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Subtypes

Depending upon a number of factors, such as size, presence of cancer cells in the lymph nodes, and involvement of other body tissues, breast cancer is assigned a "stage" number from 1 to 5. DCIS is considered "stage 0," which is a stage used to describe a noninvasive breast cancer.

As mentioned earlier, the National Cancer Institutes consider DCIS as a "precancerous" (stage 0) condition because it is contained and my never invade surrounding tissue. It is believed that cells actually learn how to become cancerous and obtain the ability to erode through the duct membrane. It is important to identify the subtypes to determine the best treatment option. More aggressive treatment may be necessary for more risky subtypes such as the comedo morphology. Many women have a combination of types.

The DCIS subtypes are: papillary, micropapillary, solid, cribiform and comedo. The more aggressive comedo type is associated with a central necrosis. Rapid cell reproduction in the comedo form exceeds perfusion capacity and results in cell death at the center. Comedo-type DCIS is more likely than any other DCIS type to become invasive (malignant).

A. Comedo morphology is composed of the most rapidly reproducing and poorly differentiated cells. These ducts ooze necrotic debris from excised tumor that resembles the substance expressed from acne lesions.
B. Cribriform morphology contains voids within ducts that resemble a swiss cheese pattern.
C. Solid morphology completely fills the duct with cells, thus the name solid.
D. Micropapillary morphology is composed of many small fern-like processes within the duct.
E. Papillary morphology contains fern-like processes within the duct.
F. Invasive breast cancer that has eroded through the duct membrane and into surrounding tissue.

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Which sub-type of DCIS has the most rapid cell reproduction rate?

Please click here to visit the Ductal Carcinoma in Situ site "Understanding DCIS"