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Chapter 11

FIG. 11.49.  Coexistent intraductal and in situ lobular carcinoma in a single duct-lobular unit. A,B: Mingling of cribriform DCIS and in situ lobular carcinoma. The DCIS is E-cadherin positive, whereas the LCIS is E-cadherin nega- tive (B). C,D: Cribriform DCIS surrounded by in situ lobular carcinoma. E: Solid apocrine DCIS in the center of a duct with LCIS at the perimeter. ( C,D: Reproduced from Rosen PP. Coexistent lobular carcinoma in situ and DCIS in a single lobular-duct unit. Am J Surg Pathol 1980;4:241–246, with permission.)

or HER2 expression. These authors observed that stromal vascularity was increased in comedo DCIS when there was marked stromal desmoplasia, but the increased vascularity was not specifically periductal in distribution. Other investigators have also studied the association be- tween the architectural pattern of DCIS and periductal neo- vascularity. Heffelfinger et al. 165 recorded the distribution

of capillaries in contact with the basement membrane of ducts in various conditions, including proliferative changes and DCIS. The mean score for vascularity was increased significantly between normal and proliferative ducts (0.187 vs. 0.836) and between both of these categories and DCIS as a group (1.525). Variations inmean scores were seen in subtypes of DCIS, ranging from 0.962 for micropapillary