How is DCIS?

➢ DCIS has a wide variety of histologic appearances, including solid, comedo, cribriform, papillary, micropapillary, and "clinging” types. ➢ Nuclear appearances range from bland and monotonous (low nuclear grade) to pleomorphic (high nuclear grade). ➢ The distinctive comedo subtype is characterized by extensive central necrosis, which produces toothpastelike necrotic tissue that extrudes from transected ducts on application of gentle pressure. ➢ Calcifications frequently are associated with DCIS ➢ constitutes only 5% of breast cancers in unscreened populations but up to 30% in screened populations, largely because of the ability of mammography to detect calcifications. ➢ Current treatment strategies for DCIS use surgery and irradiation to eradicate the lesion. ➢ Treatment with anti-estrogenic agents such as tamoxifen also is used to decrease the risk of recurrence of ER-positive DCIS. ➢ The prognosis is excellent, with greater than 97% long-term survival. ➢ If untreated, DCIS progresses to invasive cancer in roughly one-third of cases, usually in the same breast and quadrant as the earlier DCIS