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Breast Cancer Research
Published in: Breast Cancer Research 5/2003

01-10-2003 | Review

The diagnosis and management of pre-invasive breast disease: Ductal carcinoma in situ (DCIS) and atypical ductal hyperplasia (ADH) – current definitions and classification

Authors: Sarah E Pinder, Ian O Ellis

Published in: Breast Cancer Research | Issue 5/2003

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Abstract

Intraductal epithelial proliferations of the breast are at present classified into three groups; distinction is made histologically and clinically between usual epithelial hyperplasia and atypical ductal hyperplasia (ADH) and between ADH and ductal carcinoma in situ (DCIS). Although evidence indicates that these boundaries are not ideal on a morphological, immunohistochemical, or genetic basis, this three-tier system is accepted and used at present. The current definitions, histological features, and system of classification of ADH and DCIS are described in this manuscript.
Literature
1.
Lakhani SR, Collins N, Stratton MR, Sloane JP: Atypical ductal hyperplasia of the breast: clonal proliferation with loss of heterozygosity on chromosomes 16q and 17p. J Clin Pathol. 1995, 48: 611-615.CrossRefPubMedPubMedCentral
2.
Ellis IO, Pinder SE, Elston CW: A critical appraisal of existing classification systems of epithelial hyperplasia and in situ neoplasia of the breast with proposals for future methods of categorization: where are we going?. Semin Diagn Pathol. 1999, 16: 202-208.PubMed
3.
Page DL, Dupont WD: Anatomic indicators (histologic and cytologic) of increased breast cancer risk. Breast Cancer Res Treat. 1993, 28: 157-166.CrossRefPubMed
4.
Connolly JL, Schnitt SJ: Clinical and histologic aspects of proliferative and non-proliferative benign breast disease. J Cell Biochem – Supplement. 1993, 17G: 45-48.CrossRef
5.
Marshall LM, Hunter DJ, Connolly JL, Schnitt SJ, Byrne C, London SJ, Colditz GA: Risk of breast cancer associated with atypical hyperplasia of lobular and ductal types. Cancer Epidemiol Biomarkers Prev. 1997, 6: 297-301.PubMed
6.
Bartow SA, Pathak DR, Black WC, Key CR, Teaf SR: Prevalence of benign, atypical, and malignant breast lesions in populations at different risk for breast cancer. A forensic autopsy study. Cancer. 1987, 60: 2751-2760.CrossRefPubMed
7.
Stomper PC, Cholewinski SP, Penetrante RB, Harlos JP, Tsangaris TN: Atypical hyperplasia: frequency and mammographic and pathologic relationships in excisional biopsies guided with mammography and clinical examination. Radiology. 1993, 189: 667-671.CrossRefPubMed
8.
Page DL, Dupont WD, Rogers LW, Rados MS: Atypical hyperplastic lesions of the female breast. A long-term follow-up study. Cancer. 1985, 55: 2698-2708.CrossRefPubMed
9.
Dupont WD, Parl FF, Hartmann WH, Brinton LA, Winfield AC, Worrell JA, Schuyler PA, Plummer WD: Breast cancer risk associated with proliferative breast disease and atypical hyperplasia. Cancer. 1993, 71: 1258-1265.CrossRefPubMed
10.
Ma L, Boyd NF: Atypical hyperplasia and breast cancer risk: a critique. Cancer Causes Control. 1992, 3: 517-525.CrossRefPubMed
11.
Page DL, Jensen RA: Evaluation and management of high risk and premalignant lesions of the breast. World J Surg. 1994, 18: 32-38.CrossRefPubMed
12.
London SJ, Connolly JL, Schnitt SJ, Colditz GA: A prospective study of benign breast disease and the risk of breast cancer. JAMA. 1992, 267: 941-944. 10.1001/jama.267.7.941.CrossRefPubMed
13.
Tavassoli FA, Norris HJ: A comparison of the results of long-term follow-up for atypical intraductal hyperplasia and intraductal hyperplasia of the breast. Cancer. 1990, 65: 518-529.CrossRefPubMed
14.
Page DL, Dupont WD: Indicators of increased breast cancer risk in humans. J Cell Biochem. 1992, 50 (suppl G): 175-182.CrossRef
15.
Page DL, Rogers LW: Combined histologic and cytologic criteria for the diagnosis of mammary atypical hyperplasia. Hum Pathol. 1992, 23: 1095-1097.CrossRefPubMed
16.
National Coordinating Group for Breast Screening Pathology: Pathology Reporting in Breast Cancer Screening. Sheffield: NHSBSP Publications. 1995, 2
17.
