DCIS: Types and Clinical Behavior
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Questions and Answers

What is the risk of developing invasive breast cancer?

  • Moderate
  • High (correct)
  • Low
  • Unknown

    • How often is DCIS detected as a palpable mass?

  • Never
  • Less frequently (correct)
  • Sometimes
  • Frequently

    • What is the chance of developing invasive carcinoma if left untreated for the Comedo type of DCIS?

  • 30%
  • 0%
  • 50%
  • 100% (correct)

    • What is Paget's disease of the breast?

    <p>A rare manifestation of breast cancer</p> Signup and view all the answers

    What is the characteristic presentation of Paget's disease of the breast?

    <p>A unilateral erythematous eruption with a scale crust</p> Signup and view all the answers

    What is the frequency of Paget's disease of the breast?

    <p>1-2% of breast cancers</p> Signup and view all the answers

    What is the characteristic histology of LCIS?

    <p>Monomorphic small round cells filling the acini of lobules</p> Signup and view all the answers

    What is the risk of developing invasive carcinoma for LCIS if left untreated?

    <p>30% after 20 years</p> Signup and view all the answers

    What percentage of invasive breast carcinomas are of the lobular type?

    <p>10% to 15%</p> Signup and view all the answers

    Which type of breast carcinoma is characterized by a pushing border and a syncytial arrangement of tumor cells?

    <p>Medullary carcinoma</p> Signup and view all the answers

    What is the approximate percentage of mucinous (colloid) carcinoma amongst all breast carcinomas?

    <p>2% to 5%</p> Signup and view all the answers

    What is the general prognosis for breast cancer patients, considering the risk factors mentioned?

    <p>Neutral, as both genetic and hormonal factors play a role</p> Signup and view all the answers

    What percentage of ductal carcinoma in situ (DCIS) is associated with invasive carcinoma?

    <p>20% to 30%</p> Signup and view all the answers

    What is the primary difference between ductal carcinoma in situ (DCIS) and lobular carcinoma in situ (LCIS)?

    <p>DCIS is confined to the ducts, while LCIS is confined to the lobules</p> Signup and view all the answers

    What is the typical histological feature of ductal carcinoma in situ (DCIS)?

    <p>Malignant cells that are confined to the duct system</p> Signup and view all the answers

    What is the name of the type of carcinoma in situ that is associated with a high risk of invasive carcinoma?

    <p>Ductal carcinoma in situ</p> Signup and view all the answers

    What is a characteristic of Invasive Ductal Carcinoma, NOS?

    <p>They have a firm, hard, and irregular border with small foci of chalky white stroma</p> Signup and view all the answers

    Which type of breast cancer tends to occur in older women and is slow growing?

    <p>Colloid (mucinous) Carcinoma</p> Signup and view all the answers

    What is the characteristic histological pattern of Invasive Lobular Carcinoma?

    <p>Single infiltrating malignant cells, forming a line often one cell width</p> Signup and view all the answers

    Which type of breast cancer has a soft, fleshy consistency and lacks desmoplasia?

    <p>Medullary Carcinoma</p> Signup and view all the answers

    What is the second most common type of breast cancer?

    <p>Invasive Lobular Carcinoma</p> Signup and view all the answers

    Which type of breast cancer is often bilateral and multicentric?

    <p>Invasive Lobular Carcinoma</p> Signup and view all the answers

    What is the characteristic sound of Invasive Ductal Carcinoma, NOS when cut or scraped?

    <p>A grating sound</p> Signup and view all the answers

    What is the characteristic appearance of Colloid (mucinous) Carcinoma when cut?

    <p>A soft, glistening surface</p> Signup and view all the answers

    Study Notes

    Breast Cancer

    • High risk of development of invasive breast cancer
    • DCIS (Ductal Carcinoma In Situ) is a mammographically sensitive procedure for detection
    • DCIS presents as calcifications, or less frequently as a vaguely palpable mass or nipple discharge

    DCIS Subtypes

    • Comedo type: 100% chance to develop invasive carcinoma if untreated
    • Cribriform and micropapillary types: 30% chance to develop invasive carcinoma
    • Other subtypes: solid, papillary

    Paget's Disease of the Breast

    • Rare manifestation of breast cancer (1-2%)
    • Presents as a unilateral erythematous eruption with a scale crust
    • Pruritus is common and may be mistaken for eczema
    • Malignant cells (Paget cells) are found scattered in the epidermis
    • Palpable mass is present in 50-60% of women, indicating an underlying invasive carcinoma

    Lobular Carcinoma In Situ (LCIS)

    • Uncommon and always an incidental finding in a biopsy performed for another reason
    • Cannot be detected clinically, and mammography is not useful
    • Frequently multicentric and bilateral
    • Histology: monomorphic small round cells filling the acini of lobules
    • Clinical behavior: 30% can develop into invasive cancer after 20 years of diagnosis if left untreated

    Invasive Ductal Carcinoma (NOS)

    • Grossly, firm, hard, and have an irregular border
    • Characteristic grating sound when cut or scraped
    • Accompanied by varying amounts of DCIS
    • Histology: large and pleomorphic tumor cells, usually within a dense stroma, showing glandular formation

    Invasive Lobular Carcinoma

    • Second most common type, forming up to 10% of breast cancers
    • May occur alone or in combination with ductal carcinoma
    • Tends to be bilateral and multicentric
    • Histology: single infiltrating malignant cells, forming a line (Indian file pattern)

    Medullary Carcinoma

    • Well-circumscribed mass, clinically and radiologically resembles fibroadenoma
    • No desmoplasia, therefore soft and fleshy in consistency
    • Histology: solid sheets of malignant cells surrounded by many lymphocytes and plasma cells, with scant fibrous stroma

    Colloid (Mucinous) Carcinoma

    • Tends to occur in older women
    • Sharply circumscribed, lacks fibrous stroma, and is slow-growing
    • Soft and has a glistening cut surface

    Breast Cancer Risk Factors

    • History of breast cancer or other cancer (e.g., ovary)
    • Exercise: some studies showed decreased risk
    • Breast-feeding: longer duration, lower risk
    • Dietary factors: high fat diet and excessive alcohol consumption
    • Environmental toxins: pesticides
    • Radiation exposure: associated with increased risk for breast cancer

    Breast Carcinoma Classification

    • Majority of breast cancer is Adenocarcinoma
    • Two major types: ductal and lobular
    • Classified morphologically according to whether they have penetrated the basement membrane:
      • Carcinoma in situ (non-invasive)
      • Invasive carcinoma

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    Description

    Learn about Ductal Carcinoma in Situ (DCIS), its detection through mammography, and its different subtypes including comedo, cribriform, solid, papillary, and micropapillary. Understand the clinical behavior of DCIS and its risk of developing into invasive breast cancer.

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