Difference between revisions of "Non-invasive breast carcinoma"

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*Diagnosis based on nuclear abnormalities ''and'' architecture.
*Diagnosis based on nuclear abnormalities ''and'' architecture.
*It is typically picked-up during radiologic screening.
*It is typically picked-up during radiologic screening.
===Subtypes===
Subtypes are based on architecture:
*Solid.
**No spaces between cells.
*Cribriform.
**Honeycomb-like appearance: circular holes.
**"Cookie cutter" appearance/"punched-out" appearance/"Roman bridges" -- cells surround the circular holes.
*Papillary.
**Papillae with fibrovascular cores.
*Micropapillary.
**Small papillae without fibrovascular cores.
**Have "drum stick" shape.
NOTE: ''comedonecrosis'' - used to be considered a separate subtype -- essentially ''solid'' type DCIS with [[necrosis]].


===Microscopic===
===Microscopic===
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Note:
Note:
*Apocrine changes of cytoplasm -- nuclei should be ~4x RBC for low grade, 5x RBC for high grade.<ref>URL: [http://surgpathcriteria.stanford.edu/breast/dcis/apocrinedcis.html http://surgpathcriteria.stanford.edu/breast/dcis/apocrinedcis.html]. Accessed on: 4 August 2011.</ref>
*Apocrine changes of cytoplasm -- nuclei should be ~4x RBC for low grade, 5x RBC for high grade.<ref>URL: [http://surgpathcriteria.stanford.edu/breast/dcis/apocrinedcis.html http://surgpathcriteria.stanford.edu/breast/dcis/apocrinedcis.html]. Accessed on: 4 August 2011.</ref>
====Subtypes====
Subtypes are based on architecture:
*Solid.
**No spaces between cells.
*Cribriform.
**Honeycomb-like appearance: circular holes.
**"Cookie cutter" appearance/"punched-out" appearance/"Roman bridges" -- cells surround the circular holes.
*Papillary.
**Papillae with fibrovascular cores.
*Micropapillary.
**Small papillae without fibrovascular cores.
**Have "drum stick" shape.
NOTE: ''comedonecrosis'' - used to be considered a separate subtype -- essentially ''solid'' type DCIS with [[necrosis]].


====Grading DCIS====
====Grading DCIS====
Graded 1-3 (low-high)<ref>URL: [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>URL: [http://surgpathcriteria.stanford.edu/breast/dcis/ http://surgpathcriteria.stanford.edu/breast/dcis/]. Accessed on: 4 August 2011.</ref> - compare lesional nuclei to one another.
*Grade 1:  
*Grade 1:  
**Nuclei 2-3x size of RBC.
**Nuclei 2-3x size of RBC.
**NO necrosis.
**No necrosis.
*Grade 2:  
*Grade 2:  
**Nuclei 2-3x size of RBC.
**Nuclei 2-3x size of RBC.
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