A 55-year-old woman has a stellate breast mass with microcalcifications on mammography. Core biopsy shows atypical epithelial cells in a cribriform pattern filling ducts with central comedonecrosis. No stromal invasion is seen. This lesion is classified as:

• A Infiltrating ductal carcinoma — not otherwise specified
• B Lobular carcinoma in situ (LCIS)
• C Atypical ductal hyperplasia (ADH)
• D High-grade ductal carcinoma in situ (DCIS) ✓

Explanation

DCIS involves malignant ductal epithelium confined within the basement membrane without stromal invasion. High-grade DCIS shows pleomorphic nuclei, cribriform or solid patterns, and central comedonecrosis with dystrophic calcifications — the basis for mammographic microcalcifications. LCIS fills lobular units, lacks comedonecrosis, and has discohesive cells due to E-cadherin loss. ADH is similar to low-grade DCIS but does not fully qualify morphologically or in extent.

Reference: Robbins & Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.