Article and Video CATEGORIES

Cancer Journey

Search By

Dr. Jack West is a medical oncologist and thoracic oncology specialist, and Executive Director of Employer Services at the City of Hope Comprehensive Cancer Center in Duarte, CA.

Lung Cancer Video Library - Bronchioloalveolar Carcinoma (BAC): What is It?
Fri, 05/29/2015 - 06:00
Author
Howard (Jack) West, MD, Associate Clinical Professor, Medical Oncology, Executive Director, Employer Services, Founder, President and CEO of GRACE
Image
GRACE Cancer Video Library - Lung

GCVL_LU-AA01_Bronchioloalveolar Carcinoma (BAC): What is It?

Bronchioloalveolar carcinoma (BAC), also known as adenocarcinoma in situ, is an unusual subtype of lung cancer with its own appearance under a microscope and on imaging. Dr. Jack West introduces some of the basics of the unique features of BAC.

 

Download PDF Transcript

 

 

Transcript

One of the unusual sub-types of lung cancer is called bronchioloalveolar carcinoma, or BAC. In fact, it’s a pretty controversial type of cancer, with its own behavior and its own prognosis. It also goes by a few potentially different names. The older name for it is BAC, bronchioloalveolar carcinoma, but some pathologists use a new terminology and call it adenocarcinoma in situ. We’ll talk more about what that means, but the behavior tends to be quite unusual.

GCVL_LU-AA01 - BAC intro slide 1b

When you look at it under a microscope, it has its own appearance that does not invade or make solid tumors that go into the lung tissue. Instead, it has what’s called a lepidic pattern. Lepidic means scale-like, and so it really causes just a thin lining that overlies the thin air sacks for the lungs, but that interferes with the ability of the lungs to exchange air. Because of that, it causes shortness of breath and a cough in many people, at least if there is a significant size to the area involved.

GCVL_LU-AA01 - BAC intro slide 2b

BAC can be quite variable. It can be just a very tiny little nodule, it can be multiple spots throughout the lungs, or it can be very large areas of confluent involvement in one or more lungs. And of course, the more of the lung that’s involved, the more severe a patient’s symptoms tend to be.

It has a unique appearance because it tends not to grow invading into tissues and then jumping into the blood and spreading elsewhere — it’s really limited to the lungs only. We will often see a pattern of diffused haziness within the lungs on a chest x-ray or a CAT scan and sometimes you’ll see a spattering of lots of nodules within the lungs as its own pattern.

One of the newer terms for it is adenocarcinoma in situ, and this implies a pre-malignant condition. By that, it means that it is not actually a life-threatening cancer, and this speaks to the often very favorable prognosis of these lesions, at least when they’re smaller and a solitary spot in the lungs. In those cases, when they’re taken out, they have a nearly 100% survival at 5 years. However, the survival is more variable when patients have multiple nodules or when they have larger areas involved.

In addition, the term adenocarcinoma in situ really applies to a non-mucinous cancer, and there are other adenocarcinomas that make mucin, a product of what becomes phlegm or mucus, that patients will sometimes cough up. If patients have cancer that does make this mucin, it tends not to have as favorable a prognosis.

We’ll talk more about how multi-focal BAC is managed in a separate video.

Video Language

Next Previous link

Previous PostNext Post

Related Content

Image
Mandarin LCVL
Video
王林医生用普通话讨论重要的肺癌信息。这些信息包括靶向治疗、晚期疾病的症状、循环肿瘤 DNA、治疗方案等。我们鼓励您与社区中说普通话的人分享。 Dr. Lin Wang discusses important lung cancer information in Mandarin. This information includes targeted therapy, symptoms of advanced disease, circulating tumor DNA, treatment options, and more. We encourage you to share this with the Mandarin speakers in your community. To watch the complete Playlist visit: https://www.youtube.com/playlist?list=PLWsyUmdjLXhGnSxobmz4CBP3pxAj7nDa…;  
Image
Tell your story!  Apply now for the Clinical Trials Experiences through Storytelling Program
Article
We are excited to launch our third year of this program; tell your story and help us help others! Apply Online Now!     GRACE Patient Perspectives: Clinical Trials Experiences Storytelling Program Overview  
Image
Blood Cancer OncTalk
Video
Blood Cancer OncTalk was a live presentation that brought together top oncologists to discuss emerging concepts and treatment options in blood cancer. The program was chaired by Dr. Aaron Goodman, with the participation of Dr. Mazie Tsang, Hematologist / Oncologist; Dr. Autumn Jeong, Hematologist / Oncologist; Dr. Shaji Kumar, Hematologist / Oncologist; and Dr. Sridevi Rajeeve, Hematologist / Oncologist.

Forum Discussions

Hi Caregiver and welcome to Grace.  I'm sorry that you need to be here and hope we can help.  Osimertinib has better efficacy than gefitinib (including OS and reaching the brain)...

Hi Bob, Welcome to Grace.  I'm sorry about your sil.  Unfortunately, cancer becomes resistant to TKIs like tagrisso.  Sometimes all of the cancer becomes resistant at once and sometimes just parts...

Recent Comments

JOIN THE CONVERSATION
Hi Tammy,  Welome to Grace. …
By JanineT GRACE … on Tue, 05/16/2023 - 13:44
Concerned
By Tndiuka10 on Fri, 05/12/2023 - 21:13
Hi Caregiver and welcome to…
By JanineT GRACE … on Fri, 05/12/2023 - 14:20
Hi Bob, Welcome to Grace.  I…
By JanineT GRACE … on Tue, 05/02/2023 - 12:29