DCIS with Micropapillary Features

Micropapillary describes the shape and size of the DCIS cells.  On it's own (i.e. when not found together with comedo type DCIS) it's a low grade or moderate grade DCIS which tends to grow very slowly.  As a non-comedo type of DCIS, it is considered less aggressive than comedo-type DCIS and less likely to be associated with a microinvasion.   Here are 3 sources of information about this:

http://www.dcis.info/biopsy-examination.html    Micropapillary and papillary. These two types have fern-like projections of cells into the center of the duct. The micropapillary type projections are smaller than the papillary type. 

http://www.breastcancer.org/symptoms/dcis/type_grade.jsp   Papillary: The cells grow in fingerlike projections, toward the inside of the duct.    A Cancer cells       B Basement membrane      C Lumen (center of duct)

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http://www.imaginis.com/breasthealth/dcis.asp   Types of Ductal Carcinoma in Situ

The term, ductal carcinoma in situ (DCIS), refers to a family of cancers that occur in the breast ducts.  There are two categories of DCIS: non-comedo and comedo.  The term, comedo, describes the appearance of the cancer.  When comedo type breast tumors are cut, the dead cells inside of them (necrosis) can be expressed out just like a comedo or blackhead on the skin.

The most common non-comedo types of DCIS are:

• Solid DCIS: cancer cells completely fill the affected breast ducts.
• Cribiform DCIS: cancer cells do not completely fill the affected breast ducts; there are gaps between the cells.
• Papillary and micropapillary DCIS: the cancer cells arrange themselves in a fern-like pattern within the affected breast ducts; micropapillary DCIS cells are smaller than papillary DCIS cells.

Comedo type DCIS (also referred to as Comedocarcinoma) tends to be more aggressive than the non-comedo types of DCIS.  Pathologists are able to easily distinguish between comedo type DCIS and other non-comedo types when examining the cells under a microscope because comedo type DCIS tends to plug the center of the breast ducts with necrosis (dead cells).  When necrosis is associated with cancer, it often means that the cancer is able to grow quickly.  Necrosis is often seen with microcalcifications (tiny calcium deposits that can indicate cancer).

http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WWK-4SF9G9J-6&_user=10&_rdoc=1&_fmt=&_orig=search&_sort=d&view=c&_version=1&_urlVersion=0&_userid=10&md5=717f720abdb8fbf73eb0c6622e7e607d

Mom2

Here is a new study that shows how DCIS can progress to invasive.There is a lot of research going on with early BC and Canada is heading up one of the largest ever by Dr Rackovitch from Sunnybrook.

Beesie may correct me if I am wrong,but I read that DCIS does NOT fill up and eventually burst. That would suggest that it is just a matter of time that it becomes invasive. Not true. The cells have to undergo a change in order to become invasive. That is why some DCIS can change, and other types do not. They are making progress in making that determination. Years ago every woman had mastectomies, then every woman had rads regardless of the type and amount. Now major breast centers are questioning rads for every case. I answered your pm, but I wanted to add to Beesie's info. Yes, micro-pappilary DCIS is not generally aggressive. My cell types  and  small amount of DCIS were what led me to not having rads. I'm sure it would have been a different story if they thought the micro cells were nasty. Hope that helps, Nada

This is my first post... I was diagnosed 12/30/10 with DCIS grade 3 after a sterotactic biopsy.  I also had an MRI which showed I had multifocal too much DCIS for local excisions as my surgeon felt he would be chasing margins.  I am going to be scheduled tomorrow.  I don't know what the surg date is yet as I am having bilateral mastectomy sentinal nodes on right side.  I am so worried it will be invasive somewhere.  I find myself so emotional and have been on the verge of tears all day today.  I have noticed an itchy rash on my left breast.  It's so hard not to worry about the surgery but everytime I have had something done it seems it's worse than I thought.  I had a normal mammogram last year so this is very concerning as it seems it came on sooooo fast!  Just needed to vent, I love this site, it is so going to help me!