At the histological level, DCIS is a heterogeneous group of proliferations varying in cytological and architectural features. The traditional classification of DCIS follows the growth pattern, which may be characterized as solid, cribriform, comedo, micropapillary or papillary. Different histological patterns often coexist in the same lesion.
Due to a lack of reproducibility and prognostic power, other classifications have been proposed. There is strong evidence that nuclear grade and presence of necrosis are the best predictors of recurrence. The Van Nuys Prognostic Index (VPNI), based on tumor size, nuclear atypia, presence of necrosis and excision margin width is a commonly used algorithm for predicting likelihood of recurrence.
Solid
Solid
Comedo
Comedo
Cribriform
Cribriform
Micropapillary
Micropapillary
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