Ductal Carcinoma
In Situ
355
FIG. 11.28.
DCIS, “comedo,” with periductal fibrosis.
A:
Solid DCIS with central necrosis and con-
centric periductal fibrosis.
B:
Prominent periductal neovascularity forms a distinct zone between the
comedoDCIS and peripheral concentric fibrosis.
C,D:
Aremarkably thick, reduplicated basementmem-
brane forms a broad collar around these ducts between the DCIS and a zone of neovascularization.
FIG. 11.29.
DCIS, “comedo” type.
A,B:
Periductal lymphocytic reaction is concentrated at a site of
possible microinvasion at the upper border of this duct.
an excessive diameter are deprived of one or more essential
metabolites, such as oxygen, as a result of limited diffusion in
the nonvascularized intraductal neoplastic epithelium. It has
been theorized that the presence of a hypoxic compartment in
DCIS with comedonecrosis renders this type of DCIS relatively
radioresistant and contributes to a high risk of local recurrence
after breast conservation and radiotherapy for carcinomas with
this feature.
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