Study of histomorphological patterns of ductal carcinoma in situ (DCIS) occurring simultaneously with infiltrating duct carcinoma (IDC) of breast in menopausal females

Breast cancer ranks second according to the incidence of cancers among women in the world. The peak incidence of breast cancer in developed countries is above the age of 50 years whereas in India it is above the age of 40. Ductal carcinoma in situ lies along a spectrum of preinvasive lesions originating within normal breast tissue, with histological progression from atypical hyperplasia to invasive breast cancer. DCIS is generally categorized by architectural description into five groups, comedo, solid, cribriform, papillary and micropapillary. Studies have found a significant association between nuclear grade of DCIS and histological grade of infiltrating carcinoma. In the present study, out of 60 cases, 33 (55%) show a single growth pattern while 27 (45%) showed a mixed growth pattern. In the present study, comedo pattern is most commonly observed in DCIS lesions with a single growth pattern (48%), followed by solid pattern (42%), and cribriform pattern (06%). The micropapillary pattern was the least common pattern (04%). In the present study, a highly significant correlation was found between the nuclear grade of DCIS and Bloom Richardson grade of infiltrating ductal carcinoma. The present study has validated the concept that nuclear grade of DCIS, as well as architectural pattern, are significantly correlated with the histological grade of invasive carcinoma.