Basics of Bronchioloalveolar Carcinoma (BAC)

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Bronchioloalveolar carcinoma, or BAC, is a unique subtype of non-small cell lung cancer (NSCLC) that has unique features in terms of the demographics of who gets it, how it appears on scans, how it often behaves, and potentially in how it responds to treatment. It is a subset of lung cancer for which most of what we know emerged in the last 10 years, with our understanding of this entity, and even the definition of BAC, still evolving. What is BAC? BAC was first identified and defined as a separate subtype of lung cancer by Dr.

Watching Small Lung Lesions Do Nothing: "Ground Glass Opacities" Don't Progress Over Years If They're Watched, Not Resected

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In one of my earliest posts about bronchioloalveolar carcinoma (BAC) (in the dark ages, pre-Twitter), I wrote on the subject of managing small BAC-type lesions, which tend to appear as small hazy areas called "ground glass opacities" (GGOs) and suggested that some of these cancers may be so indolent that they don't need to be treated, even if they have the word "carcinoma" in the diagnosis.

BAC No More?

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The most expert lung cancer pathologists in the world are planning a revision of the classification of lung adenocarcinomas that is expected to be approved and implemented next year, and it's going to make some big changes. Specifically, it's planning to eliminate the diagnosis of bronchioloalveolar carcinoma (BAC), reflecting our evolving understanding of this disease.

Tales from the Clinic: Mucinous BAC

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In my last post I outlined the typical clinical scenario for pneumonic bronchioloalveolar carcinoma (BAC), which is typically the mucinous subtype of this unusual disease. In fact, we are still actively learning a great deal about BAC, enough for the lung cancer experts to begin to develop a more sophisticated view that the mucinous and non-mucinous subtypes have different behaviors and respond differently to treatments.

Pneumonic BAC: The Subtype Very Unlike Other Forms of BAC

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One of the issues with BAC is that I've referred to it as potentially very indolent, but as we've learned more about BAC, it's become clear that there is a great degree of heterogeneity in BAC cases. We're learning that the cases that are more often slowly progressing and sometimes exceptionally responsive to EGFR inhibitors like tarceva and iressa are far more likely to be non-mucinous BAC. These typically have the appearance of innumerable small nodules throughout the lungs.