Ductal carcinoma in situ
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