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László Tabár, M.D. FACR (Hon)
Pathophysiology, histopathologic-imaging correlation.
The similarity between the structure and function of the breast and prostate has been known for a long time, but there are serious discrepancies in the terminology describing breast and prostate cancers. The use of the large, thick-section (3D) histopathology technique for both organs exposes the contradictions inherent to the current breast cancer terminology. Pathologists with expertise in diagnosing prostate cancer take the anatomic site of cancer origin into account when using the terms AAP (acinar adenocarcinoma of the prostate) and DAP (ductal adenocarcinoma of the prostate) to distinguish between the prostate cancers originating from the fluid-producing acinar portion of the organ (AAP) and the tumors originating either purely from the larger ducts (DAP) or from both the acini and the main ducts combined (DAP and AAP). Long-term patient outcome is closely correlated with this terminology, because patients with DAP have a significantly poorer prognosis than patients with AAP.
The current breast cancer terminology could be improved by modeling it after the method of classifying prostate cancer to reflect the anatomic site of breast cancer origin: acinar adenocarcinoma of the breast (AAB) and ductal adenocarcinoma of the breast (DAB), having an excellent correlation with patient outcome.