High Grade ductal carcinoma in situ.

whirlwind123 · August 2015

My pathology report reads:

Lesion right brast 10 oclock, core biopsy: high grade ductal carcinoma in situ

Microcalcifications associated with DCIS and breast tissue.

Intrdepartmental consultation is obtained. Calponin and p63 immunostains are positive in myoepithelial cells confirming the above diagnosis. Some of the DCIS shows apocrine-like cytoplasmic change.

I was also told it takes up about 1/3 of my breast., any answers to what this means would be greatly appreciated.

nadiakay · August 2015

Hi whirlwind,

my mom's core biopsy report also mentionned: "p-63 and cd-10 highlight myoepithelial cells around the ducts" with no evidence of microinvasion.

BarredOwl was kind enough to explain that myoepithelial cells' presence confirm the DCIS diagnosis. The research that I have done so far also suggests the same.

Did you have a palpable mass or was it all discovered during the mamogram only?

whirlwind123 · August 2015

Mammogram and ultrasound nothing palaple

BarredOwl · August 2015

Hi Whirlwind123 and Nadiakay:

I agree with Nadiakay, although I am not sure whether the pathologist looks for the presence of myoepithelial cells or some of evidence of an intact layer of myoephithelial cells. But my reading is the same: they looked for evidence of invasion, didn't see it, so they have concluded it is DCIS (still in the duct), which is good. It is always a good idea to confirm any information/interpretation you get from us with your doctors, since we are just patient-laypersons.

As posted elsewhere (and slightly expanded here), the ducts are surrounded by an outer layer of myoepithelial cells. When the tumor cells are confined to the inside of the duct as in DCIS, the ducts have an intact layer of myoepithelial cells. When there is invasion, the cancer cells break through the wall of the duct breaching the myoepithelial layer. Immunohistochemical stains for myoepithelial cell markers (e.g., p63 and CD-10; or p63, myosin and calponin) are used to better visualize the myoepithelial layer as part of this assessment.

I am not sure what the implications of the DCIS having "apocrine-like cytoplasmic change" would be.

BarredOwl

ballet12 · August 2015

There is a form of DCIS which is called apocrine DCIS, and there is a recent DCIS thread dealing with this. I was diagnosed with this, as were a couple of other women. It is more rare than other DCIS, and often shows no ER/PR response (although I had some ER sensitivity, no PR. I don't know if having "apocrine-like cytological changes" is exactly the same thing, although cells with apocrine features appear much larger than typical cells in the breast.

High Grade ductal carcinoma in situ.

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