Breast Cancer

, Volume 11, Issue 4, pp 325–333 | Cite as

Ductal carcinomain situ and related lesions of the breast: Recent advances in pathology practice

  • Takuya MoriyaEmail author
  • Hisashi Hirakawa
  • Takashi Suzuki
  • Hironobu Sasano
  • Noriaki Ohuchi
Review Article


The incidence of ductal carcinoma in situ (DCIS) of the breast has increased significantly in Japanese women. It comprises 14.1% (172/1216) of all primary breast cancers at our institute, and nowadays this histological type is familiar to the surgeons and pathologists of any institute.

Several subclassifications have been published recently. Most based on nuclear atypia and the presence of comedonecrosis, and sometimes on the structures of the involved glands. These classifications are correlated with the biological behavior, tumor extent and the risk for local recurrences. The diagnostic accuracy of minimally invasive procedures (aspiration biopsy cytology/core needle biopsy) may differ between subclasses.

Atypical ductal hyperplasia (ADH) and microinvasive ductal carcinomas are lesions which resemble but deviate from the DCIS spectrum. The incidence of ADH seems to be lower than in Western countries. Patients with ADH may have a risk for subsequent breast cancer, because ADH is frequently associated with contralateral breast carcinomas. Microinvasion should be treated with caution, but we could not find any metastatic foci in microinvasive ductal carcinomas (T1mic). Tentatively, ADH may be treated similarly to non-comedo (low-grade) DCIS cases, according to our limited clinical experience.

Key words

Breast Ductal carcinomain situ Atypical ductal hyperplasia Intraepithelial neoplasia Microinvasive carcinoma 


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Copyright information

© The Japanese Breast Cancer Society 2004

Authors and Affiliations

  • Takuya Moriya
    • 1
    Email author
  • Hisashi Hirakawa
    • 2
  • Takashi Suzuki
    • 1
  • Hironobu Sasano
    • 1
  • Noriaki Ohuchi
    • 2
  1. 1.Department of PathologyTonoku University HospitalAoba-ku, SendaiJapan
  2. 2.Department of SurgeryTohoku University Postgraduate School of MedicineJapan

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