Surgical Pathology Criteria

Lobular Carcinoma in Situ of the Breast

Differential Diagnosis

Ductal vs. Lobular may be a problem in pagetoid or complete involvement of ducts by LCIS, in solid low grade DCIS, or in lobular involvement by DCIS cells (cancerization of lobules)
DCIS LCIS
Cohesive Non-cohesive
May show moderate to marked pleomorphism Mild to moderate pleomorphism
No pagetoid involvement of ducts May show pagetoid pattern in ducts
May show irregular or partial involvement of acini Uniform involvment of acini
Frequent cribriform or micropapillary pattern No cribriform spaces or micropapillae
Frequently amphophilic cytoplasm Cytoplasm usually clear to eosinophilic
E-cadherin positive E-cadherin negative
Indeterminate cases will be encountered and should be treated as DCIS (excision with clear margins)

LCIS vs. Atypical Lobular Hyperplasia (ALH)

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