Tag Archives: Ductal Carcinoma In Situ

Breast – DCIS

Ductal Carcinoma In Situ (DCIS)
  • Neoplastic proliferation resembling small ducts with expanded duct and acinar structures
  • Myoepithelial cell layer is intact surrounding the neoplastic proliferation (non-invasive tumor)
  • Typically express E-Cadherin
  • Bilateral in 10-20% of cases
  • Detected by mammography (not clinically evident)
  • Represents 15-30% of neoplasms identified in screening populations
  • Typically identified by abnormal calcification, sometimes as abnormal densities
Comedo DCIS
  • High grade pleomorphic nuclei
  • Central necrosis
Non-comedo DCIS
  • Lacks either high grade nuclei or central necrosis
  • Subtypes/patterns
    • Solid DCIS
    • Micropapillary DCIS
    • Cribiform DCIS
  • DCIS grading
    • Low-grade DCIS
      • 1%/year risk of developing an invasive carcinoma
    • Intermediate-grade DCIS
    • High-grade DCIS
Paget Disease
  • Nipple manifestation of disease (1-4% of cases) – looks like eczema on the nipple
  • Tumor cells extend into the epidermis of the skin overlying the nipple from underlying DCIS within the ductal system of the breast.
  • 50-60% of women will have an underlying palpable mass
    • Vast majority will have an invasive carcinoma (often ER neg./Her-2 pos.)
    • Women without a palpable mass will usually only have DCIS
Photomicrographs
Breast - High Grade DCIS
High power view of high grade breast DCIS.
Breast - High Grade DCIS
High power view of breast high grade DCIS.
Smooth Muscle Myosin - High Grade DCIS
Smooth Muscle Myosin – High Grade DCIS
Smooth Muscle Myosin - High Grade DCIS
Smooth Muscle Myosin – High Grade DCIS
Smooth Muscle Myosin - High Grade DCIS
Smooth Muscle Myosin – High Grade DCIS
References

Kumar, Vinay, Abul K. Abbas, and Jon C. Aster. Robbins and Cotran Pathologic Basis of Disease. Ninth edition. Philadelphia, PA: Elsevier/Saunders, 2015.