van de Vijver M J
Department of Pathology, Netherlands Cancer Institute, Amsterdam, The Netherlands.
Recent Results Cancer Res. 1998;152:123-34. doi: 10.1007/978-3-642-45769-2_11.
Ductal carcinoma in situ (DCIS) of the breast represents a proliferation of malignant epithelial cells within the ducts and lobules of the breast, without invasion through the basement membrane. It is believed that all invasive carcinomas are preceded by DCIS; however, it is not known what proportion of patients with DCIS will develop invasive carcinoma and after what interval. DCIS is heterogeneous with respect to its clinical presentation, mammographic abnormalities, histology and biology. The risk of progression to invasive carcinoma depends on the histologic type of DCIS and the size of the lesion; in the future, the analysis of the genetic alterations may also help in predicting the risk of progression to invasive breast cancer. As the risk of progression to invasive breast cancer (and the development of metastases) greatly influences the choice of treatment for DCIS, it is of importance to be able to make a reliable estimate of this risk of progression. In this chapter, the histologic classification of DCIS and the genetic alterations that have been found to date are discussed.
乳腺导管原位癌（DCIS）是指乳腺导管和小叶内恶性上皮细胞的增殖，且未突破基底膜。据信，所有浸润性癌之前都有DCIS；然而，尚不清楚DCIS患者中有多大比例会发展为浸润性癌以及间隔多久。DCIS在临床表现、乳腺X线异常、组织学和生物学方面存在异质性。进展为浸润性癌的风险取决于DCIS的组织学类型和病变大小；未来，基因改变的分析也可能有助于预测进展为浸润性乳腺癌的风险。由于进展为浸润性乳腺癌（以及发生转移）的风险极大地影响DCIS的治疗选择，能够可靠地估计这种进展风险非常重要。在本章中，将讨论DCIS的组织学分类以及迄今发现的基因改变。
