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<gallery>
Image:Breast DCIS Solid IntermediateGrade SNP.jpg|Breast - Ductal carcinoma in situ - Solid variant- Intermediate grade - Medium power (SKB)
Image:Breast DCIS Solid SNP.jpg|Breast - Ductal carcinoma in situ - Solid variant- Intermediate grade - Low power (SKB)
Image:Breast DCIS Solid PA.JPG|Breast - Ductal carcinoma in situ - Solid variant - Medium power (SKB)
Image:Breast DCIS Comedonecrotic 2 PA.JPG|Breast - Ductal carcinoma in situ - Solid variant - Comedonecrosis (SKB)
Image:Breast DCIS Comedonecrosis MP PA.JPG|Breast - Ductal carcinoma in situ - Solid variant - Comedonecrosis (SKB)
</gallery>
DDx:
*[[LCIS]].
**May show dyscohesion
**More monomorphic population of cells
====Cribriform ductal carcinoma in situ====
Features:
*Honeycomb-like appearance: circular holes.
*"Cookie cutter" appearance/"punched-out" appearance/"Roman bridges" -- cells surround the circular holes.
<gallery>
Image:Breast DCIS Cribriform MP CTR.jpg|Breast - Ductal carcinoma in situ - cribriform varient - medium power (SKB)
Image:Breast DCIS Cribriform PA.JPG|Breast - Ductal carcinoma in situ - cribriform varient - medium power (SKB)
</gallery>
DDx:
*[[Collagenous spherulosis]].
*[[Adenoid cystic carcinoma of the breast]].
*Invasive cribriform carcinoma of the breast
====Papillary ductal carcinoma in situ====
Features:
*Papillae with fibrovascular cores.
*Papillae lack a myoepithelial layer
*Papillae are lined by atypical cells.
*Papillae within a ductal space lined by myoepithelial cells.
<gallery>
Image:Breast DCIS PapillaryVariant LP PA.JPG|Breast - Ductal carcinoma in situ - Papillary variant - low power (SKB)
Image:Breast DCIS Papillary PA.JPG|Breast - Ductal carcinoma in situ - Papillary variant - Medium power (SKB)
</gallery>
DDX:
*[[Intraductal papilloma]]
*Ductal carcinoma in situ arising within an intraductal papilloma
*[[Intracystic papillary breast carcinoma]]
*[[Invasive papillary breast carcinoma]]
====Micropapillary ductal carcinoma in situ====
Features:
*Small papillae without fibrovascular cores.
*Have "drum stick" shape.
DDx:
*[[Gynecomastoid hyperplasia]].
<gallery>
Image:Breast DCIS MicropapillaryType MP CTR.jpg|Breast - Ductal carcinoma in situ - micropapillary variant - Medium power - (SKB)
Image:Breast DCIS Micropapillary SNP.jpg|Breast - Ductal carcinoma in situ - micropapillary variant - High power - (SKB)
Image:Breast DCIS Apocrine PA.JPG|Breast - Ductal carcinoma in situ - Micropapillary type with apocrine features - High power - (SKB)
</gallery>
===Grading DCIS===
Graded 1-3 (low-high)<ref>URL: [http://surgpathcriteria.stanford.edu/breast/dcis/ http://surgpathcriteria.stanford.edu/breast/dcis/]. Accessed on: 4 August 2011.</ref> - compare lesional nuclei to one another.
*Grade 1:
**Nuclei 2-3x size of [[RBC]].
**No necrosis.
*Grade 2:
**Nuclei 2-3x size of RBC.
**+/-[[Necrosis]].
*Grade 3:
**Nuclei >3x size of RBC.
**Necrosis usually present.
Notes:
*It is often hard to find RBCs when you want 'em. DCIS is pleomorphic.
*If no RBCs are present to compare with compare the nuclei to one another.
*If you see nuclei >3x larger than their neigbour you're ready to call DCIS Grade 3.
===Size criteria for low-grade DCIS===
ADH is diagnosed if the lesion is small - specifically:<ref name=Ref_BP168>{{Ref BP|168}}</ref><ref>{{Ref DCHH|258}}</ref>
# < Two membrane-bound spaces.
# < 2 mm extent. ‡
The treatment is similar; ADH and DCIS are both excised.
The differences are:
*DCIS is cancer, i.e. this has life insurance implications.
*Radiation treatment - DCIS is irradiated; ADH does ''not'' get radiation.
Notes:
* ‡ 3 mm is used in papillary lesions.{{fact}}
===Micrometastasis in DCIS===
Micrometastasis in DCIS - not significant.<ref name=pmid14601079>{{Cite journal | last1 = Lara | first1 = JF. | last2 = Young | first2 = SM. | last3 = Velilla | first3 = RE. | last4 = Santoro | first4 = EJ. | last5 = Templeton | first5 = SF. | title = The relevance of occult axillary micrometastasis in ductal carcinom...
==See also==
*[[Non-invasive breast carcinoma]].
*[[Breast carcinoma with an extensive intraductal component]].
==References==