Tavassoli FA: Intraduct hyperplasias, ordinary and atypical. In Pathology of the Breast Connecticut: Appleton and Lange. 1992, 155-191.
18.
Sloane JP, Amendoeira I, Apostolikas N, Bellocq JP, Bianchi S, Boecker W, Bussolati G, Coleman D, Connolly CE, Eusebi V, DeMiguel C, Dervan P, Drijkoningen R, Elston CW, Faverly D, Gad A, Jacquemier J, Lacerda M, MartinezPenuela J, Munt C, Peterse JL, Rank F, Sylvan M, Tsakraklides V, Zafrani B: Consistency achieved by 23 European pathologists from 12 countries in diagnosing breast disease and reporting prognostic features of carcinomas. Virchows Archiv. 1999, 434: 3-10. 10.1007/s004280050297.CrossRefPubMed
19.
20.
Schnitt SJ, Connolly JL, Tavassoli FA, Fechner RE, Kempson RL, Gelman R, Page DL: Interobserver reproducibility in the diagnosis of ductal proliferative breast lesions using standardised criteria. Am J Surg Pathol. 1992, 16: 1133-1143.CrossRefPubMed
21.
Van Dongen JA, Fentiman IS, Harris JR, Holland R, Peterse JL, Salvadori B, Stewart HJ: In situ breast cancer: the EORTC consensus meeting. Lancet. 1989, ii: 25-27. 10.1016/S0140-6736(89)90263-8.CrossRef
22.
Faverly DR, Burgers L, Bult P, Holland R: Three dimensional imaging of mammary ductal carcinoma in situ: clinical implications. Semin Diagn Pathol. 1994, 11: 193-198.PubMed
23.
24.
Holland R, Hendriks JHCL, Verbeek ALM, Mrauvunac M, Schuur-mans Stekhoven JH: Extent, distribution, and mammographic/histological correlations of breast ductal carcinoma in situ. Lancet. 1990, 335: 519-522. 10.1016/0140-6736(90)90747-S.CrossRefPubMed
25.
Page DL, Dupont WD, Rogers LW, Landenberger M: Intraductal carcinoma of the breast: Follow up after biopsy alone. Cancer. 1982, 49: 751-758.CrossRefPubMed
26.
Page DL, Dupont WD, Rogers LW, Jensen RA, Schuyler PA: Continued local recurrence of carcinoma 15–25 years after a diagnosis of low grade ductal carcinoma in situ of the breast treated only by biopsy. Cancer. 1995, 76: 1197-1200.CrossRefPubMed
27.
Betsill WLJ, Rosen PP, Lieberman PH, Robbins GF: Intraductal carcinoma. Long-term follow-up after treatment by biopsy alone. JAMA. 1978, 239: 1863-1867. 10.1001/jama.239.18.1863.CrossRefPubMed
28.
Ketcham A, Moffat F: Vexed surgeons, perplexed patients, and breast cancer which may not be be cancer. Cancer. 1990, 65: 387-393.CrossRefPubMed
29.
Van Dongen JA, Holland R, Peterse JL, Fentiman IS, Lagios MD, Millis RR, Recht A: Ductal carcinoma in-situ of the breast; second EORTC consensus meeting. Eur J Cancer. 1992, 28: 626-629.CrossRefPubMed
30.
Holland R, Peterse JL, Millis RR, Eusebi V, Faverly D, Vandevijver MJ, Zafrani B: Ductal carcinoma in situ: a proposal for a new classification. Semin Diagn Pathol. 1994, 11: 167-180.PubMed
31.
Badve S, A'Hern RP, Ward AM, Millis RR, Pinder SE, Ellis IO, Gusterson BA, Ellis IO: Prediction of local recurrence of ductal carcinoma in situ of the breast using five histological classifications: A comparative study with long follow-up. Hum Pathol. 1998, 29: 915-923.CrossRefPubMed
32.
Silverstein MJ, Poller DN, Waisman JR, Colburn WJ, Barth A, Gierson ED, Lewinsky B, Gamagami P, Slamon DJ: Prognostic classification of breast ductal carcinoma-in-situ. Lancet. 1995, 345: 1154-1157. 10.1016/S0140-6736(95)90982-6.CrossRefPubMed
33.
Poller DN, Silverstein MJ, Galea M, Locker AP, Elston CW, Blamey RW, Ellis IO: Ductal carcinoma in situ of the breast. A proposal for a new simplified histological classification. Association between cellular proliferation and c-erbB-2 protein expression. Mod Pathol. 1994, 7: 257-262.PubMed
34.
Silverstein MJ, Lagios MD, Craig PH, Waisman JR, Lewinsky BS, Colburn WJ, Poller DN: A prognostic index for ductal carcinoma in situ of the breast. Cancer. 1996, 77: 2267-2274. 10.1002/(SICI)1097-0142(19960601)77:11<2267::AID-CNCR13>3.0.CO;2-V.CrossRefPubMed
Metadata
Title
The diagnosis and management of pre-invasive breast disease: Ductal carcinoma in situ (DCIS) and atypical ductal hyperplasia (ADH) – current definitions and classification
Authors
Sarah E Pinder
Ian O Ellis
Publication date
01-10-2003
Publisher
BioMed Central
Published in
Breast Cancer Research / Issue 5/2003
Electronic ISSN: 1465-542X
DOI
https://doi.org/10.1186/bcr623

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