breast (Table 1) [3]. Most of these studies have shown the associated breast pathology to be cysts, adenosis, papillomatosis, oncocytic metaplasia, periductal inflammation, radial scars, atypical ductal hyperplasia, florid hyperplasia and ductal adenoma with epithelial cells involving nerve bundles [3–9] with a higher propensity in papillomatosis and sclerosing adenosis [4,5]. The presence of nerve invasion by bland-looking epithelium of mammary glands or ducts with benign appearance of the background process makes the etiopathogenesis uncertain.
Small Glandular Proliferations of the Breast
2012, Surgical Pathology ClinicsCitation Excerpt :Sclerosing adenosis may secondarily involve radial scars, intraductal papillomas, and fibroadenomas. Invasion of peripheral nerves may be seen in sclerosing adenosis, and carcinoma should not be diagnosed based on this finding (Fig. 5).13,14 Foci of sclerosing adenosis and, in some cases, even histologically unremarkable ducts may show pseudoinfiltrative growth into adipose tissue, giving the glands an appearance that resembles invasive carcinoma (Fig. 6A, B).
Sclerosing Lesions: Sclerosing Adenosis, Radial Scar/Complex Sclerosing Lesion, and Microglandular Adenosis
2011, Breast Pathology: A Volume in the Series: Foundations in Diagnostic Pathology
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Supported in part by the Division of Anatomic Pathology (Breast Consultation Service), Vanderbilt University Medical Center, Nashville, TN; and Conselho Nacional de Desenvolvimento Científico e Tecnológico/Brazil (300070/88-8, NV).
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Address correspondence and reprint requests to David L. Page, MD, Vanderbilt University Medical Center Department of Pathology, Medical Center North, 2201 West End Ave, Nashville, TN 37232-2561.