A 45-year-old woman has a 2.5 cm palpable breast mass. Core biopsy shows invasive carcinoma with solid nests, central comedo-type necrosis, and high mitotic rate. Immunohistochemistry is positive for E-cadherin. What is the most likely diagnosis?
- A Invasive lobular carcinoma
- B Invasive ductal carcinoma, no special type ✓
- C Medullary carcinoma
- D Mucinous carcinoma
Correct answer: B. Invasive ductal carcinoma, no special type
Explanation
High-grade invasive ductal carcinoma (NST) frequently shows central necrosis and high mitotic rate. E-cadherin positivity confirms ductal lineage and excludes lobular carcinoma. Medullary carcinoma has a syncytial pattern and lymphoid infiltrate but lacks comedo necrosis. Mucinous carcinoma pools extracellular mucin and typically has a low mitotic rate.
Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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