Definition of Ductal Carcinoma In Situ (DCIS) and Lobular Carcinoma In Situ (LCIS)

  • Ductal carcinoma in situ (DCIS):
    • Is noninvasive carcinoma of the breast
    • Is defined as:
      • The proliferation of malignant epithelial cells confined to the mammary ducts and without evidence of invasion through the basement membrane
      • Is an intra ductal proliferation of malignant epithelial cells within the tubulolobular system of the breast with no evidence of invasion across the basement membrane
    • Because it is noninvasive:
      • DCIS does not pose a risk of metastasis
    • There appears to be a continuum between flat epithelial atypia, atypical ductal hyperplasia (ADH), and DCIS:
      • With DCIS being the final step in the pathway prior to the development of invasive disease
    • Both clinical risk factors and molecular changes associated with malignant transformation:
      • Are similar between DCIS and invasive cancer
    • The coexistence of DCIS and invasive carcinoma within one lesion:
      • Suggests that DCIS acts as a precursor lesion to invasive carcinoma
    • Further evidence of the capacity to progress:
      • Is that half of all recurrences after breast-conserving surgery (BCS) for DCIS, with or without adjuvant treatment:
        • Are invasive.
  • Lobular carcinoma in situ:
    • Although previously considered a form of noninvasive carcinoma:
      • Lobular carcinoma in situ (LCIS) is now understood to be:
        • A pathologic marker of increased bilateral breast cancer risk
    • Atypical lobular hyperplasia (ALH) and LCIS:
      • Are both forms of lobular neoplasia and, together with atypical ductal hyperplasia (ADH):
        • Represent proliferative nonmalignant breast lesions

#Arrangoiz #CancerSurgeon #BreastSurgeon #SurgicalOncologist #BreastCancer #LCIS #DCIS #DuctalCarcinomaInsitu #LobularNeoplasia #LobularCarcinomaInsitu #Surgeon #Teacher #Miami #Mexico #MSMC #MountSinaiMedicalCenter

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