Pathology of Ductal Carcinoma In Situ (DCIS)

Rodrigo Arrangoiz MS, MD, FACS, FSSO
  • DCIS is a proliferation of malignant cells that have not breached the ductal basement membrane:
    • They arise from ductal epithelium:
      • In the region of the terminal ductal–lobular unit (TDLU)
  • DCIS had previously been considered one stage in the continuum of histologic progression from ADH to invasive carcinoma:
    • But, in fact, DCIS comprises a heterogeneous group of lesions:
      • With variable histologic architecture, molecular and cellular characteristics, and clinical behavior
  • Malignant cells proliferate:
    • Until the ductal lumen is obliterated
    • There is an associated breakdown of the myoepithelial cell layer of the basement membrane surrounding the ductal lumen
  • DCIS has also been linked with changes in the surrounding stroma resulting in:
    • Fibroblast proliferation
    • Lymphocyte infiltration
    • Angiogenesis
  • Thus, although the process is poorly understood:
    • Most but not all invasive ductal carcinomas are believed to arise from DCIS:
      • Which is considered a nonobligate precursor of invasive breast carcinoma
Architectural heterogeneity is a common feature of DCIS. Even in the same lesion, DCIS may show different growth patterns. Image is showing a cribriform DICS
Micropapillary DCIS
Papillary DCIS
Solid DCIS

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

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Published by Rodrigo Arrangoiz MS, MD, FACS, FSSO

My name is Rodrigo Arrangoiz I am a breast surgeon/ thyroid surgeon / parathyroid surgeon / head and neck surgeon / surgical oncologist that works at Center for Advanced Surgical Oncology in Miami, Florida. I was trained as a surgeon at Michigan State University from (2005 to 2010) where I was a chief resident in 2010. My surgical oncology and head and neck training was performed at the Fox Chase Cancer Center in Philadelphia from 2010 to 2012. At the same time I underwent a masters in science (Clinical research for health professionals) at the University of Drexel. Through the International Federation of Head and Neck Societies / Memorial Sloan Kettering Cancer Center I performed a two year head and neck surgery and oncology / endocrine fellowship that ended in 2016. Mi nombre es Rodrigo Arrangoiz, soy cirujano oncólogo / cirujano de tumores de cabeza y cuello / cirujano endocrino que trabaja Center for Advanced Surgical Oncology en Miami, Florida. Fui entrenado como cirujano en Michigan State University (2005 a 2010 ) donde fui jefe de residentes en 2010. Mi formación en oncología quirúrgica y e n tumores de cabeza y cuello se realizó en el Fox Chase Cancer Center en Filadelfia de 2010 a 2012. Al mismo tiempo, me sometí a una maestría en ciencias (investigación clínica para profesionales de la salud) en la Universidad de Drexel. A través de la Federación Internacional de Sociedades de Cabeza y Cuello / Memorial Sloan Kettering Cancer Center realicé una sub especialidad en cirugía de cabeza y cuello / cirugia endocrina de dos años que terminó en 2016.

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