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Das Mammakarzinom aus pathohistologischer Sicht

  • A. Reiner
Part of the Angewandte Onkologie book series (AONKOLOGIE)

Zusammenfassung

Aus pathohistologischer Sicht sind Epithelhyperplasien der Mamma als wesentliche Risikofaktoren für die Entwicklung eines invasiven Karzinoms einzustufen. Dazu zählen lobuläre und duktale Epithelhyperplasien. Bei den duktalen Epithelhyperplasien werden solche mit und solche ohne Zellatypien unterschieden. Bei duktalen Epithelhyperplasien ohne Zellatypien ist das Risiko, ein invasives Karzinom zu entwickeln, nur unwesentlich um 1,5–2fach gegenüber der Allgemeinpopulation gesteigert [1]. Im Gegensatz dazu sind duktale und lobuläre Epithelhyperplasien mitAtypien ein wesentlicher Risikofaktor. Hier ist die Erwartung, in den nächsten 10–20 Jahren ein invasives Karzinom zu entwickeln, 4–5 x größer als in einer altersentsprechenden Vergleichsgruppe [1]. Den größten Risikofaktor stellt das Carcinoma lobulare in situ dar. Das Risiko für ein invasives Karzinom ist hier 10–11 x größer [2–4]. Subsequente invasive Karzinome treten in annähernd gleicher Häufigkeit in der ipsilateralen und kontralateralen Mamma auf [2, 5]. Mehr als ein Drittel der invasiven Karzinome entwickelt sich erst nach mehr als 20 Jahren [2]. Das Risiko aller Epithelhyperplasien wird noch durch das Vorliegen einer Familienanamnese mit Mammakarzinom gesteigert [6]. Allerdings kommen Epithelhyperplasien mit gesteigertem Karzinomrisiko relativ selten vor. Atypische duktale Hyperplasien sind in ca. 2% bis 6% aller Mammabiopsien zu finden, jedoch bei jungen Frauen seltener als bei alten Frauen. Atypische lobuläre Hyperplasien machen ca. 1% der Mammabiopsien aus und werden vor allem perimenopausal diagnostiziert.

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© Springer-Verlag/Wien 1992

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  • A. Reiner

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