Ductal carcinoma in situ: Difference between revisions
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At least a '''low/intermediate/high''' grading (by Van Nuys criteria) as follows:<ref>{{cite web|url=http://surgpathcriteria.stanford.edu/breast/dcis/grading.html|title=Ductal Carcinoma in Situ of the Breast|website=Stanford Medical School|date=2020-08-27}}</ref> | |||
;Low grade DCIS | ;Low grade DCIS | ||
*Nuclei 10-15 microns (2-3 times the size of a red blood cell) | *Nuclei 10-15 microns (2-3 times the size of a red blood cell) | ||
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*Nucleoli are prominent, enlarged | *Nucleoli are prominent, enlarged | ||
*Necrosis is almost universal and lumenal | *Necrosis is almost universal and lumenal | ||
{{Moderate-begin}}Use these to give a '''numerical grading''' as follows:<ref name="Allred2010">{{cite journal|last1=Allred|first1=D. C.|title=Ductal Carcinoma In Situ: Terminology, Classification, and Natural History|journal=JNCI Monographs|volume=2010|issue=41|year=2010|pages=134–138|issn=1052-6773|doi=10.1093/jncimonographs/lgq035}}</ref> | |||
{|class=wikitable | |||
!rowspan=2| Feature !!colspan=3| Points !! | |||
|- | |||
! 1 !! 2 !! 3 | |||
|- | |||
! Nuclear grade | |||
|- | |||
! Glands/papillae | |||
| >75% || 10% - 75% || <10% | |||
|- | |||
! Mitotic rate (per 10 HPF) | |||
| <1 || 1 - 2 || >2 | |||
|- | |||
! Central necrosis | |||
| <10% || 10% - 50% || >50% | |||
|} | |||
The points for each feature are added together, giving the following result:<ref name="Allred2010"/> | |||
*4 - 7 points: '''Grade 1''' | |||
*8 - 9 points: '''Grade 2''' | |||
*10 - 12 points: '''Gerade 3''' | |||
{{Bottom}} | {{Bottom}} | ||
Revision as of 09:33, 15 October 2020
Author:
Mikael Häggström [note 1]
Comprehensiveness
On this resource, the following formatting is used for comprehensiveness:
- Minimal depth
- (Moderate depth)
- ((Comprehensive))
Gross examination
As per:
or mastectomy.
Microscopic evaluation
Malignant epithelial cells confined to the ductal system of the breast.[1]
Differential diagnoses
- Invasive ductal carcinoma
- Has invasion through the basement membrane.[1]
There is no single definite cutoff, but the following are suggested cutoffs defining a ductal carcinoma in situ:[2]
- Size over 2 mm.
- Involving more than one duct.
Grading
At least a low/intermediate/high grading (by Van Nuys criteria) as follows:[3]
- Low grade DCIS
- Nuclei 10-15 microns (2-3 times the size of a red blood cell)
- Nuclei oval, round, regular, evenly dispersed chromatin up to mildly irregular and minimally pleomorphic
- Nucleoi, if present, are small and indistinct
- Intermediate grade DCIS
- Same nuclear features as low grade
- Substantial tumor cell (comedo) necrosis is present
- High grade DCIS
- Nuclei >15 microns (over 3 times the size of a red blood cell)
- Nuclei are pleomorphic with clumped chromatin
- Nucleoli are prominent, enlarged
- Necrosis is almost universal and lumenal
(Use these to give a numerical grading as follows:[4]
| Feature | Points | |||
|---|---|---|---|---|
| 1 | 2 | 3 | ||
| Nuclear grade | ||||
| Glands/papillae | >75% | 10% - 75% | <10% | |
| Mitotic rate (per 10 HPF) | <1 | 1 - 2 | >2 | |
| Central necrosis | <10% | 10% - 50% | >50% | |
The points for each feature are added together, giving the following result:[4]
- 4 - 7 points: Grade 1
- 8 - 9 points: Grade 2
- 10 - 12 points: Gerade 3
Notes
- ↑ For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Patholines:Authorship for details.
Main page
References
- ↑ 1.0 1.1 Siziopikou, Kalliopi P. (2013). "Ductal Carcinoma In Situ of the Breast: Current Concepts and Future Directions ". Archives of Pathology & Laboratory Medicine 137 (4): 462–466. doi:. ISSN 0003-9985.
- ↑ Tozbikian, Gary; Brogi, Edi; Vallejo, Christina E.; Giri, Dilip; Murray, Melissa; Catalano, Jeffrey; Olcese, Cristina; Van Zee, Kimberly J.; et al. (2016). "Atypical Ductal Hyperplasia Bordering on Ductal Carcinoma In Situ ". International Journal of Surgical Pathology 25 (2): 100–107. doi:. ISSN 1066-8969.
- ↑ . Ductal Carcinoma in Situ of the Breast. Stanford Medical School (2020-08-27).
- ↑ 4.0 4.1 Allred, D. C. (2010). "Ductal Carcinoma In Situ: Terminology, Classification, and Natural History ". JNCI Monographs 2010 (41): 134–138. doi:. ISSN 1052-6773.
Image sources