Ductal carcinoma in situ: Difference between revisions

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*Size over 2 mm.
*Size over 2 mm.
*Involving more than one duct.
*Involving more than one duct.
===Grading===
Criteria by Van Nuys are 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
*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
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{{Bottom}}

Revision as of 19:20, 27 August 2020

Author: Mikael Häggström [note 1]

Gross examination

As per:

or mastectomy.

Microscopic evaluation

File:DCIS - Intraductal carcinoma of the breast.jpg

Malignant epithelial cells confined to the ductal system of the breast.[1]

Differential diagnoses

Invasive ductal carcinoma
Has invasion through the basement membrane.[1]
Atypical ductal hyperplasia

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

Criteria by Van Nuys are 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

Notes

  1. ↑ 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. ↑ 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:10.5858/arpa.2012-0078-RA. ISSN 0003-9985. 
  2. ↑ 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:10.1177/1066896916662154. ISSN 1066-8969. 
  3. ↑ . Ductal Carcinoma in Situ of the Breast. Stanford Medical School (2020-08-27).

Image sources


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