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Difference between revisions of "Non-invasive breast carcinoma"
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Non-invasive breast carcinoma (view source)
Revision as of 00:02, 29 November 2010
, 00:02, 29 November 2010→Ductal neoplasia: change hierarchy
(+ADH, more on lobular hyperplasia, re-organize) |
(→Ductal neoplasia: change hierarchy) |
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#Ductal carcinoma in situ (DCIS). | #Ductal carcinoma in situ (DCIS). | ||
The difference between ADH and DCIS ''is'': | |||
#The degree of '''nuclear atypia'''; high grade is DCIS. | |||
#The '''extent'''; small lesions are ADH, large lesions (low-grade) DCIS. | |||
==Ductal carcinoma in situ== | ==Ductal carcinoma in situ== | ||
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NOTE: ''comedonecrosis'' - used to be considered a separate subtype -- essentially ''solid'' type DCIS with necrosis. | NOTE: ''comedonecrosis'' - used to be considered a separate subtype -- essentially ''solid'' type DCIS with necrosis. | ||
=== | ===Microscopic=== | ||
Features: | |||
*Nuclear pleomorphism -- most important feature. | *Nuclear pleomorphism -- most important feature. | ||
*Nuclear size - compared to RBCs to grade DCIS. | *Nuclear size - compared to RBCs to grade DCIS. | ||
| Line 48: | Line 48: | ||
**Nuclei spaced equally. | **Nuclei spaced equally. | ||
===Size criteria for DCIS=== | ====Size criteria for low-grade DCIS==== | ||
DCIS must meet the following size criteria:<ref name=Ref_BP168>{{Ref BP|168}}</ref> | DCIS must meet the following size criteria:<ref name=Ref_BP168>{{Ref BP|168}}</ref> | ||
* | *Two membrane-bound spaces - ''OR'' - 2 mm. | ||
*If it isn't DCIS... it's atypical ductal hyperplasia (ADH). | **If it isn't (low-grade) DCIS... it's atypical ductal hyperplasia (ADH). | ||
The treatment is similar; ADH and DCIS are both excised. | The treatment is similar; ADH and DCIS are both excised. | ||
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*Radiation treatment - DCIS is irradiated; ADH does ''not'' get radiation. | *Radiation treatment - DCIS is irradiated; ADH does ''not'' get radiation. | ||
===Grading DCIS=== | ====Grading DCIS==== | ||
Graded 1-3 (low-high)<ref>[http://surgpathcriteria.stanford.edu/breast/dcis/ http://surgpathcriteria.stanford.edu/breast/dcis/]</ref> - compare lesional nuclei to one another. | Graded 1-3 (low-high)<ref>[http://surgpathcriteria.stanford.edu/breast/dcis/ http://surgpathcriteria.stanford.edu/breast/dcis/]</ref> - compare lesional nuclei to one another. | ||
*Grade 1 | *Grade 1 | ||