Spectrum of atypical ductal hyperplasia (ADH) and ductal carcinoma in-situ (DCIS): Diagnostic challenges

IF 2.9 3区 医学 Q2 MEDICAL LABORATORY TECHNOLOGY Seminars in Diagnostic Pathology Pub Date : 2024-11-01 DOI:10.1053/j.semdp.2024.09.001
Philip Bomeisl , Hannah Gilmore
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Abstract

Breast specimens are some of the more common specimens sent to the pathology laboratory for diagnosis. From a clinical perspective, the diagnoses fall into three broad categories: benign, atypical and malignant with patients then being managed according to established guidelines. However, the pathologic diagnosis can sometimes be challenging, and the distinction between these categories is sometimes far more subtle and subjective than non-pathologist may understand. One recurring diagnostic challenge in breast pathology is the diagnosis of atypical ductal hyperplasia (ADH) versus ductal carcinoma in situ (DCIS). While many cases are straightforward, others are quite borderline and challenging to classify consistently with significant interobserver variation amongst pathologists. The distinction between ADH and DCIS is critical from a clinical management perspective because one is treated as a risk factor, and the other as a malignancy that will be completely surgically excised and may require radiation therapy. This review will address the spectrum of ADH and DCIS with the associated diagnostic challenges in the real-world setting from presentation at core needle biopsy to surgery.
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非典型导管增生(ADH)和导管原位癌(DCIS)的谱系:诊断难题。
乳腺标本是送往病理实验室进行诊断的最常见标本。从临床角度来看,诊断可分为三大类:良性、非典型和恶性,然后根据既定指南对患者进行处理。然而,病理诊断有时也很有挑战性,这些类别之间的区别有时比非病理学家理解的要微妙和主观得多。乳腺病理诊断中经常遇到的一个难题是非典型性导管增生(ADH)与导管原位癌(DCIS)的诊断。虽然很多病例简单明了,但也有一些病例非常边缘化,病理学家之间的观察者差异很大,很难进行一致的分类。从临床管理的角度来看,ADH 和 DCIS 之间的区别至关重要,因为前者被视为风险因素,而后者则被视为恶性肿瘤,需要通过手术完全切除,并可能需要放射治疗。本综述将讨论 ADH 和 DCIS 的范围,以及在现实世界中从核心针活检到手术的整个过程中所面临的相关诊断挑战。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
4.80
自引率
0.00%
发文量
69
审稿时长
71 days
期刊介绍: Each issue of Seminars in Diagnostic Pathology offers current, authoritative reviews of topics in diagnostic anatomic pathology. The Seminars is of interest to pathologists, clinical investigators and physicians in practice.
期刊最新文献
Intricacies of plexiform unicystic ameloblastoma: A rare intraluminal journey in the jaw. Targetoid hemosiderotic hemangioma: A review article. Intraoperative evaluation of sentinel lymph nodes in patients with breast cancer: A review emphasizing clinical concepts pathologists need to know Intraoperative evaluation of surgical margins in breast cancer Spectrum of atypical ductal hyperplasia (ADH) and ductal carcinoma in-situ (DCIS): Diagnostic challenges
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