The diagnosis and management of pre-invasive breast disease: ductal carcinoma in situ (DCIS) and atypical ductal hyperplasia
(ADH)current definitions and classification.
Atypical ductal hyperplasia
and ductal carcinoma in situ can occasionally show extravasated mucin.
The radiating ducts often demonstrate a spectrum of nonproliferative and proliferative change, including columnar cell change, adenosis, apocrine metaplasia, ductal hyperplasia
, and papillomata (Figure 7, D).
Needle core biopsies containing coexisting atypical ductal hyperplasia
(ADH), lobular carcinoma in situ (LClS)/atypical lobular hyperplasia (ALH), and papillary lesions were excluded.
38,64,65) Bratthauer et al (64) reported that CK903 demonstrated a perinuclear cytoplasmic staining pattern in 100% (40 of 40) of the classic lobular intraepithelial neoplasias (atypical lobular hyperplasia and LCIS) and, in contrast, was negative in all 20 cases (100%) of classic ductal intraepithelial neoplasias (atypical ductal hyperplasia
[ADH] and DCIS).
In the Nurses' Health Study, (18,19) the Mayo Clinic Cohort, (20) and the Nashville Cohort, (21,22) 4% to 9% of breast biopsies contained atypical ductal hyperplasia
(ADH) or atypical lobular hyperplasia (ALH).
9) Alternatively, the staining pattern of CK5/6 is extremely helpful in differentiating usual ductal hyperplasia
from atypical ductal hyperplasia
(ADH) and DCIS.
Discrepancy in interpretations between reads using either WSI or OM by the same pathologist and between pathologists occurred with selected lesions such as florid hyperplasia, atypical ductal hyperplasia
, ductal carcinoma in situ with or without microinvasion, and papillary lesions.
Myoepithelial cells are present in the normal mammary duct system and are often prominent in benign lesions, such as usual ductal hyperplasia
, sclerosing adenosis, and intraductal papilloma.
At the low end of the spectrum, low-grade DCIS needs to be distinguished from atypical ductal hyperplasia
28-32) Losses of 16q and gains of 1q are also seen in other ER+ proliferations, including columnar cell lesions and well-differentiated, invasive ductal carcinoma, including tubular carcinoma, low-grade DCIS, and atypical ductal hyperplasia
, establishing the genetic homogeneity between these lesions.
Those smears with suspicious cell clumps and features suggestive of ductal hyperplasia