Moriya T, Kasami M, Akiyama F, Ichihara S, Kurosumi M, Tsuda H, Umemura S, Akashi-Tanaka S, Imamura H, Iwase H, Shin E, Harada Y, Mitsuyama S, Ohuchi N
Department of Pathology, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan.
Breast Cancer. 2000;7(4):321-5. doi: 10.1007/BF02966398.
As the incidence of ductal carcinoma in situ (DCIS) is increasing, it is necessary to make a guideline for the pathological examination and diagnosis of DCIS, by creating criteria based on clinical and biological aspects of the disease.
We collected biopsy specimens originally diagnosed as benign lesions, from patients who subsequently developed invasive carcinoma in the ipsilateral breast. The histology of the biopsy specimens was re-evaluated principally according to the 1995 Philadelphia Consensus on DCIS. Histopathological agreement on each biopsy specimen was made by the JBCS Study Group members under a multiviewer microscope. In the course of making conclusive agreements among the pathologists, we developed a consensus for the histopathological diagnosis of DCIS, especially non-comedo types.
DCIS is defined as a carcinoma of ductal epithelial origin, without any evidence of stromal invasion. It is necessary to note the methods of pathologic examination required to diagnose DCIS. Stromal invasion is an important prognostic factor, and should be diagnosed with caution. Classification of proliferative ductal lesions as benign or malignant (DCIS), the subtype of DCIS (nuclear grade, architecture, and necrosis), and the histological grading of DCIS are proposed and recommended.
Although we have made a new proposal according to current concepts, there are still several unresolved problems. Thus further examination and modification will be necessary in the future.
随着乳腺导管原位癌（DCIS）发病率的上升，有必要依据该疾病的临床和生物学特征制定标准，从而为DCIS的病理检查与诊断制定指南。
我们收集了最初被诊断为良性病变的活检标本，这些标本来自随后在同侧乳腺发生浸润性癌的患者。活检标本的组织学主要依据1995年费城DCIS共识进行重新评估。JBCS研究小组成员在多视野显微镜下对每个活检标本达成组织病理学共识。在病理学家达成最终共识的过程中，我们针对DCIS尤其是非粉刺型的组织病理学诊断形成了共识。
DCIS被定义为导管上皮起源的癌，无任何间质浸润证据。必须注意诊断DCIS所需的病理检查方法。间质浸润是一个重要的预后因素，诊断时应谨慎。提出并推荐了将增生性导管病变分类为良性或恶性（DCIS）、DCIS的亚型（核分级、结构和坏死）以及DCIS的组织学分级。
尽管我们依据当前概念提出了新建议，但仍存在一些未解决的问题。因此，未来有必要进一步检查和修正。
