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| Ductal Carcinoma in Situ |
| Etiology • Unknown |
| Pathogenesis • Some evidence that BRCA1 abnormalities already present in in situ disease • See discussion of infilatrating duct carcinoma for more details., |
| Epidemiology • Increasing age • More frequent in women of low parity with first child after 30 • Increased in obesity • Increased in women with history of atypical hyperplasia • Increased in women with history of breast carcinoma • Increased in women with mother or sibling with breast cancer |
| General Gross Description • May be associated with microcalcifications within the lumens • Gross findings may be of fibrocystic change • May form mass • In comedo variant cysts (dilated ducts) are filled with granular, yellow white material • May be associated with invasive carcinoma |
| General Microscopic Description • There are several varieties including papillary (delicate fibrovascular cores covered with atypical cells), cribriform (multiple lumens within a single duct), solid, micropapillary (tiny epithelial papillae), comedo (around necrotic center) and clinging in which only one to two abnormal cell layers "cling" to the basement membrane. • All show loss of typical bilayered epithelium • All show enlarged round to oval nuclei with nucleoli; comedo variety typically shows nuclear pleomorphism, hyperchromasia, large nucleoli and mitotic activity • All show loss of polarity towards lumen • All types may show intraluminal microcalcifications |
| Clinical Correlation • Increased risk of breast cancer 10 fold • Lesions are generally extirpated surgically with clear margins |
| References • Cotran RS, Kumar V, Robbins SL: Robbins Pathologic Basis of Disease. 5th edition. Philadelphia, W.B. Saunders, 1994, pp. 1099-1108. • Scully, R. et.al. Proc. Nat.Acad. Sci. 94(11): 5605-5610, 1997. |
| Ductal Carcinoma in Situ |
| Synopsis by: Melinda Sanders M.D. (T04000M85002)[305] |
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