Histological subtypes of ductal carcinoma in situ of the breast.
BACKGROUND
It has become common to divide ductal carcinoma in situ (DCIS) of the breast into two main groups, comedo or noncomedo by tumor morphology. But noncomedo DCIS can be further stratified into several morphological patterns that exhibit several different growth patterns and most DCIS lesions have more than one pattern. In this study, DCIS elements were classified by morphological pattern and the association between predominant or recessive elements of DCIS lesions and clinicopathological findings was evaluated.


METHODS
DCIS lesions from 46 patients were studied regarding the histological architectural patterns: comedo, cribriform, papillary, solid and micropapillary. The predominant architectural pattern which comprised more than 50% of the cells of the cancerous lesion was defined as the major element of the tumor and minor elements consisted of less than 50% but more than 25% of cells comprising the tumor.


RESULTS
Of 24 tumors containing a comedo pattern as the major or minor element, 9 (38%) had microscopic intraductal spread over 2 cm and 11 (46%) had involvement of lobules, which was significantly higher than that observed in other types. Of 20 tumors containing a cribriform pattern as the major or minor element, 8 (40%) had microscopic intraductal spread over 2 cm and 9 (45%) had involvement of lobules, which was significantly higher than that seen in other types. Of 10 tumors containing a papillary type as the major or minor element, 5 (50%) had discrete multicentric lesions in the ipsilateral or contralateral breast, which was significantly higher than that seen in other types.


CONCLUSIONS
DCIS lesions containing a comedo or cribriform element are more likely to have microscopic spread and involvement of lobules and DCIS lesions containing a papillary element are likely to be multicentric, whether the pattern are predominant in the tumor or not.
Ajisaka
Hideyuki
H
Department of Surgery II, School of Medicine, Kanazawa University, Takara-machi 13-1, Japan. ajihide@sun1.tch.pref.toyama.jp
Tsugawa
Koichiro
K
Noguch
Masakuni
M
Miwa
Miwa
M
Nonomura
Akitaka
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000473:pathology*; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000473:pathology*; D002291:Carcinoma, Papillary / Q000473:pathology; D005260:Female; D006801:Humans; D008875:Middle Aged; D009362:Neoplasm Metastasis