Ducto-lobular carcinoma in situ: Clinical and pathological findings in three cases with review of literature

Jaspreet Ahuja, Louise Bordeleau, Anita Bane


In situ carcinomas of the breast are traditionally divided into ductal and lobular based on a combination of morphological features. Ductal carcinoma in situ (DCIS) is further differentiated from lobular carcinoma in situ (LCIS) by the presence of membranous E-cadherin protein expression. The expression of this protein is lacking in the neoplastic cells of LCIS due to underlying molecular alterations in the E-cadherin gene (CDH1) but present in cases of DCIS. Pathologists frequently employ the use of E-cadherin immunohistochemistry as an ancillary aid to distinguish DCIS from LCIS in morphologically ambiguous cases. In a small minority of in situ carcinomas a dual population of neoplastic cells is present within the same terminal duct lobular unit with morphological and/or immunohistochmeical evidence of both ductal and lobular histology, an entity we and others refer to as ducto-lobular carcinoma in situ (DLCIS). Herein we describe three such cases in detail to include morphological features, E-cadherin immunohistochemical staining pattern, clinical history, management and follow-up. In addition a comprehensive review of the literature of such cases is summarised and an algorithmic approach to their future diagnosis proposed.

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DOI: https://doi.org/10.5430/crcp.v2n3p72


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Case Reports in Clinical Pathology

ISSN 2331-2726(Print)  ISSN 2331-2734(Online)

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