Ductal Carcinoma in Situ of the Breast
Definition
- A lesion composed of neoplastic ductal cells, without stromal invasion
Diagnostic Criteria
- Low and intermediate grade DCIS require cytologic, architectural and size criteria to be met
- High grade DCIS requires only cytologic criteria
- Link below to separate pages for each grade for complete criteria or select Grading at left for summary
- Low grade
- Round, regular to mildly irregular nuclei up to 2-3x the size of a RBC
- No comedo necrosis
- Intermediate grade
- Round, regular to mildly irregular nuclei up to 2-3x the size of a RBC
- Substantial comedo necrosis
- High grade
- Pleomorphic nuclei >3x the size of a RBC
- Substantial comedo necrosis usually present, not required
- Low grade
- Usual architectural types (see detailed descriptions on the various grades, links above)
- Useful for recognition and description but grade is more clinically useful
- Cribriform
- Micropapillary
- Solid (mosaic, microacinar)
- Comedo
- Special types
- Criteria for minimal stromal invasion
Richard L Kempson MD
Department of Pathology
Stanford University School of Medicine
Stanford CA 94305-5342Original posting:: October 14, 2006