|Print Date:||May 25, 2013, 4:44 pm|
|Title||Ductal Carcinoma in situ with Mircoinvasion|
|Text||In situ and invasive breast cancers have characteristic histologic patterns allowing for their classification. Ductal carcinoma in-situ (DCIS) is a term reserved for cancer cells that remain within the basement membrane of the draining duct of a terminal lobular unit.
The term microinvasive DCIS is used when there are clearly separate foci of infiltration of non-specialized interlobular stroma (invasion) measuring less than 2mm. The likelihood of finding microinvasion in DCIS is greater in lesions of larger size. The significance of defining microinvasive DCIS as a separate entity is to determine whether the clinical behavior of this lesion is more closely related to DCIS, invasive breast cancer, or something in-between. Currently, there is no consensus regarding the treatment of such a lesion. At the institution where this patient is seen, the initial recommended treatment is excisional biopsy.
Immunostaining may be useful by differentiating tumor cells from inflammatory cells and confirming the presence or absence of the smooth muscle, actin-positive layer of myoepithelial cells that should not be present around the microinvasive area. The two relevant cell layers in the breast lobule, the apocrine cells and the myoepithelial basement membrane cells can be easily distinguished through these methods. Monoclonal antibodies to the p63 gene, a homolog of the tumor-suppressor p53, are highly specific for the basal or progenitor layers of many epithelial tissues. Monoclonal antibodies to Calponin ( a 34 Kd polypeptide) are also useful as a marker for myoepithelial and basal lamina in differentiating microinvasive from in situ ductal carcinomas of the breast.
|Contributor||Kevin F. McCarthy (Civilian Medical Center)|
|Peer Reviewer||Claudia E Galbo (Uniformed Services University)|
|Record Number||: 6362|
|Location:||Breast and Mammography|
|MedPix® Medical Image Database |
Content Text and Images may be Copyright © 1999 - 2006 by the Original Contributors