Ductal Carcinoma in Situ of the Breast
Grading / Staging / Report
- We use the following grading criteria (Van Nuys)
- Low grade DCIS
- Nuclei 2-3x the size of a RBC (10-15 microns)
- Nuclei oval, round, regular, evenly dispersed chromatin up to mildly irregular and minimally pleomorphic
- Nucleoi, if present, small and indistinct
- Intermediate grade DCIS
- Same nuclear features as Low Grade
- Substantial tumor cell (comedo) necrosis present
- High grade DCIS
- Nuclei >3x the size of a RBC (>15 microns)
- Nuclei pleomorphic with clumped chromatin
- Nucleoli prominent, enlarged
- Necrosis almost universal, lumenal
- Staging not applicable
- The surgical pathology report should contain or address the following:
- Type of resection or biopsy and location
- Type of DCIS
- Grade of DCIS
- Size of lesion
- Distance to closest margin
- Presence of calcifications if they were the reason for the biopsy
- Results of any supplementary studies performed
