Comedo-type ductal carcinoma in situ
Citation, DOI, disclosures and article data
At the time the article was created Stefano Pacifici had no recorded disclosures.View Stefano Pacifici's current disclosures
A comedo-type ductal carcinoma in situ, also known as comedocarcinoma in situ, is a high grade subtype of ductal carcinoma in situ (DCIS). It is the most aggressive of intraductal carcinomas. In 30% of cases it can be multicentric and/or multifocal.
Comedo-type DCIS is diagnosed histologically when at least one duct in the breast is filled and expanded by large, markedly atypical cells.
Comedo-type DCIS completely fills and dilates the ducts and lobules of the terminal duct lobular units (TDLU) with plugs of high grade tumor cells with pleomorphic nuclei and central necrosis ("comedonecrosis").
Infiltrating ductal carcinoma (infiltrative ductal carcinoma with central necrosis) may so closely mimic the pattern of DCIS with central comedonecrosis that on initial morphological analysis these foci of tumors are often labeled as DCIS (high grade, comedo-type).
There is a risk of occult infiltration. A comedo that extends for >2.5 cm has an invasive component in 45% of cases.
As with DCIS in general, it appears as linear or segmental clumped non-mass enhancement.
- 1. Tavassoli FA. Pathology of the breast. McGraw-Hill Professional. (1999) ISBN:0838577040. Read it at Google Books - Find it at Amazon
- 2. Rovere GQ, Warren R, Benson JR. Early breast cancer, from screening to multidisciplinary management. Informa HealthCare. (2006) ISBN:1841843849. Read it at Google Books - Find it at Amazon
- 4. Grio R, Macchioni S, Zaccheo F et-al. [Infiltrating comedocarcinoma of the breast]. Minerva Ginecol. 1985;37 (10): 565-9. - Pubmed citation
- 5. Bongiorni G, Marchisio V, Bragaja S. [Comedocarcinoma: a tumor histotype to be reevaluated]. Radiol Med. 1990;79 (6): 590-2. - Pubmed citation
- 6. Phillips LS, Millikan RC, Schroeder JC et-al. Reproductive and hormonal risk factors for ductal carcinoma in situ of the breast. Cancer Epidemiol. Biomarkers Prev. 2009;18 (5): 1507-14. doi:10.1158/1055-9965.EPI-08-0967 - Pubmed citation
- 6. Leonard GD, Swain SM. Ductal carcinoma in situ, complexities and challenges. J. Natl. Cancer Inst. 2004;96 (12): 906-20. J. Natl. Cancer Inst. (link) - Pubmed citation
- 8. Pervez S, Khan H. Infiltrating ductal carcinoma breast with central necrosis closely mimicking ductal carcinoma in situ (comedo type): a case series. J Med Case Reports. 2007;1 : 83. doi:10.1186/1752-1947-1-83 - Free text at pubmed - Pubmed citation