Histological Features of DCIS
Histologically, DCIS exhibits a variety of architectural patterns, which include
comedo,
solid,
cribriform,
papillary, and
micropapillary. These patterns can sometimes occur in combination within the same lesion.
Comedo Type: Characterized by high-grade nuclei and central necrosis, often resulting in calcifications that can be detected on mammograms.
Solid Type: Consists of malignant cells filling the ductal lumen without forming any specific patterns.
Cribriform Type: Features multiple, small, round spaces within the ducts, giving it a sieve-like appearance.
Papillary Type: Identified by the presence of fibrovascular cores covered by malignant epithelial cells.
Micropapillary Type: Exhibits small, delicate, finger-like projections within the ducts.
Clinical Significance of DCIS
DCIS is often asymptomatic and is typically detected through
screening mammography due to the presence of microcalcifications. Although it is non-invasive, if left untreated, DCIS can progress to invasive ductal carcinoma, which has a greater potential to metastasize and pose serious health risks.
Treatment Options
Treatment for DCIS aims to prevent progression to invasive cancer and usually includes surgical options such as
lumpectomy or
mastectomy. Depending on the tumor's characteristics, additional therapies such as
radiation therapy or
hormonal therapy may be recommended.
Prognosis
The prognosis for DCIS is generally excellent, especially when detected early and treated appropriately. The risk of recurrence or progression to invasive cancer is significantly reduced with appropriate treatment.
